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Uric Acid Nephrolithiasis

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41. Uric Acid Nephropathy (Overview)

acid into the more soluble compound allantoin. Three forms of kidney disease have been attributed to excess uric acid: acute uric acid nephropathy, chronic urate nephropathy, and uric acid nephrolithiasis. These disorders share the common element of excess uric acid or urate deposition, although the clinical features vary. [ ] Next: Pathophysiology Properties of uric acid Uric acid, the product of the xanthine oxidase–catalyzed conversion of xanthine and hypoxanthine, is the final metabolite (...) ), a condition that is also known as Lesch-Nyhan syndrome. This is an X-linked disorder that results in mental retardation, involuntary movement, self-mutilation, gout, and early kidney failure. In these patients, chronic uric acid overproduction causes hyperuricemia and uricosuria. The incidence of chronic kidney disease is high in these individuals, who have intratubular uric acid deposits and interstitial urate deposits. Uric acid nephrolithiasis Uric acid stones, which represent 5-10% of all renal

2014 eMedicine.com

42. Uric Acid Nephropathy (Follow-up)

, Kim SR, Shin HC, Jung WJ. Association of nephrolithiasis with metabolic syndrome and its components. Metabolism . 2013 Jun. 62(6):808-13. . Emami-Naini A, Eshraghi A, Shahidi S, Mortazavi M, Seyrafian S, Roomizadeh P, et al. Metabolic evaluation in patients with nephrolithiasis: A report from Isfahan, Iran. Adv Biomed Res . 2012. 1:65. . . Roncal-Jimenez C, García-Trabanino R, Barregard L, Lanaspa MA, Wesseling C, Harra T, et al. Heat Stress Nephropathy From Exercise-Induced Uric Acid Crystalluria (...) Uric Acid Nephropathy (Follow-up) Uric Acid Nephropathy Follow-up: Deterrence/Prevention, Prognosis Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjQ0MjU1LWZvbGxvd3Vw processing > Uric Acid Nephropathy Follow-up

2014 eMedicine.com

43. Uric Acid Stones (Follow-up)

Computerized Tomography Imaging: Development and Preliminary Assessment of a Pixel Mapping Software. J Urol . 2018 Feb. 199 (2):487-494. . Oh MM, Ham BK, Kang SH, Bae JH, Kim JJ, Yoo KH, et al. Urine alkalinization may be enough for the treatment of bilateral renal pelvis stones associated with Lesch-Nyhan syndrome. Urol Res . 2011 Oct. 39(5):417-9. . Sakhaee K, Maalouf NM. Metabolic syndrome and uric acid nephrolithiasis. Semin Nephrol . 2008 Mar. 28(2):174-80. . Raj GV, Auge BK, Assimos D, Preminger GM (...) Uric Acid Stones (Follow-up) Uric Acid Stones Follow-up: Further Outpatient Care, Further Inpatient Care, Inpatient & Outpatient Medications Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTgzNzU5LWZvbGxvd3Vw

2014 eMedicine Pediatrics

44. Uric Acid Stones (Treatment)

with Lesch-Nyhan syndrome. Urol Res . 2011 Oct. 39(5):417-9. . Sakhaee K, Maalouf NM. Metabolic syndrome and uric acid nephrolithiasis. Semin Nephrol . 2008 Mar. 28(2):174-80. . Raj GV, Auge BK, Assimos D, Preminger GM. Metabolic abnormalities associated with renal calculi in patients with horseshoe kidneys. J Endourol . 2004 Mar. 18(2):157-61. . Undefined. . Barrat TM, PG Duffy. Nephrocalcinosis and Urolithiasis. Pediatric Nephrology . 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1999. 933 (...) Uric Acid Stones (Treatment) Uric Acid Stones Treatment & Management: Medical Care, Surgical Care, Consultations Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTgzNzU5LXRyZWF0bWVudA== processing > Uric Acid

2014 eMedicine Pediatrics

45. Uric Acid Stones (Overview)

for the treatment of bilateral renal pelvis stones associated with Lesch-Nyhan syndrome. Urol Res . 2011 Oct. 39(5):417-9. . Sakhaee K, Maalouf NM. Metabolic syndrome and uric acid nephrolithiasis. Semin Nephrol . 2008 Mar. 28(2):174-80. . Raj GV, Auge BK, Assimos D, Preminger GM. Metabolic abnormalities associated with renal calculi in patients with horseshoe kidneys. J Endourol . 2004 Mar. 18(2):157-61. . Undefined. . Barrat TM, PG Duffy. Nephrocalcinosis and Urolithiasis. Pediatric Nephrology . 4th ed (...) Uric Acid Stones (Overview) Uric Acid Stones: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTgzNzU5LW92ZXJ2aWV3 processing > Uric Acid Stones Updated: Jun 11, 2018

