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Uric Acid Nephrolithiasis

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82. Study of the Biological and Physical Manifestations of Spontaneous Uric Acid Kidney Stone Disease

Study of the Biological and Physical Manifestations of Spontaneous Uric Acid Kidney Stone Disease Pathophysiology of Uric Acid Nephrolithiasis - Full Text View - Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Pathophysiology (...) of Uric Acid Nephrolithiasis (IUAN) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. Identifier: NCT00904046 Recruitment Status : Recruiting First Posted : May 19, 2009 Last Update Posted : May 22, 2018 See Sponsor: University of Texas

2009 Clinical Trials

83. BSR guideline on the management of gout

fractional clearance of uric acid in > 90% of patients with gout [ ]. Age, male gender, menopausal status in females, impairment of renal function, hypertension and the co-morbidities that comprise the metabolic syndrome are all risk factors for incident gout associated with decreased excretion of uric acid, as are the use of diuretic and many anti-hypertensive drugs, ciclosporin, low-dose aspirin, alcohol consumption and lead exposure. Tophi and chronic arthritis [ ], alcohol consumption [ ] and recent (...) [ , ] and secondary care [ , ] do not achieve reductions of serum uric acid (sUA) levels to the target level recommended in the BSR/BHPR (300 µmol/l) or EULAR (360 µmol/l) guidelines. Finally, as evidence has accumulated that the provision of information to patients with gout is suboptimal [ ] and qualitative studies have begun to define a range of patient and provider barriers to effective care [ ], preliminary data are emerging that demonstrate that these barriers can be overcome, and outcomes improved

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2017 British Society for Rheumatology

84. CRACKCast E123 – Selected Oncologic Emergencies

than bisphosphonates, but tachyphylaxis may develop; consider calcitonin in hypercalcemic patients with active cardiac or neurologic symptoms (eg, dysrhythmias, seizures). TLS is manifested by the combination of hyperkalemia, hyperuricemia, hyperphosphatemia, and hypocalcemia, often accompanied by acute renal failure. Patients with TLS should have their potassium, phosphate, calcium, and uric acid levels, as well as renal indices monitored closely. Intravenous fluids should be administered, as well (...) Hyperuricemia treatment i) Allopurinol (prevents conversion xanthine –> uric acid, does not eliminate existing uric acid) ii) Rasburicase (direct elimination) Hypocalcemia treatment i) IV Calcium only if cardiac or neurological complications [13] What is Leukostasis? How does it present? Pathophysiology WBC high enough to cause vascular congestion, particularly in lungs or CNS (no specific WBC threshold), most often occurs in pulmonary or central nervous systems. Associated with leukemias (AML, CLL

2017 CandiEM

85. CRACKCast E097 – Renal Failure

, hemoglobinuria Other Diseases and Conditions Severe liver disease Allergic reactions NSAIDs 6) List the RFs for contrast induced ATN According to LITFL Top 3: Pre-existing renal disease (especially Cr >120) Diabetes mellitus Age >75yrs Others: CHF Hypertension Hypovolemia Nephrotoxins (NSAIDs, cyclosporin, aminoglycosides, amphotericin) High dose contrast, intra-arterial worse than IV Cirrhosis/nephrotic syndrome Multiple myeloma PVD High uric acid and hypercholesterolemia 7) List the causes of postrenal (...) renal failure Box 87.3 Intrarenal and Ureteral Causes Kidney stone Sloughed papilla Malignancy Retroperitoneal fibrosis Uric acid, oxalic acid, or phosphate crystal precipitation Sulfonamide, methotrexate, acyclovir, or indinavir precipitation Bladder Kidney stone Blood clot Prostatic hypertrophy Bladder carcinoma Neurogenic bladder Urethra Phimosis Stricture 8) List the causes of pigment induced AKI Box 87.5 Rhabdomyolysis and myoglobinuria Crush injury Compartment syndrome Electrical injury

2017 CandiEM

86. Surgical Management of Stones: AUA/Endourology Society Guideline

or distal ureteral stones who require intervention (who were not candidates for or who failed MET), clinicians should recommend URS as first-line therapy. For patients who decline URS, clinicians should offer SWL. (Index Patients 2,3,5,6) Strong Recommendation; Evidence Level Grade B 12. URS is recommended for patients with suspected cystine or uric acid ureteral stones who fail MET or desire intervention. Expert Opinion 13. Routine stenting should not be performed in patients undergoing SWL. (Index (...) ' published in 2014. 6 The surgical management of patients with various stones is described below and divided into 13 respective patient profiles. Index Patients 1-10 are non-morbidly obese; non-pregnant adults (≥ 18 years of age) with stones not thought to be composed of uric acid or cystine; normal renal, coagulation and platelet function; normally positioned kidneys; intact lower urinary tracts without ectopic ureters; no evidence of sepsis; and no anatomic or functional obstruction distal to the stone

