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Uric Acid Nephrolithiasis

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121. Renal Calculi (Follow-up)

paramount whenever a UTI is suspected in conjunction with hydronephrosis or renal colic a septic patient. The vast majority of symptomatic urinary tract calculi are now treated with noninvasive or minimally invasive techniques. Open surgical excision of a stone from the urinary tract is now limited to isolated atypical cases. Guidelines are now available to assist the urologist in selecting surgical treatments. The 2005 AUA staghorn calculus guidelines recommend percutaneous nephrostolithotomy (...) %). [ ] Anatrophic nephrolithotomy Anatrophic nephrolithotomy was classically an open procedure indicated for large staghorn calculi. It involved accessing the kidney through an open approach, identifying the avascular plane of Brodel, which is a relatively avascular plane in the posterior kidney, and then making an incision through this plane and subsequently removing the calculus. During this procedure the renal artery is clamped, which raises the risk for ischemic injury, as well as reperfusion injury once

2014 eMedicine Emergency Medicine

122. Renal Calculi (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 (...) . [ ] The term nephrolithiasis specifically refers to calculi in the kidneys, but this article discusses both renal calculi (see the first image below) and ureteral calculi (ureterolithiasis; see the second image below). Ureteral calculi almost always originate in the kidneys, although they may continue to grow once they lodge in the ureter. Small renal calculus that would likely respond to extracorporeal shockwave lithotripsy. Distal ureteral stone observed through a small, rigid ureteroscope prior

2014 eMedicine Emergency Medicine

123. Evaluate the Efficacy and Safety of Arhalofenate for Preventing Flares and Reducing Serum Uric Acid in Gout Patients

Evaluate the Efficacy and Safety of Arhalofenate for Preventing Flares and Reducing Serum Uric Acid in Gout Patients Evaluate the Efficacy and Safety of Arhalofenate for Preventing Flares and Reducing Serum Uric Acid in Gout Patients - Full Text View - ClinicalTrials.gov 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. Evaluate the Efficacy and Safety of Arhalofenate for Preventing Flares and Reducing Serum Uric Acid in Gout Patients 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. Read our for details. ClinicalTrials.gov Identifier: NCT02063997 Recruitment Status : Completed First Posted

2014 Clinical Trials

124. Uric acid and the kidney. (Abstract)

Uric acid and the kidney. Uric acid, the end product of purine metabolism, is excreted predominantly by the proximal tubules. Abnormal serum levels of uric acid are due to alterations in production or excretion. Fractional excretion of uric acid is helpful in determining the underlying etiology of hypouricemia or hyperuricemia in children. Abnormalities in the molecular mechanisms that control renal uric acid tubular transport are implicated in various disorders associated with abnormal uric (...) acid levels. Gout is rare in children; yet its presence necessitates evaluation for enzymatic defects in purine metabolism. Well-known effects of uric acid on the kidney include nephrolithiasis and acute kidney injury (AKI) in the setting of tumor lysis. However, recent data suggest that uric acid may be an important factor in the pathogenesis of AKI in general, as well as of chronic kidney disease (CKD) and hypertension. Hence, uric acid may not only be a marker but also a potential therapeutic

2014 Pediatric Nephrology

125. MKSAP: 28-year-old man is evaluated for recurrent nephrolithiasis

), blood pressure is 131/78 mm Hg, pulse rate is 84/min, and respiration rate is 12/min. BMI is 22. The abdominal examination shows healed surgical incisions and is otherwise unremarkable. The remainder of the examination is normal. Laboratory studies, including complete blood count, electrolytes, and kidney function, are normal. Urinalysis is normal; 24-hour urine chemical analysis shows normal levels of calcium, citrate, and uric acid, but elevated oxalate. Plain abdominal radiographs show multiple (...) kidney stones 3 years ago following his last bowel surgery. Analysis of the stones has consistently shown calcium oxalate, and he has been adherent to a low oxalate diet, oral hydration to maintain urine output of at least 2 L/d, and intake of 2 g of calcium carbonate with each meal. However, he has continued to have periodic episodes of kidney stones. Medical history is otherwise unremarkable. Medications are infliximab and calcium carbonate. On physical examination, temperature is 37.1 °C (98.8 °F

2017 KevinMD blog

126. Uric Acid Nephropathy (Diagnosis)

), 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 (...) -term follow-up evaluation of 524 subjects with gout, the authors concluded that deterioration of kidney function could not be ascribed to hyperuricemia and gout alone. They found that in general, the decline in kidney function could be attributed to other known causes of chronic renal failure, such as nephropathy not associated with uric acid, renal stones, aging, or hypertension. In summary, little compelling evidence exists that chronic hyperuricemia leads to chronic urate nephropathy