2014 eMedicine Pediatrics

46. Uric Acid Stones (Diagnosis)

for the treatment of bilateral renal pelvis stones associated with Lesch-Nyhan syndrome. Urol Res . 2011 Oct. 39(5):417-9. . Sakhaee K, Maalouf NM. Metabolic syndrome and uric acid nephrolithiasis. Semin Nephrol . 2008 Mar. 28(2):174-80. . Raj GV, Auge BK, Assimos D, Preminger GM. Metabolic abnormalities associated with renal calculi in patients with horseshoe kidneys. J Endourol . 2004 Mar. 18(2):157-61. . Undefined. . Barrat TM, PG Duffy. Nephrocalcinosis and Urolithiasis. Pediatric Nephrology . 4th ed (...) Uric Acid Stones (Diagnosis) Uric Acid Stones: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTgzNzU5LW92ZXJ2aWV3 processing > Uric Acid Stones Updated: Jun 11, 2018

2014 eMedicine Pediatrics

47. Renal ammonium excretion after an acute acid load: Blunted response in uric acid stone formers but not in patients with type 2 diabetes. (PubMed)

Renal ammonium excretion after an acute acid load: Blunted response in uric acid stone formers but not in patients with type 2 diabetes. Idiopathic uric acid nephrolithiasis is characterized by elevated urinary net acid excretion and insufficient buffering by ammonium, resulting in excessively acidic urine and titration of the relatively soluble urate anion to insoluble uric acid. Patients with type 2 diabetes have similar changes in urinary pH, net acid excretion, and ammonium in 24-h urine (...) collections at baseline, even after controlling for dietary factors, and are at increased risk for uric acid nephrolithiasis. However, not all patients with type 2 diabetes develop kidney stones, suggesting that uric acid stone formers may have additional urinary defects, perhaps not apparent at baseline. We performed a metabolic study of 14 patients with idiopathic uric acid nephrolithiasis, 13 patients with type 2 diabetes, and 8 healthy control subjects of similar body mass index. After equilibration

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2013 American Journal of Physiology. Renal physiology

48. Nephrolithiasis as a Risk Factor for CKD: The Atherosclerosis Risk in Communities Study. (PubMed)

and race with incident CKD.In this community-based cohort, nephrolithiasis was not an independent risk factor for incident CKD overall. However, risk of CKD was unexpectedly elevated in participants with stone disease and lower plasma uric acid levels.Copyright © 2015 by the American Society of Nephrology. (...) Nephrolithiasis as a Risk Factor for CKD: The Atherosclerosis Risk in Communities Study. Previous studies demonstrated a higher risk of CKD in persons with a history of kidney stones, but these studies examined mostly white populations and did not evaluate important potential interactions such as race and plasma uric acid.In 10,678 Atherosclerosis Risk in Communities (ARIC) study participants free of CKD at baseline (ARIC visit 4 in 1996-1998), we assessed the association between a history

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2015 Clinical Journal of the American Society of Nephrology

49. Differences in 24-h urine composition between nephrolithiasis patients with and without diabetes mellitus. (PubMed)

and multivariable linear regression models were performed, comparing patients with and without DM. A subanalysis of patients with stone analysis data available was performed, comparing the stone composition of patients with and without DM.Of the 1117 patients who comprised the study population, 181 (16%) had DM and 936 (84%) did not have DM at the time of urine analysis. Univariable analysis showed significantly higher total urine volume, citrate, uric acid (UA), sodium, potassium, sulphate, oxalate, chloride (...) Differences in 24-h urine composition between nephrolithiasis patients with and without diabetes mellitus. To examine the differences in 24-h urine composition between nephrolithiasis patients with and without diabetes mellitus (DM) in a large cohort of stone-formers and to examine differences in stone composition between patients with and without DM.A retrospective review of 1117 patients with nephrolithiasis and a 24-h urine analysis was completed. Univariable analysis of 24-h urine profiles

