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Urine changing from clear to milky-white. After sedation with propofol a young man developed milky-white urine. Urinalysis showed a high concentration of uricacid crystals as being responsible. This phenomenon appears to be dose-dependent and is explained in this report. Since it is harmless and self-limiting no extensive analysis is needed when observed.
Renal ammonium excretion after an acute acid load: Blunted response in uricacid stone formers but not in patients with type 2 diabetes. Idiopathic uricacid nephrolithiasis is characterized by elevated urinary net acid excretion and insufficient buffering by ammonium, resulting in excessively acidicurine and titration of the relatively soluble urate anion to insoluble uricacid. Patients with type 2 diabetes have similar changes in urinary pH, net acid excretion, and ammonium in 24-h urine (...) on a fixed diet for 5 days, subjects were given a single oral acid load (50 meq ammonium chloride), and urine was collected hourly for 4 h. Uricacid stone formers had a lower ammonium excretory response to acute acid loading compared with diabetic and nondiabetic nonstone formers, suggesting that an ammonium excretory defect unique to uricacid stone formers was unmasked by the acid challenge. The Zucker diabetic fatty rat also did not show impaired urinary ammonium excretion in response to acute acid
Urinary excretion of calcium, magnesium, phosphate, citrate, oxalate, and uricacid by healthy schoolchildren using a 12-h collection protocol. Improving knowledge about normal urine composition in children is important for early prevention of lithiasis. We describe urinary excretion values of calcium (Ca), magnesium (Mg), phosphate (P), citrate (Cit), uricacid (Ur), and oxalate (Ox) in healthy children with and without a family history of lithiasis, using a 12-h urine collection (...) to an increased risk of lithiasis was more common in children with a family history.We report data from urine samples collected by using a simplified collection protocol. The observed differences between children with and without a family history of lithiasis could justify that in population studies aimed at setting reference values, the former are excluded.
Urinary excretion of calcium, magnesium, phosphate, citrate, oxalate, and uricacid by healthy schoolchildren using a 12-h collection protocol. Although we do not have reliable data for the true prevalence of urolithiasis during childhood, the number of patients seen in outpatient clinics and admitted for stone-related problems is steadily increasing worldwide. As for most pediatric patients a metabolic disease is the reason for stone development, because a high number of patients have severely (...) recurrent urolithiasis, early and proper diagnostic evaluation is necessary to begin adequate and preventive treatment. However, diagnostic evaluation, especially in infants and younger children, is not always easy, and frequently a diagnosis is made late. Diagnostic evaluation should start with repeated urine analysis; but how and which urine should be collected and analyzed? What is the best and most accurate method for urine collection? In a paper published in a recent issue of Pediatric Nephrology
Serum uricacid level is associated with the development of microalbuminuria in Korean men. Elevated serum uricacid (UA) could be a risk factor for hypertension, type 2 diabetes mellitus and cardiovascular disease. In addition, elevated serum UA may be associated with impaired renal function. However, it is unclear whether elevated serum UA is a cause of microalbuminuria or not. Therefore, we performed a prospective cohort study of the temporal relationship between baseline elevated serum UA (...) and the development of microalbuminuria in Korean men.A microalbuminuria-free cohort of 1743 healthy Korean men, who had their urine albumin-creatinine ratio (UACR) calculated for a medical check-up programme in 2005, was followed until 2010. Microalbuminuria was defined as a urine albumin-creatinine ratio between 30 and 300 μg/mg. Cox proportional hazards model was performed.During 5884.6 person-years of follow-up, 96 incident cases of microalbuminuria developed between 2006 and 2010. After adjusting