2014 eMedicine.com

127. Uric Acid Nephropathy (Treatment)

of chronic nephropathy alone, although this topic remains under active study and debate. The significant toxicity of allopurinol and the lifelong expense of using it make this therapy unwarranted. The emphasis should be on controlling other risk factors for kidney failure, such as diabetes and hypertension. Uric acid nephrolithiasis The goals of uric acid nephrolithiasis therapy are to reduce the existing stone size and to prevent the formation of new stones. These objectives are achieved by decreasing (...) at bedtime is usually effective in maintaining alkaline urine. Allopurinol should be used if stones recur despite the above therapies, when the urinary uric acid excretion is greater than 1000 mg/d, or if the patient has gout. Allopurinol is also indicated for dissolving or reducing the size of existing stones and when large, nonobstructing renal pelvic stones are too large to pass. Extracorporeal shock wave lithotripsy can be tried for problem calculi, but the procedure is less effective for uric acid

2014 eMedicine.com

128. Uric Acid Nephropathy (Overview)

), 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 (...) -term follow-up evaluation of 524 subjects with gout, the authors concluded that deterioration of kidney function could not be ascribed to hyperuricemia and gout alone. They found that in general, the decline in kidney function could be attributed to other known causes of chronic renal failure, such as nephropathy not associated with uric acid, renal stones, aging, or hypertension. In summary, little compelling evidence exists that chronic hyperuricemia leads to chronic urate nephropathy

2014 eMedicine.com

129. Uric Acid Nephropathy (Follow-up)

. . Guest SS. Uric acid and the kidney. Nephrology Rounds 4 . Snell Medical Communications; 2001. 1-5. Dykman D, Simon EE. Hyperuricemia and uric acid nephropathy. Arch Intern Med . 1987 Jul. 147(7):1341-5. . Nickeleit V, Mihatsch MJ. Uric acid nephropathy and end-stage renal disease--review of a non-disease. Nephrol Dial Transplant . 1997 Sep. 12(9):1832-8. . . Mene P, Punzo G. Uric acid: bystander or culprit in hypertension and progressive renal disease?. J Hypertens . 2008 Nov. 26(11):2085-92 (...) . . Borghi C, Rosei EA, Bardin T, Dawson J, Dominiczak A, Kielstein JT, et al. Serum uric acid and the risk of cardiovascular and renal disease. J Hypertens . 2015 Sep. 33 (9):1729-41; discussion 1741. . Kim Y, Shin S, Kim K, Choi S, Lee K. Effect of Urate Lowering Therapy on Renal Disease Progression in Hyperuricemic Patients with Chronic Kidney Disease. J Rheumatol . 2015 Nov. 42 (11):2143-8. . Avram Z, Krishnan E. Hyperuricaemia--where nephrology meets rheumatology. Rheumatology (Oxford) . 2008 Jul

2014 eMedicine.com

130. 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 (...) precipitation in metastable urine concentrates (see ). Uric acid stones. The terms gouty nephropathy, urate nephropathy, and uric acid nephropathy are used to describe renal insufficiency due to uric acid precipitation within the renal tubules. Uric acid urolithiasis or uric acid kidney stones refer to development of a stone or calculus composed of significant amounts of urate in the renal pelvis, ureter, or bladder. Next: Pathophysiology Uric acid is a weak acid, with an ionization constant of acid (pK

2014 eMedicine Pediatrics

131. 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 (...) . 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. 933-46. Camron JS, F Moro. Gout, Uric Acid, and Purine Metabolism in Pediatric Nephrology. Pediatric Nephrology . 1993. Vol 7: 105-18. Johnson RJ, Kivlighn SD, Kim YG, et al. Reappraisal of the pathogenesis and consequences

2014 eMedicine Pediatrics

132. 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 (...) precipitation in metastable urine concentrates (see ). Uric acid stones. The terms gouty nephropathy, urate nephropathy, and uric acid nephropathy are used to describe renal insufficiency due to uric acid precipitation within the renal tubules. Uric acid urolithiasis or uric acid kidney stones refer to development of a stone or calculus composed of significant amounts of urate in the renal pelvis, ureter, or bladder. Next: Pathophysiology Uric acid is a weak acid, with an ionization constant of acid (pK

2014 eMedicine Pediatrics

133. 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 (...) , allopurinol and dialysis may be indicated in addition to supportive care for renal failure. Most children with uric acid calculi do not have hyperuricemia. Elevated serum uric acid levels are frequently due to dehydration and excessive purine intake. Consistently low urine pH is a risk factor for stone formation. As the urine pH level increases above the pK (5.8), uric acid forms the more soluble urate ion. Children with uric acid stones frequently describe passing gravel. With persistent urinary

