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Uric Acid Nephrolithiasis

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121. Vitamin D deficiency is prevalent among idiopathic stone formers, but does correction pose any risk? (PubMed)

that baseline 24-h urinary measures related to stone risk expressed as concentration ratios over urine creatinine (Cr), such as U. Calcium/Cr, U. Oxalate/Cr, U. Citrate/Cr, and U. Uric acid/Cr were not significantly different. VitD3 supplementation did significantly increase serum 25-OH vitD levels and U. Phosphate/Cr ratios, as well as reduce serum parathyroid hormone (PTH) concentrations. Following vitD3 supplementation, there was an overall rise in 24-h urine calcium excretion, but it failed to reach (...) Vitamin D deficiency is prevalent among idiopathic stone formers, but does correction pose any risk? While vitamin D (vitD) deficiency is thought to contribute to poor health in a variety of ways and should be corrected, there is still concern about giving vitD supplements to patients with a history of nephrolithiasis. The aim is to study the prevalence of vitD deficiency and the effect on stone risk of cholecalciferol (vitD3) supplementation in a cohort of idiopathic stone formers (ISF). We

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2016 Urolithiasis

122. Pegloticase for chronic gout. (PubMed)

%, 52% and 62%. Percent time without hyperuricemia (uric acid below 6 mg/dl) was 78%, 92%, 76% and 76% respectively. No between dose differences were noted. Most common adverse events (10% or more patients) included nephrolithiasis, arthralgia, anemia, dyspnea, headache, muscle spasms, nausea and pyrexia. 89% reported one or more gout flares during the study. Pain, patient/physician global, function, quality of life, tophus size/regression and radiographic progression were not reported (...) Pegloticase for chronic gout. Pegloticase is a potential new treatment option for patients with chronic gout intolerant to other urate-lowering therapies.To assess safety (adverse events, death) and efficacy (pain, function, frequency of flares, quality of life, uric acid level, radiographic damage) of pegloticase in various doses or as compared to placebo or other interventions for treatment of hyperuricemia in patients with chronic gout.We searched six databases: The Cochrane Central Register

2010 Cochrane

123. Gout

Gout Gout - NICE CKS Clinical Knowledge Summaries Share Gout: Summary Gout is a disorder of purine metabolism characterized by a raised uric acid level in the blood (hyperuricaemia) and the deposition of urate crystals in joints and other tissues. The natural history of gout can occur in three distinct phases: A long period of asymptomatic hyperuricaemia. A period during which acute attacks of gouty arthritis are followed by variable intervals (months to years) when there are no symptoms (...) if: The diagnosis is uncertain. There is an underlying systemic illness. Gout occurs during pregnancy or in a person under 30 years of age. There are persistent symptoms despite treatment. ULT is required but allopurinol and febuxostat are not tolerated, contraindicated or inadequate in lowering serum uric acid levels to target. Complications are present. The person is at risk of adverse effects of drug treatment. Have I got the right topic? Have I got the right topic? From age 16 years onwards. This CKS topic

2015 NICE Clinical Knowledge Summaries

124. Olodaterol inhalation solution (Striverdi Respimat)

) Chronic obstructive pulmonary disease 20 (1.8) 18 (1.6) 38 (1.7) Acute respiratory failure 0 (0.0) 5 (0.4) 5 (0.2) Pulmonary hypertension 1 (0.1) 1 (0.1) 2 (0.1) Respiratory failure 1 (0.1) 1 (0.1) 2 (0.1) Gastrointestinal disorders 5 (0.4) 7 (0.6) 12 (0.5) Gastritis 1 (0.1) 1 (0.1) 2 (0.1) Intestinal obstruction 1 (0.1) 1 (0.1) 2 (0.1) Esophagitis 1 (0.1) 1 (0.1) 2 (0.1) Renal and urinary disorders 3 (0.3) 3 (0.3) 6 (0.3) Nephrolithiasis 2 (0.2) 0 (0.0) 2 (0.1) Renal failure acute 1 (0.1) 2 (0.2) 3

2014 FDA - Drug Approval Package

125. Endocrine and Nutritional Management of the Post-Bariatric Surgery Patient

to maintain body composition and mobility, improve blood lipids and lipoproteins, and help to control food intake ( – ). Modular protein supplements can be sorted into four categories: 1) protein concentrates derived from a complete protein such as milk, soy, or eggs; 2) protein concentrates derived from collagen, either alone or in combination with a complete protein; 3) doses of one or more dispensable (nonessential) amino acids; and 4) hybrids of the complete or collagen-based proteins and amino acid (...) dose. Modular protein supplements are generally provided either as a substrate for protein synthesis or as a source of one or more amino acids that may be conditionally indispensable (conditionally essential) ( ). Hospitalization with initiation of parenteral nutrition support may be required ( ) in cases of severe protein deficiency, but there are no currently accepted guidelines or clinical studies guiding nutritional therapy after weight loss surgery. Nutritional support with parenteral