of interstitium or ESRD from interstitial fibrosis and tubular atrophy (IF/TA) in the Angiotensin II Blockade for Chronic Allograft Nephropathy (ABCAN) Trial participants. Subjects underwent uricacid, iothalamte GFR, and urine albumin to creatinine (ACR) measurements annually for 5 years in addition to an allograft biopsy at baseline and 5 years.Baseline uricacid was 5.57±1.48 mg/dL; male sex, higher BMI, diuretic use, and lower GFR were associated with higher uricacid, whereas older age, less than 3 HLA (...) Uricacid and allograft loss from interstitial fibrosis/tubular atrophy: post hoc analysis from the angiotensin II blockade in chronic allograft nephropathy trial. Uricacid has been linked to the progression of native kidney disease. Studies evaluating its contribution to allograft function in kidney transplant recipients, among whom hyperuricemia is common, have yielded mixed results.We evaluated the association between baseline uricacid and the primary composite outcome of doubling
Sleeve gastrectomy reduces xanthine oxidase and uricacid in a rat model of morbid obesity. Serum uricacid (sUA) plays a major role in the development of morbidities associated with obesity, especially cardiovascular diseases. Within the purine pathway, xanthine oxidase (XOD) represents the key enzyme. The aim of this study was to investigate the dynamics of sUA and XOD following sleeve gastrectomy (SG) in a rat model of high-fat-diet (HFD) induced obesity.Over a period of 11 weeks, 30 rats (...) received a HFD, and 10 rats received a low fat diet (LFD). Thereafter, 10 randomly selected HFD rats and 10 LFD rats were sacrificed. The remaining 20 HFD rats were randomly assigned to either SG or sham operation (SH) and studied 14 days postoperatively.The white adipose tissues (WAT) from visceral (intestinal and retroperitoneal) and inguinal (subcutaneous) depots were collected. sUA and urine UA (uUA) were measured by high performance liquid chromatography-mass spectrometry (HPLC-MS/MS). Abundance
Evaluate the Efficacy and Safety of Arhalofenate for Preventing Flares and Reducing Serum UricAcid in Gout Patients Evaluate the Efficacy and Safety of Arhalofenate for Preventing Flares and Reducing Serum UricAcid 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 UricAcid 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
adjusted for age, body mass index, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, uricacid, creatinine and antidiabetic agent use showed significant associations between low urine pH and both high fasting plasma glucose and high glycated hemoglobin levels (P for trend = 0.0260, 0.0075) in men. Furthermore, after the same adjustments, prevalence rates of abnormal glucose tolerance (≥6.11 mmol/L and ≥6.99 mmol/L), increased significantly as urine pH levels decreased (P (...) Relationship between urine pH and abnormal glucose tolerance in a communityâ€based study The association between urine pH and abnormal glucose tolerance in men and women is unclear; therefore, we carried out a community-based, cross-sectional study to investigate sex-specific associations between these values, possible indicators of prediabetes and type 2 diabetes.We enrolled 4,945 Japanese individuals (2,490 men and 2,455 women), who had undergone annual health checkups. To investigate
-to-severe hypertension, hypokalemia, serum Na minus Cl at least 40 mmol/l, serum uricacid 237.92 μmol/l or less (4.0 mg/dl), and urine pH (U-pH) at least 7.0, in consecutive outpatients newly diagnosed with hypertension. The diagnostic criteria of primary aldosteronism were plasma aldosterone concentration-to-plasma renin activity ratio [ARR, (ng/dl)/(ng/ml per h)] at least 20 and at least one positive result in four types of challenge tests.Of 130 patients, 24 were diagnosed with primary aldosteronism (...) Screening of primary aldosteronism by clinical features and daily laboratory tests: combination of urine pH, sex, and serum K. To develop and validate a scoring system for selection of patients who should proceed to endocrinologic examinations of primary aldosteronism in newly diagnosed hypertensive patients.A multivariate logistic regression analysis for primary aldosteronism was undertaken by use of seven possible primary aldosteronism markers, age less than 40 years, female sex, moderate
