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Uric Acid Nephrolithiasis

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102. 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

103. 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

104. 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

105. 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

106. 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

107. 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

108. 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

109. CT-based Diagnosis of Visceral Obesity and Hepatic Steatosis is Associated with Low Urine pH. (PubMed)

CT-based Diagnosis of Visceral Obesity and Hepatic Steatosis is Associated with Low Urine pH. Uric acid nephrolithiasis is associated with an elevated visceral fat area in kidney stone formers. Hepatic steatosis has also been linked to visceral obesity and nephrolithiasis. We evaluated the association of noncontrast computerized tomography based diagnosis of visceral obesity and hepatic steatosis with 24-hour urine parameters and stone composition in kidney stone formers.A total of 98 kidney (...) ) and visceral fat area greater than 48% (OR 5.33) were associated with uric acid stones. Linear regression demonstrated that the percent of visceral fat area was associated with lower 24-hour urine pH (β-coefficient -0.438, p <0.0001).Noncontrast computerized tomography based diagnosis of visceral obesity is associated with low urine pH, high urinary sodium and uric acid stone formation. Hepatic steatosis is associated with low urine pH.Copyright © 2017 American Urological Association Education and Research

2017 Journal of Urology

110. (SWL) Versus (ODT) Versus Combined SWL And ODT For Radiolucent Stone

-dihydroxyadenine calculi. The main etiologic factors for the development of uric acid nephrolithiasis are low urinary pH, hyperuricosuria, and low urinary volume. Practically, all of those who form uric acid stones have persistently low urinary pH, and most excrete normal amounts of uric acid. This suggests the potential importance of urinary pH manipulation in dissolving UA stones. Dissolution therapy for UA calculi is based on hydration and raising the urinary pH. European guidelines recommended that urine (...) and dissolution therapy Not Applicable Detailed Description: Urolithiasis is a common morbidity worldwide, affecting 10% to 15% of the population in Europe and North America. A higher prevalence of stone disease is found in hot or dry areas, including 20% to 25% in the Middle East. Radiolucent stones are mostly uric acid (UA) calculi, which varies geographically with worldwide incidence ranges from 5 to 40% and about 7- 10 percent of all calculi. Other rare radiolucent stones include xanthine and 2,8

2017 Clinical Trials

111. This Study Tests the Effect of Certain Medicines on the Transport of Other Medicines in the Body of Healthy Men

disorders (e.g. sinu-atrial blocks of II° or III°) Myopathy Hereditary galactose or fructose intolerance, lactase deficiency, or glucose-galactose malabsorption History of nephrolithiasis Gout or clinically relevant elevation of uric acid Creatinine clearance (according to CKD EPI formula) is lower than 80 ml/min Further exclusion criteria apply Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research (...) Mechanisms of Pharmacological Action Lipid Regulating Agents Hydroxymethylglutaryl-CoA Reductase Inhibitors Enzyme Inhibitors Diuretics Natriuretic Agents Sodium Potassium Chloride Symporter Inhibitors Membrane Transport Modulators Antibiotics, Antitubercular Antitubercular Agents Anti-Bacterial Agents Anti-Infective Agents Leprostatic Agents Nucleic Acid Synthesis Inhibitors Cytochrome P-450 CYP2B6 Inducers Cytochrome P-450 Enzyme Inducers Cytochrome P-450 CYP2C8 Inducers

2017 Clinical Trials

112. Phase 2 Dose-finding IMU-838 for Ulcerative Colitis

for fluctuating liver function tests during this trial Renal impairment i.e. calculated creatinine clearance ≤60 mL/min Serum uric acid levels at Screening >1.2 x ULN (for women >6.8 mg/dL, for men >8.4 mg/dL) History or clinical diagnosis of gout Known or suspected Gilbert syndrome Indirect (unconjugated) bilirubin ≥1.2 x ULN at Screening (i.e. ≥ 1.1 mg/dL) Concurrent malignancy or prior malignancy within the previous 10 years except for the following: adequately-treated non-melanoma skin cancer (...) and ustekinumab within 8 weeks before first randomization Use of the DHODH inhibitors leflunomide or teriflunomide within 6 months before first randomization Any use of natalizumab (Tysabri™) within 12 months before first randomization Use of the following concomitant medications is prohibited at Screening and throughout the duration of the trial: any medication known to significantly increase urinary elimination of uric acid, in particular lesinurad (Zurampic™) as well as uricosuric drugs such as probenecid

2017 Clinical Trials

113. Association Study of Reported Significant Loci at 5q35.3, 7p14.3, 13q14.1 and 16p12.3 with Urolithiasis in Chinese Han Ethnicity (PubMed)

with increased level of serum magnesium. The C allele of rs1000597 was associated with higher levels of serum creatinine, uric acid, calcium and lower urine pH level. The T allele of rs4142110 was correlated with higher levels of serum magnesium, phosphorus, and lower AKP level. The G alleles of rs4293393 was associated with higher serum CO2 level. The risk alleles of these SNPs were proved to be associated with the electrolytes metabolism that may result in the formation of urolithiasis. (...) Association Study of Reported Significant Loci at 5q35.3, 7p14.3, 13q14.1 and 16p12.3 with Urolithiasis in Chinese Han Ethnicity In this study, we aimed to validate the association of 8 reported significant loci at 5q35.3, 7p14.3, 13q14.1 and 16p12.3 with urolithiasis in Chinese Han population. We performed case-control association analysis using 624 patients with nephrolithiasis and 1008 control subjects. We selected single-nucleotide polymorphism (SNPs) including rs12654812 and rs11746443

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2017 Scientific reports

114. Bilateral hydronephrosis due to obstructive ureteral stone associated with norovirus gastroenteritis (PubMed)

Bilateral hydronephrosis due to obstructive ureteral stone associated with norovirus gastroenteritis Recently, cases of urinary tract calculi causing hydronephrosis and postrenal renal failure associated with viral gastroenteritis were documented, yet few were related to norovirus. During norovirus gastroenteritis, observation of oliguria, aciduria, low FENa value, and elevation of blood or urinary uric acid level may necessitate clinical workout for nephrolithiasis.