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2010 The Endocrine Society

126. Evaluate the Effect of ALLN-177 in Reducing Urinary Oxalate in Patients With Secondary Hyperoxaluria and Kidney Stones Over 28 Days

Ages Eligible for Study: 18 Years and older (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: History of enteric or idiopathic hyperoxaluria or kidney stones Urinary oxalate ≥ 50 mg/24 hours Exclusion Criteria: Hyperuricosuria Glomerular filtration rate < 45 mL/min/1.73m2 Hypercalcemia or hyperthyroidism Autoimmune disorder requiring systemic steroids Acute renal colic, primary hyperoxaluria, pure uric acid and/or cysteine stones, renal (...) Hyperoxaluria Nephrolithiasis Hyperoxaluria Kidney Stones Dietary Hyperoxaluria Drug: ALLN-177 Drug: Placebo Phase 2 Detailed Description: This is a multicenter, randomized, double-blind, placebo controlled study to evaluate the efficacy of ALLN 177 compared with placebo in reducing the urinary excretion of oxalate in subjects with secondary hyperoxaluria and kidney stones. ALLN-177 is an orally administered form of oxalate decarboxylase. The goal of therapy with ALLN-177 is to reduce urinary oxalate

2015 Clinical Trials

127. Evaluate the Effect of ALLN-177 in Reducing Urinary Oxalate in Patients With Hyperoxaluria and Kidney Stones

urosepsis, renal failure, renal tubular acidosis, primary hyperparathyroidism, primary hyperoxaluria, pure uric acid and cystine stones, and/or medullary sponge kidney Treatment with cholestyramine Average daily dietary intake of oxalate <75 mg per day 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 staff using the contact information provided by the sponsor. Please refer to this study by its (...) Posted : January 11, 2018 Sponsor: Allena Pharmaceuticals Information provided by (Responsible Party): Allena Pharmaceuticals Study Details Study Description Go to Brief Summary: The purpose of this study is to evaluate the safety, tolerability, and efficacy of different doses of ALLN 177 for reducing urinary oxalate excretion in patients with secondary hyperoxaluria and recurrent kidney stones. Condition or disease Intervention/treatment Phase Secondary Hyperoxaluria Nephrolithiasis Kidney Stones

2015 Clinical Trials

128. Renal Calculi: An Unusual Presentation of T-Cell Acute Lymphoblastic Leukemia. (PubMed)

Renal Calculi: An Unusual Presentation of T-Cell Acute Lymphoblastic Leukemia. Spontaneous tumor lysis syndrome is a rare initial presentation of hematologic malignancy in children that typically presents with complications of electrolyte derangement, specifically hyperkalemia, hyperphosphatemia, and hyperuricemia. We report a case of a 5-year-old boy who presented to the emergency department with gross hematuria, abdominal pain, and vomiting and was ultimately diagnosed with uric acid (...) nephrolithiasis and acute renal failure secondary to spontaneous tumor lysis syndrome in the setting of T-cell acute lymphoblastic leukemia. Tumor lysis syndrome is considered an oncologic emergency, and in this case, the child required urgent treatment with potassium-binding agents, rasburicase, and hemodialysis. This case demonstrates that occult hematologic malignancy should be suspected in cases of nephrolithiasis and acute renal failure when found in conjunction with hyperuricemia despite a normal

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2015 Pediatrics

129. Prospective evaluation of urinary metabolic indices in severely obese adolescents after weight loss surgery. (PubMed)

total of 55 samples were analyzed from 14 severely obese adolescents and from 17 severely obese adolescents after bariatric surgery (RYGB, 10; SG, 7). Median body mass index was similar between the RYGB and SG groups. The median 24-hour excretion of oxalate was significantly elevated in the RYGB group. Calcium and uric acid excretion and the median supersaturation of calcium oxalate, calcium phosphate, and uric acid were similar among all groups.Elevated excretion of oxalate in the urine of severely (...) Prospective evaluation of urinary metabolic indices in severely obese adolescents after weight loss surgery. Observational studies in obese adults have found abnormal urinary metabolic indices that predispose to nephrolithiasis. Few studies have been performed in severely obese adolescents.To assess urinary stone risk factors in severely obese adolescents and in those undergoing 2 types of weight loss surgery.Children's hospital, United States.A prospective cross-sectional study was performed