2016 American Urological Association

87. Chronic Kidney Disease for the Medical Resident: A Cheat Sheet for Primary Care Providers

electrolytes for eGFR and electrolyte abnormalities (e.g. metabolic acidosis) ● Complete Blood Cell Count (Anemia) ● Lipid profile ● Uric Acid ● Serum albumin ● Renal ultrasound ○ to look for hydronephrosis, obstruction, cysts, stones, and assess kidney size and characterization ● Urinalysis ○ Quantify proteinuria with urine protein-to-creatinine ratio (Urine albumin-to-creatinine will miss multiple myeloma Bence-Jones proteins) ○ Look for hematuria or other signs of glomerulonephritis ● Consider biopsy (...) to the glomerular filtering capabilities. Other risk factors include a family history of CKD, autoimmune disease (e.g. SLE, vasculitis, scleroderma), HIV, Hepatitis B or C, amyloidosis, obstructive nephropathy from recurrent UTI or nephrolithiasis, and certain medications ( , immune suppressants, HIV medications). may also contribute to CKD, . Recent evidence suggests . Staging and Estimating GFR Staging CKD is most frequently done by calculating the estimated glomerular function rate (eGFR) as a proxy

2018 Renal Fellow Network

88. Relationship Between Body Mass Index and Quantitative 24-Hour Urine Chemistries in Patients With Nephrolithiasis. (PubMed)

. In women, multivariate analysis demonstrated positive association between BMI and urine sodium, creatinine, and phosphate and a negative relationship with urine citrate and sulfate.Increasing body mass index was related to several risk factors for urinary stone disease in this study, including increasing urine sodium and decreasing pH in men and increasing urine uric acid, sodium, and decreasing urine citrate in women. Just as general recommendations for patients with nephrolithiasis include high (...) explored using bivariate and multivariate linear regression.On bivariate analysis, increasing body mass index was associated with a significant increase in sodium, calcium, citrate, uric acid, magnesium, calcium oxalate, uric acid, and a decrease in pH in men. In women, it was associated with a significant increase in sodium, uric acid, oxalate, uric acid, and decreasing pH. On multivariate analysis, BMI was associated only with increases in sodium and calcium oxalate and decrease in pH in men

2009 Urology

89. A Prospective Study of Risk Factors for Nephrolithiasis After Roux-en-Y Gastric Bypass Surgery. (PubMed)

to undergo Roux-en-Y gastric bypass surgery were enrolled in this prospective study between November 2006 and November 2007. Exclusion criteria included history of nephrolithiasis or inflammatory bowel disease. Serum uric acid, parathyroid hormone, calcium, albumin, and creatinine and 24-hour urine collections were obtained within 6 months before Roux-en-Y gastric bypass, and at 6 to 12 months postoperatively. A Wilcoxon signed-rank test was used to compare preoperative and postoperative serum laboratory (...) A Prospective Study of Risk Factors for Nephrolithiasis After Roux-en-Y Gastric Bypass Surgery. Roux-en-Y gastric bypass surgery has become an increasingly common form of weight management. Early retrospective reviews have suggested that new onset nephrolithiasis develops in some patients after undergoing Roux-en-Y gastric bypass. We present a prospective longitudinal study to assess risk factors for nephrolithiasis after Roux-en-Y gastric bypass.A total of 45 morbidly obese patients scheduled

2009 Journal of Urology

90. Topiloric/Uriadec (topiroxostat)

for the indications and dosage and administration as shown below. [Indication] Gout, hyperuricaemia [Dosage and administration] The usual adult initial dosage is 20 mg/dose of topiroxostat orally administered twice daily in the morning and evening. Thereafter, the dose should be gradually increased, as needed, while monitoring blood uric acid levels. The usual maintenance dosage should be 60 mg/dose twice daily. The dose may be adjusted according to the patient’s condition, up to 80 mg/dose twice daily. 4 Review (...) of topiroxostat orally administered twice daily in the morning and evening. Thereafter, the dosage should be gradually increased, as needed, while monitoring blood uric acid levels. The usual maintenance dosage should be 60 mg/dose twice daily. The dose may be adjusted according to the patient’s condition, up to 80 mg/dose twice daily. II. Summary of the Submitted Data and Outline of Review by the Pharmaceuticals and Medical Devices Agency (PMDA) A summary of the submitted data and an outline of the review