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2017 Clinical Case Reports

115. Preventive Kidney Stones: Continue Medical Education (PubMed)

abdominal film and renal sonography, a noncontrast helical computed tomography scan of the abdomen is the diagnostic procedure of choice for detection of small and radiolucent kidney stones with sensitivity and specificity of nearly 100%. Stones smaller than 5 mm in diameter often pass the urinary tract system and rarely require surgical interventions. The main risk factors for stone formation are low urine output, high urinary concentrations of calcium, oxalate, phosphate, and uric acid compounded (...) Preventive Kidney Stones: Continue Medical Education Nephrolithiasis is a common health problem across the globe with a prevalence of 15%-20%. Idiopathic hypercalciuria is the most common cause of nephrolithiasis, and calcium oxalate stones are the most common type of stones in idiopathic hypercalciuric patients. Calcium phosphate stones are frequently associated with other diseases such as renal tubular acidosis type 1, urinary tract infections, and hyperparathyroidism. Compared with flat

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2017 International journal of preventive medicine

116. Zurampic - lesinurad

SD standard deviation SE standard error SI International System of Units SMQ Standardised MedDRA Query SOC (MedDRA) system organ class sUA serum uric acid (also referred to as serum urate) SURI selective uric acid reabsorption inhibitor TEAE treatment-emergent adverse event UK United Kingdom ULT urate-lowering therapy URAT1 uric acid transporter 1 US United States uUA urinary uric acid vs versus XO xanthine oxidase XOI xanthine oxidase inhibitor Assessment report EMA/6459/2016 Page 5/128 1 (...) treatment of hyperuricaemia in combination with allopurinol or febuxostat in gout patients when additional therapy is warranted (i.e. not at target serum uric acid levels or with presence of tophus). Zurampic is indicated in adults. The legal basis for this application refers to: Article 8.3 of Directive 2001/83/EC - complete and independent application. The applicant indicated that lesinurad was considered to be a new active substance. The application submitted is composed of administrative information

2016 European Medicines Agency - EPARs

118. 2012 KDIGO Clinical Practice Guideline for the Evaluation and Management of CKD

pressure 490 th percentile ando95 th percentile), following the age-based Recommended Daily Intake. (1C) 3.1.19.2: We recommendsupplemental freewater and sodiumsupplementsforchildrenwith CKD and polyuria to avoid chronic intravascular depletion and to promote optimal growth. (1C) Hyperuricemia 3.1.20: There is insuf?cient evidence to support or refute the use of agents to lower serum uric acid concentrations in people with CKD and either symptomatic or asymptomatic hyperuricemia in order to delay (...) antihypertensive agents; K persistent abnormalities of serum potassium; K recurrent or extensive nephrolithiasis; K hereditary kidney disease. 5.1.2: We recommend timely referral for planning renal replacement therapy (RRT) in people with progressive CKD in whom the risk of kidney failure within 1 year is 10–20% or higher w , as determined by validated risk prediction tools. (1B) *If this is a stable isolated ?nding, formal referral (i.e., formal consultation and ongoing care management) may not be necessary

2012 National Kidney Foundation

119. Health Supervision in the Management of Children and Adolescents With IBD: NASPGHAN Recommendations

of urine creatinine, electrolytes, calcium, magnesium, uric acid, citrate, oxalate, volume, and pH should be obtained. Bone Health in Children With IBD Recent data underscore the need for physicians caring for children with IBD to pay particular attention to assessing and ensuring adequate vitamin D and calcium intake by their patients. Significant deficits in bone mass have been observed in 10% to 40% of children presenting with IBD, and these deficits appear to be more pronounced in patients with CD (...) involving the small bowel, especially those with extensive disease or resections involving the terminal ileum, should have periodic assessment of serum vitamin B 12 and folate levels. Patients with CD and either significant small bowel involvement or a history of small bowel resection are also at increased risk for the development of zinc deficiency (44). Similarly, patients with CD who have undergone terminal ileal resection are at increased risk for impaired absorption of bile acids. These unabsorbed

2012 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

120. Obstructive Uropathy as an Initial Presentation of Primary Myelofibrosis: Case Report and Review of Literature (PubMed)

Obstructive Uropathy as an Initial Presentation of Primary Myelofibrosis: Case Report and Review of Literature Primary myelofibrosis (PMF) is a rare hematological disorder associated with progressive cytopenia and extra-medullary hematopoiesis. Acute kidney injury in this disease has been reported from diverse etiologies such as renal and peri-renal extramedullary hematopoiesis and tumor lysis syndrome. We report a patient who presented with obstructive uropathy from uric acid stones who (...) was incidentally diagnosed with PMF during workup for persistent thrombocytosis and leukocytosis. Marrow histopathology was unique in presenting features of early PMF despite clinical picture mimicking essential thrombocythemia. Despite a common background of hyperuricemia in myeloproliferative neoplasms, AKI resulting from urate nephrolithiasis has seldom been reported in PMF. Published data on this association and clinical management is reviewed briefly.

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2016 Indian Journal of Hematology & Blood Transfusion

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