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2015 Surgery for Obesity and Related Diseases

130. Effect of Potassium Citrate on Calcium Phosphate Stones in a Model of Hypercalciuria. (PubMed)

was collected at 6, 12, and 18 weeks. At 18 weeks, stone formation was visualized by radiography. Urine citrate, phosphate, oxalate, and pH levels were higher and urine calcium level was lower in rats fed potassium citrate. Furthermore, calcium oxalate and calcium phosphate supersaturation were higher with potassium citrate; however, uric acid supersaturation was lower. Both groups had similar numbers of exclusively calcium phosphate stones. Thus, potassium citrate effectively raises urine citrate levels (...) Effect of Potassium Citrate on Calcium Phosphate Stones in a Model of Hypercalciuria. Potassium citrate is prescribed to decrease stone recurrence in patients with calcium nephrolithiasis. Citrate binds intestinal and urine calcium and increases urine pH. Citrate, metabolized to bicarbonate, should decrease calcium excretion by reducing bone resorption and increasing renal calcium reabsorption. However, citrate binding to intestinal calcium may increase absorption and renal excretion of both

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2015 Journal of the American Society of Nephrology

131. Dietary Calcium Supplementation, Gut Permeability and Microbiota in Type 2 Diabetics

hormone, 25-dihydroxy vitamin D, calcium, fasting glucose, fasting insulin, fructosamine, hemoglobin, HbA1c, uric acid, triglycerides, cholesterol total and partial, lipopolysaccharide, inflammatory markers) will be evaluated at baseline and after 12 weeks. The statistical analysis will be performed with the use of SPSS software (SPSS Inc., Chicago, IL, 2008, version 17.0). Parametric or non-parametric tests will be applied, according to the distribution of variables (level of statistical significance (...) of recurrent nephrolithiasis Caffeine consumption of> 300 mg / day Pregnancy, lactation or postmenopausal Anemia Cardiovascular, infectious, inflammatory, thyroid, liver, kidney or intestinal disease Use of anti-inflammatory, antacids, antibiotics and laxatives drugs Major gastrointestinal surgery. 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 staff using the contact information provided

2015 Clinical Trials

132. The Predictors of Successful Oral Dissolution Therapy in Radiolucent Renal Stones; A Prospective Evaluation

table for MeSH terms Calculi Urolithiasis Kidney Calculi Nephrolithiasis Pathological Conditions, Anatomical Urologic Diseases Kidney Diseases Urinary Calculi Citric Acid Sodium Citrate Allopurinol Uric Acid Potassium Citrate Anticoagulants Calcium Chelating Agents Chelating Agents Sequestering Agents Molecular Mechanisms of Pharmacological Action Antimetabolites Enzyme Inhibitors Gout Suppressants Antirheumatic Agents Free Radical Scavengers Antioxidants Protective Agents Physiological Effects (...) alkalinization Potassium citrate 20 mEq three times daily Hyperuricosuric patients (24-hours urine uric acid more than 750 mg/day in male and more than 650mg/day in females), will receive Allopurinol, a competitive inhibitor of xanthine oxidase, in a dose of 300 mg daily. Life style modification Adequate fluid intake in order to maintain urine volume between 2-3 L per day. Dietary recommendations In hyperuricosuric patients (24-hours urine uric acid more than 750 mg/day in male and more than 650mg/day

2015 Clinical Trials

133. Stone formation and management after bariatric surgery. (PubMed)

Stone formation and management after bariatric surgery. Obesity is a significant health concern and is associated with an increased risk of nephrolithiasis, particularly in women. The underlying pathophysiology of stone formation in obese patients is thought to be related to insulin resistance, dietary factors, and a lithogenic urinary profile. Uric acid stones and calcium oxalate stones are common in these patients. Use of surgical procedures for obesity (bariatric surgery) has risen over (...) the past two decades. Although such procedures effectively manage obesity-dependent comorbidities, several large, controlled studies have revealed that modern bariatric surgeries increase the risk of nephrolithiasis by approximately twofold. In patients who have undergone bariatric surgery, fat malabsorption leads to hyperabsorption of oxalate, which is exacerbated by an increased permeability of the gut to oxalate. Patients who have undergone bariatric surgery show characteristic 24 h urine parameters