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2015 BJU international

50. The diurnal variation in urine acidification differs between normal individuals and uric acid stone formers. (PubMed)

of nephrolithiasis and uric acid stones result from excessively low urine pH. Here we placed 9 healthy volunteers and 10 uric acid stone formers on fixed metabolic diets to study the diurnal pattern of urinary acidification. All showed clear diurnal trends in urinary acidification, but none of the patterns were affected by inhibitors of the gastric proton pump. Uric acid stone formers had similar patterns of change throughout the day but their urine pH was always lower compared to healthy volunteers. Uric acid (...) The diurnal variation in urine acidification differs between normal individuals and uric acid stone formers. Many biological functions follow circadian rhythms driven by internal and external cues that synchronize and coordinate organ physiology to diurnal changes in the environment and behavior. Urinary acid-base parameters follow diurnal patterns and it is thought these changes are due to periodic surges in gastric acid secretion. Abnormal urine pH is a risk factor for specific types

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2012 Kidney international

51. Nephrolithiasis (Overview)

of calculus (eg, calcium oxalate, uric acid, cystine), respectively Microscopic urinalysis 24-Hour urine profile Imaging studies The following imaging studies are used in the evaluation of nephrolithiasis: Noncontrast abdominopelvic CT scan: The imaging modality of choice for assessment of urinary tract disease, especially acute renal colic Renal ultrasonography: To determine presence of a renal stone and the presence of hydronephrosis or ureteral dilation; used alone or in combination with plain (...) , which innervate the intramural ureter and bladder, are responsible for some of the bladder symptoms that often accompany an intramural ureteral calculus. Nephrolithiasis: acute renal colic. Distribution of nerves in the flank. Previous Next: Pathophysiology Formation of stones Urinary tract stone disease is likely caused by two basic phenomena. The first phenomenon is supersaturation of the urine by stone-forming constituents, including calcium, oxalate, and uric acid. Crystals or foreign bodies can

2014 eMedicine.com

52. Nephrolithiasis: Acute Renal Colic (Overview)

and type of calculus (eg, calcium oxalate, uric acid, cystine), respectively Microscopic urinalysis 24-Hour urine profile Imaging studies The following imaging studies are used in the evaluation of nephrolithiasis: Noncontrast abdominopelvic CT scan: The imaging modality of choice for assessment of urinary tract disease, especially acute renal colic Renal ultrasonography: To determine presence of a renal stone and the presence of hydronephrosis or ureteral dilation; used alone or in combination (...) narcotic analgesics (eg, codeine, morphine sulfate, oxycodone/APAP, hydrocodone/APAP, dilaudid, fentanyl) Alpha blockers (eg, tamsulosin, terazosin) Antiemetics (eg, metoclopramide, ondansetron) Antibiotics (eg, ampicillin, gentamicin, trimethoprim-sulfamethoxazole, ciprofloxacin, levofloxacin, ofloxacin) Stone Prevention/Chemolysis Uricosuric agents (eg, allopurinol) Alkalinizing agents (eg, potassium citrate, sodium bicarbonate): For uric acid and cysteine calculi Thiazide diuretics- helps treat

2014 eMedicine.com

53. Nephrolithiasis (Treatment)

Nephrolithiasis (Treatment) Nephrolithiasis Treatment & Management: Approach Considerations, Emergency Management of Renal Colic, Surgical Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDM3MDk2LXRyZWF0bWVudA (...) == processing > Nephrolithiasis Treatment & Management Updated: Jun 21, 2018 Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Nephrolithiasis Treatment Approach Considerations Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure, the focus

2014 eMedicine.com

54. Nephrolithiasis: Acute Renal Colic (Treatment)

Nephrolithiasis: Acute Renal Colic (Treatment) Nephrolithiasis Treatment & Management: Approach Considerations, Emergency Management of Renal Colic, Surgical Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDM3MDk2LXRyZWF0bWVudA== processing > Nephrolithiasis Treatment & Management Updated: Jun 21, 2018 Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Nephrolithiasis Treatment Approach Considerations Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure

2014 eMedicine.com

55. Nephrolithiasis (Follow-up)

Nephrolithiasis (Follow-up) Nephrolithiasis Treatment & Management: Approach Considerations, Emergency Management of Renal Colic, Surgical Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDM3MDk2LXRyZWF0bWVudA (...) == processing > Nephrolithiasis Treatment & Management Updated: Jun 21, 2018 Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Nephrolithiasis Treatment Approach Considerations Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure, the focus