2013 Pharmaceuticals and Medical Devices Agency, Japan

91. Prevention of Recurrent Kidney Stones

with residual or recurrent struvite stones in whom surgical options have been exhausted, AUA cites acetohydroxamic acid as a treatment option. AUA recommends potassium citrate for patients with uric acid and cystine stones in order to raise urinary pH to an optimal level. Prevention of Recurrent Kidney Stones ACP (2014) Recommendation 1 : The ACP recommends management with increased fluid intake spread throughout the day to achieve at least 2 L of urine per day to prevent recurrent nephrolithiasis. ( Grade (...) high urinary calcium (limit sodium intake and consume 1,000-1,200 mg/day of dietary calcium); calcium oxalate stones and relatively high urinary oxalate (limit intake of oxalate-rich foods and maintain normal calcium consumption); calcium stones and relatively low urinary citrate (increase intake of fruits and vegetables and limit non-dairy animal protein); uric acid stones or calcium stones and relatively high urinary acid (limit intake of non-dairy animal protein); cystine stones (limit sodium

2015 National Guideline Clearinghouse (partial archive)

92. Modification of lifestyle and nutrition interventions for management of early chronic kidney disease

, diuresis, natriuresis, and kaliuresis with associated blood pressure changes, increased risk for nephrolithiasis, and various metabolic alterations. Although there was a dearth of evidence pertaining to HP diets in patients with CKD, it was concluded that, while there are no clear renal-related contraindications to HP diets in individuals with healthy kidney function, the theoretical risks should (...) therapy. Once blood pressure is controlled, low-dose acetylsalicylic acid therapy should be considered. _______________________________________________________________________________________________________________________ Early Chronic Kidney Disease July 2012 Page 20 of 50 SUGGESTIONS FOR FUTURE RESEARCH 1. An RCT of different levels of fluid intake ( 3L/day) on CKD progression in patients with stage 1-3 CKD. 2. A study of the impact of moderation of alcohol intake on CKD progression in patients

2013 KHA-CARI Guidelines

94. Medical Management of Kidney Stones

. (Clinical Principle) 4. Clinicians should obtain or review available imaging studies to quantify stone burden. (Clinical Principle) 5. Clinicians should perform additional metabolic testing in high-risk or interested first-time stone formers and recurrent stone formers. (Standard; Evidence Strength: Grade B) 6. Metabolic testing should consist of one or two 24-hour urine collections obtained on a random diet and analyzed at minimum for total volume, pH, calcium, oxalate, uric acid, citrate, sodium (...) . Clinicians should counsel patients with uric acid stones or calcium stones and relatively high urinary uric acid to limit intake of non-dairy animal protein. (Expert Opinion) 13. Clinicians should counsel patients with cystine stones to limit sodium and protein intake. (Expert Opinion) Pharmacologic Therapies 14. Clinicians should offer thiazide diuretics to patients with high or relatively high urine calcium and recurrent calcium stones. (Standard; Evidence Strength Grade B) 15. Clinicians should offer

2014 American Urological Association

95. Diagnosis and management of glycogen storage disease type I: a practice guideline of the American College of Medical Genetics and Genomics

to hyperfiltration may occur in adolescents and young adults with GSD I, similar to what is seen in diabetic patients. Severe renal injury with proteinuria, hypertension, and decreased creatinine clearance due to focal segmental glomeru- losclerosis and interstitial fibrosis, ultimately leading to end- stage renal disease, may also be seen in young adults. 62 Patients with persistently elevated blood lactate, serum lipids, and uric acid levels appear more at risk for nephropathy. 58,63 Patients with GSD Ib have (...) , a hyperlipidemia Hypoglycemia is usually less severe, but the patient may have more severe ketosis and absence of hyperlactatemia and hyperuricemia; ? AST , ALT usually higher (may be >500? U/l); cardiac and skeletal muscle involvement with ? CK concentrations in GSD IIIa; normal blood lactate and uric acid GSD IV (branching enzyme deficiency) Hepatomegaly, ? AST and ALT, a prolonged PT and low albumin in advanced stage of disease Lack of hypoglycemia until end-stage liver disease; PT commonly prolonged in GSD

2014 American College of Medical Genetics and Genomics

96. A heterozygous variant in the SLC22A12 gene in a Sri Lanka family associated with mild renal hypouricemia. (PubMed)

A heterozygous variant in the SLC22A12 gene in a Sri Lanka family associated with mild renal hypouricemia. Renal hypouricemia is a rare heterogeneous inherited disorder characterized by impaired tubular uric acid transport, reabsorption insufficiency and /or acceleration of secretion. The affected individuals are predisposed to nephrolithiasis and recurrent episodes of exercise-induced acute kidney injury. Type 1 is caused by dysfunctional variants in the SLC22A12 gene (URAT1), while type 2 (...) is caused by defects in the SLC2A9 gene (GLUT9). To date, more than 150 patients with the loss-of-function mutations for the SLC22A12 gene have been found (compound heterozygotes and/or homozygotes), most of whom are Japanese and Koreans.Herein, we report a nine year old Sri Lankan boy with renal hypouricemia (serum uric acid 97 μmol/L, fractional excretion of uric acid 33%).The sequencing analysis of SLC22A12 revealed a potentially deleterious missense variant c.1400C > T (p.T467 M, rs200104135