2014 eMedicine Pediatrics

134. Significant differences in struvite and cystine stone frequency seen among Chinese nephrolithiasis patients living in North America compared to those living in China Full Text available with Trip Pro

rates of calcium-based and uric acid calculi as well as urinary pH were seen among both groups.Significant differences exist between Chinese nephrolithiasis patients living in China compared to those living in North America, highlighting the importance of environmental factors in addition to genetics in modulating risk for urinary stone disease. (...) Significant differences in struvite and cystine stone frequency seen among Chinese nephrolithiasis patients living in North America compared to those living in China Interracial disparities in nephrolithiasis prevalence have been reported, but the interplay between genetics and the environment for urinary stone disease risk factors is poorly understood. To examine how environment may alter genetic predisposition for stone formation, we established the International Chinese Consortium

2016 Translational andrology and urology

135. Might E-cadherin promoter polymorphisms of rs16260 and rs5030625 associate with the risk of nephrolithiasis? Full Text available with Trip Pro

urea nitrogen (BUN), creatinine and serum parathyroid hormone (PTH) as well as 24 h urine excretions of creatinine, Na, K, Cl, phosphate, Ca, Mg, citrate, oxalate, uric acid, albumin and BUN.Significant differences were found between rs16260 and the risk of nephrolithiasis. Patients having CA genotype of rs16260 CDH1 polymorphism were associated with an almost trifold increased risk for developing kidney stone than those with the AA genotype (95 % CI 1.08-7.28, OR 2.8, P = 0.033). We also found (...) (PCR-RLFP). Haplotype frequencies were also analyzed. To determine the association of rSNPs of CDH1 gene with the clinicopathological features of nephrolithiasis, nearly all possible etiological factors were documented. These factors were family history, gender, age, body mass index, liquid consumption, eating habits, tea-coffee and meat (oxalate rich) consumption, adequate physical activity, and all serum and urine levels-the serum levels of Na, K, Cl, phosphate, Ca, Mg, uric acid, albumin, blood

2016 SpringerPlus

136. Nephrolithiasis in elderly population; effect of demographic characteristics Full Text available with Trip Pro

to be the case group and other subjects without a history of kidney stones served as control group. Demographic and anthropometric data, smoking, diabetes and metabolic syndrome (MetS), calcium (Ca), vitamin D, parathyroid hormone (PTH), uric acid and urine pH were compared in both groups.In this study, 1390 elderly people with the mean age of 69.37 ± 7.42 years were evaluated which 202 (14.53%) cases had renal stones. The patients with nephrolithiasis were younger (P = 0.010) and had higher uric acid (...) Nephrolithiasis in elderly population; effect of demographic characteristics Kidney stone (nephrolithiasis) is one of the most common diseases. During the past several decades, its prevalence and incidence have increased markedly in elderly population.This study was conducted to evaluate the risk factors for nephrolithiasis in elderly population.This study was based on the Amirkola Health and Ageing Project (AHAP). Elderly people with kidney stones in every size, type and number were considered

2016 Journal of nephropathology

137. Nephrolithiasis as a Risk Factor for CKD: The Atherosclerosis Risk in Communities Study. Full Text available with Trip Pro

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 (...) 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.

2015 Clinical Journal of the American Society of Nephrology

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

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

2015 BJU international

139. Renal Calculi Full Text available with Trip Pro

Renal Calculi The pathogenesis of renal calculi is reviewed in general terms followed by the results of investigation of 439 patients with renal calculi studied by the author at Toronto General Hospital over a 13-year period. Abnormalities of probable pathogenetic significance were encountered in 76% of patients. Idiopathic hypercalciuria was encountered in 42% of patients, primary hyperparathyroidism in 11%, urinary infection in 8% and miscellaneous disorders in 8%. The incidence of uric acid (...) than in males. The efficacy of various measures advocated for the prevention of renal calculi is also reviewed. In the author's experience the administration of thiazides has been particularly effective in the prevention of calcium stones. Thiazides cause a sustained reduction in urinary calcium excretion and increase in urinary magnesium excretion. These agents also appear to affect the skeleton by diminishing bone resorption and slowing down bone turnover.

1970 Canadian Medical Association Journal

140. Uric Acid

is a metabolic-by-product of purine catabolism Uricase converts Uric Acid to allantoin in most mammals, but is dysfunctional in humans Uric Acid varies considerably with purine and intake, as well as III. Interpretation: Normal Uric Acid: 2-7 mg/dl IV. Interpretation: Increased (Hyperuricemia) See V. Interpretation: Decreased Medications High dose ASA s Renal tubule disease ( ) disease Protein or purine deficient diet Xanthine-oxidase deficiency Images: Related links to external sites (from Bing (...) Uric Acid Uric Acid Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Uric Acid Uric Acid Aka: Uric Acid II. Physiology Uric Acid

2015 FP Notebook

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