2015 Nature reviews. Urology

134. Evaluation and medical management of kidney stones in children. (PubMed)

composition to those that form in adulthood. Approximately 75% to 80% of stones are composed of predominantly calcium oxalate, 5% to 10% are predominantly calcium phosphate, 10% to 20% are struvite and 5% are pure uric acid. The recurrence rate of nephrolithiasis in patients with stones that form during childhood is poorly defined. Ultrasound should be used as the initial imaging study to evaluate children with suspected nephrolithiasis, with noncontrast computerized tomography reserved for those in whom (...) . Potassium citrate is a potentially effective medication for children with calcium oxalate stones and concomitant hypocitraturia, as well as children with uric acid stones. However, long-term compliance with therapy and the effect on decreasing stone recurrence in children are unknown. Based largely on efficacy in adult populations, thiazide diuretics should be considered in the treatment of children with calcium based stones and persistent hypercalciuria refractory to reductions in salt intake.The

2014 Journal of Urology

137. Evaluating the Effect of ALLN-177 to Reduce Urinary Oxalate Excretion in Calcium Oxalate Kidney Stone Formers With Hyperoxaluria

procedures History of enteric or idiopathic hyperoxaluria and at least one calcium oxalate kidney stone Hyperoxaluria >36mg of oxalate/24-hr May be taking drugs for the prevention of stone disease as long as there have been no changes in these medications for at least 3 months Exclusion Criteria: Uric acid ≥1.5g/24-hr Estimated glomerular filtration rate of < 60 mL/min Positive results from drug urine screen Requires daily vitamin C (defined as >10 days of >300 mg/day) Diagnosis of hypercalcemia (...) or hypothyroidism Obstructive uropathy, chronic urosepsis, renal failure, renal tubular acidosis, primary hyperparathyroidism, primary hyperoxaluria, pure uric acid and cystine stones, and/or medullary sponge kidney. Auto-immune disorder requiring high dose steroids or other immunosuppressant drugs. Subjects who are pregnant. Women of childbearing potential must have a negative pregnancy test prior to enrollment and must practice approved methods of birth control during the trial History of cancer diagnosis

2014 Clinical Trials

138. A Study In Healthy Elderly People To Evaluate Safety, Toleration, Pharmacokinetics and Pharmacodynamics of Multiple Oral Doses Of PF-06743649

Concentration (Tmax) [ Time Frame: up to 14 days ] Plasma Decay Half-Life (t1/2) [ Time Frame: up to 14 days ] Amount of drug recovered unchanged in urine during the dosing interval (Aetau) [ Time Frame: up to 14 days ] Percent of dose recovered unchanged in urine during the dosing interval(Aetau%) [ Time Frame: up to 14 days ] Renal clearance (CLr) [ Time Frame: up to 14 days ] Secondary Outcome Measures : Change from baseline in serum uric acid level [ Time Frame: up to 14 days ] Change from baseline (...) in serum levels of xanthine and hypoxanthine [ Time Frame: up to 14 days ] Urinary uric acid levels [ Time Frame: up to 14 days ] Urinary xanthine levels [ Time Frame: up to 14 days ] Urinary hypoxanthine levels [ Time Frame: up to 14 days ] Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study

2014 Clinical Trials

139. A Study In Healthy People To Evaluate Safety, Toleration, Pharmacokinetics And Pharmacodynamics Of Multiple Oral Doses Of PF-06743649

-Life (t1/2) [ Time Frame: up to 14 days ] Amount of drug recovered unchanged in urine during the dosing interval (Aetau) [ Time Frame: up to 14 days ] Percent of dose recovered unchanged in urine during the dosing interval(Aetau%) [ Time Frame: up to 14 days ] Renal clearance (CLr) [ Time Frame: up to 14 days ] Secondary Outcome Measures : Change from baseline in serum uric acid level [ Time Frame: up to 14 days ] Change from baseline in serum levels of xanthine and hypoxanthine [ Time Frame: up (...) to 14 days ] Urinary uric acid levels [ Time Frame: up to 14 days ] Urinary xanthine levels [ Time Frame: up to 14 days ] Urinary hypoxanthine levels [ Time Frame: up to 14 days ] Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using

2014 Clinical Trials

140. Fragmentation of Urinary Calculi in Vitro by Burst Wave Lithotripsy. (PubMed)

at the surface nearest to the transducer until the stone was disintegrated. All natural and artificial stones were fragmented at the highest focal pressure of 6.5 MPa with a mean treatment duration of 36 seconds for uric acid stones to 14.7 minutes for cystine stones. At a frequency of 170 kHz the largest artificial stone fragments were less than 4 mm. Exposure at 285 and 800 kHz produced only fragments less than 2 mm and less than 1 mm, respectively.Stone comminution with burst wave lithotripsy is feasible (...) as a potential noninvasive treatment method for nephrolithiasis. Adjusting the fundamental ultrasound frequency allows for stone fragment size to be controlled.Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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2014 Journal of Urology

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