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2018 BMC Pediatrics

97. Renal Resisitive Index as an Indicator of the Progression of Diabetic Nephropathy

Last Update Posted : September 14, 2018 See Sponsor: Assiut University Information provided by (Responsible Party): radwa awad abd elhafiz ibrahim, Assiut University Study Details Study Description Go to Brief Summary: diabetic nephropathy is one of the leading causes of end stage renal disease Condition or disease Intervention/treatment Phase Diabetic Nephropathy Diagnostic Test: renal arterial resistive index Diagnostic Test: uric acid level Diagnostic Test: serum urea and creatinine Diagnostic (...) Study Completion Date : September 2019 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment Active Comparator: cases laboratory tests including (random blood glucose , serum urea and creatinine , lipogram , serum uric acid , HbA1c , urine analysis , 24 hours urinary proteins ) abdominal ultrasonography dupplex on the renal vessels Diagnostic Test: renal arterial resistive index done by dupplex on renal arteries Diagnostic

2018 Clinical Trials

98. Abdominal Radiography with Digital Tomosynthesis: an Alternative to Computed Tomography for Identification of Urinary Calculi? (PubMed)

was determined using nearest-neighbor match with generalized linear mixed modeling.Total of 59 stones were identified on reference read. Overall, NCCT and DT were both superior to KUB alone (P < .001) while the difference between DT and NCCT was not significant (P = .06). When evaluating uric acid stones, NCCT and DT outperformed KUB (P < .01 and P < .05, respectively) while DT and NCCT were similar (P = .16). Intrarenal stones were better evaluated on DT and NCCT (P < .001 compared to KUB), while DT (...) Abdominal Radiography with Digital Tomosynthesis: an Alternative to Computed Tomography for Identification of Urinary Calculi? To compare the accuracy of plain abdominal radiography (kidneys, ureter, and bladder [KUB]) with digital tomosynthesis (DT) to noncontrast computed tomography (NCCT), the gold standard imaging modality for urinary stones. Due to radiation and cost concerns, KUB is often used for diagnosis and follow-up of nephrolithiasis. DT, a novel technique that produces high-quality

2018 Urology

99. Sulopenem Followed by Sulopenem-etzadroxil/Probenecid vs Ertapenem Followed by Cipro for Complicated UTI in Adults

, others) Chronic indwelling catheters or stents Ileal loops or vesico-urethral reflux Recent trauma to the pelvis or urinary tract within the prior 30 days History of seizures Patients with a history of blood dyscrasias Patients with a history of uric acid kidney stones Patients with acute gouty attack Patients on chronic methotrexate therapy Females of child-bearing potential who are unable to take adequate contraceptive precautions, have a positive pregnancy test result within 24 hours of study (...) of an indwelling catheter ii. >100 mL of residual urine after voiding iii. Neurogenic bladder iv. Obstructive uropathy due to nephrolithiasis, tumor or fibrosis v. Azotemia due to intrinsic renal disease vi. Urinary retention in men possibly due to benign prostatic hypertrophy vii. Surgically modified or abnormal urinary tract anatomy At least two of the following signs or symptoms: Rigors, chills or fever/hypothermia Flank pain or pelvic pain Nausea or vomiting Dysuria, urinary frequency or urinary urgency

2017 Clinical Trials

100. Effectiveness of Treatment Modalities on Kidney Stone Recurrence. (PubMed)

interventions associated with reduced calcium stone risk include adequate dietary calcium intake and restriction of sodium, protein, and oxalate intake, among others. Pharmaceutical therapy may be required if lifestyle changes are insufficient to minimize risk of stone recurrence, and must be targeted to the specific metabolic abnormalities portending risk for a given patient. Therapeutic options for idiopathic calcium stone disease include thiazides, citrate salts, and uric acid-lowering agents. Alkali (...) salts are also the treatment of choice for uric acid stone disease. Management of struvite stone disease is largely surgical, but acetohydroxamic acid is a proven second line therapy. Cystinuria requires lifestyle modifications and may call for thiol-binding agents. Significant heterogeneity of the clinical population with stone disease has previously limited opportunities for large randomized controlled trials. However, as clinical phenotypes and genotypes are increasingly clarified

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2017 Clinical Journal of the American Society of Nephrology

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