2014 eMedicine.com

56. Nephrolithiasis: Acute Renal Colic (Follow-up)

Nephrolithiasis: Acute Renal Colic (Follow-up) Nephrolithiasis Treatment & Management: Approach Considerations, Emergency Management of Renal Colic, Surgical Care Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDM3MDk2LXRyZWF0bWVudA== processing > Nephrolithiasis Treatment & Management Updated: Jun 21, 2018 Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Nephrolithiasis Treatment Approach Considerations Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure

2014 eMedicine.com

57. Nephrolithiasis (Diagnosis)

of calculus (eg, calcium oxalate, uric acid, cystine), respectively Microscopic urinalysis 24-Hour urine profile Imaging studies The following imaging studies are used in the evaluation of nephrolithiasis: Noncontrast abdominopelvic CT scan: The imaging modality of choice for assessment of urinary tract disease, especially acute renal colic Renal ultrasonography: To determine presence of a renal stone and the presence of hydronephrosis or ureteral dilation; used alone or in combination with plain (...) , which innervate the intramural ureter and bladder, are responsible for some of the bladder symptoms that often accompany an intramural ureteral calculus. Nephrolithiasis: acute renal colic. Distribution of nerves in the flank. Previous Next: Pathophysiology Formation of stones Urinary tract stone disease is likely caused by two basic phenomena. The first phenomenon is supersaturation of the urine by stone-forming constituents, including calcium, oxalate, and uric acid. Crystals or foreign bodies can

2014 eMedicine.com

58. Nephrolithiasis: Acute Renal Colic (Diagnosis)

and type of calculus (eg, calcium oxalate, uric acid, cystine), respectively Microscopic urinalysis 24-Hour urine profile Imaging studies The following imaging studies are used in the evaluation of nephrolithiasis: Noncontrast abdominopelvic CT scan: The imaging modality of choice for assessment of urinary tract disease, especially acute renal colic Renal ultrasonography: To determine presence of a renal stone and the presence of hydronephrosis or ureteral dilation; used alone or in combination (...) narcotic analgesics (eg, codeine, morphine sulfate, oxycodone/APAP, hydrocodone/APAP, dilaudid, fentanyl) Alpha blockers (eg, tamsulosin, terazosin) Antiemetics (eg, metoclopramide, ondansetron) Antibiotics (eg, ampicillin, gentamicin, trimethoprim-sulfamethoxazole, ciprofloxacin, levofloxacin, ofloxacin) Stone Prevention/Chemolysis Uricosuric agents (eg, allopurinol) Alkalinizing agents (eg, potassium citrate, sodium bicarbonate): For uric acid and cysteine calculi Thiazide diuretics- helps treat

2014 eMedicine.com

59. Nephrolithiasis/Urolithiasis

junction (UVJ), and the point at which the ureter crosses the iliac vessels. An additional site is on the right side, where the ureter passes through the root of the mesentery. Calcium stones as small as 1-2 mm can be seen. Cystine stones as small as 3-4 mm may be depicted, but uric acid stones are usually not seen unless they have become calcified. Typically, phleboliths are round or oval, and they may demonstrate a central lucency. However, they are often difficult to distinguish from ureteral (...) Nephrolithiasis/Urolithiasis Urinary Calculi (Urolithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzgxOTkzLW92ZXJ2aWV3 processing > Urinary

2014 eMedicine Radiology

60. Diseases 2.0: Uric acid stones linked to diabetes

Sep;2(5):883-8. Epub 2007 Aug 16.PMID: 17702734 4: Cameron MA, Baker LA, Maalouf NM, Moe OW, Sakhaee K. Circadian variation in urine pH and uric acid nephrolithiasis risk.Nephrol Dial Transplant. 2007 Aug;22(8):2375-8. Epub 2007 May 3. No abstractavailable.PMID: 17478488 5: Cameron MA, Maalouf NM, Adams-Huet B, Moe OW, Sakhaee K. Urine composition in type 2 diabetes: predisposition to uric acidnephrolithiasis.J Am Soc Nephrol. 2006 May;17(5):1422-8. Epub 2006 Apr 5.PMID: 16597681 Share: | | One (...) Diseases 2.0: Uric acid stones linked to diabetes Diseases 2.0: Uric acid stones linked to diabetes – Clinical Correlations Search Diseases 2.0: Uric acid stones linked to diabetes July 3, 2008 3 min read Commentary By David Goldfarb, M.D. Professor of Medicine, NYU Medical Center, Chief Nephrology Section VA New York Harbor At the recent meeting of the National Kidney Foundation in Dallas, Dr. Orson Moe reviewed the links between diabetes and uric acid stones . Uric acid stones are most often

2008 Clinical Correlations

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