Can a Simplified 12-Hour Night Time Urine Collection Predict Urinary Stone Risk? To determine if there is correlation between nighttime 12-hour and traditional 24-hour urine collection in regard to chemistry values and the supersaturations of calcium oxalate, calcium phosphate, and uricacid for the metabolic evaluation of nephrolithiasis.Ninety-five patients were prospectively enrolled from 2013 to 2015. Patients >18 years of age who presented to a tertiary stone clinic and who would normally (...) be counseled for 24-hour urine collection were eligible for the study. Participants completed 24-hour urine collections twice, with each divided into 2 separate 12-hour collections. Day-time collection began after the first morning void and continued for 12 hours. The night collection proceeded for the next 12 hours through the first morning void.Forty-nine 24-hour samples from 35 patients met inclusion criteria and were included in the analysis. Overall, there was strong correlation between the night 12
Relative Supersaturation of 24-hour Urine and Likelihood of Kidney Stones. The relative supersaturation of calcium oxalate, calcium phosphate and uricacid is used clinically in kidney stone prevention. The magnitude of the association between relative supersaturation and stone risk requires further quantification.We performed a cross-sectional study using 24-hour urine collections from the NHS (Nurses' Health Study) I and II, and HPFS (Health Professionals Follow-up Study) cohorts to quantify (...) the association between the relative supersaturation of calcium oxalate, calcium phosphate and uricacid, and the likelihood of stone formation.The OR of being a stone former was 5.85 (95% CI 3.40-10.04) in NHS I, 6.38 (95% CI 3.72-11.0) in NHS II and 6.95 (95% CI 3.56-13.6) in HPFS for the highest category of calcium oxalate relative supersaturation compared with less than 1.0. The OR of being a stone former was 1.86 (95% CI 0.94-3.71) in NHS I, 4.37 (95% CI 2.68-7.10) in NHS II and 3.59 (95% CI 2.04-6.31
uricacid and high-sensitivity C-reactive protein, estimated glomerular filtration rate, and smoking and drinking status). Using multiple logistic regression analyses, adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for MetS incidence were calculated across urine pH categories. Path analysis was used to determine the relationship between MetS and urine pH.Subjects with MetS had significantly lower urine pH (5.9 ± 0.7) than those without MetS (6.0 ± 0.7) (p < 0.001). Partial (...) Fasting Single-Spot Urine pH Is Associated with Metabolic Syndrome in the Japanese Population To investigate the relationship between urine pH and metabolic syndrome (MetS) and its components, while controlling for covariates.This cross-sectional study was conducted on 5,430 Japanese subjects (4,691 without MetS; 739 with MetS) undergoing health assessments. Partial correlation analysis and analysis of covariance were used for controlling confounding parameters (age, gender, levels of serum
Acid [ Time Frame: Baseline up to 24 weeks ] Test parameter UricAcid shall be measured at the local laboratory Change from baseline in health status as measured through EuroQol 5 Dimension 5 Level Health State Utility Index (EQ-5D-5L) questionnaire [ Time Frame: Baseline up to 24 weeks ] The EQ-5D-5L Questionnaire consists of 5 domains: mobility, self-care, usual activities, pain/discomfort, anxiety/depression Change from baseline in health status as measured through EuroQol-Visual Analogue Scale (...) A Study to Evaluate the Renal Protective Effect (Urine Albumin-to-Creatinine Ratio (UACR)), Efficacy and Safety of Ipragliflozin in Type 2 Diabetes Mellitus Patients With Albuminuria A Study to Evaluate the Renal Protective Effect (Urine Albumin-to-Creatinine Ratio (UACR)), Efficacy and Safety of Ipragliflozin in Type 2 Diabetes Mellitus Patients With Albuminuria - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration
found to be consistent with our selection criteria. However, only 8 studies were included in quantitative analysis, due to data availability. The present study showed a higher increased in urine pH for citrus-based products (mean difference, 0.16; 95% CI 0.01-0.32) and urinary citrate (mean difference, 124.49; 95% CI 80.24-168.74) compared with a control group. However, no differences were found in urine volume, urinary calcium, urinary oxalate, and urinary uricacid. From subgroup analysis, we (...) Effect of citrus-based products on urine profile: A systematic review and meta-analysis. Background. Urolithiasis is a disease with high recurrence rate, 30-50% within 5 years. The aim of the present study was to learn the effects of citrus-based products on the urine profile in healthy persons and people with urolithiasis compared to control diet and potassium citrate. Methods. A systematic review was performed, which included interventional, prospective observational and retrospective
at the glomerulus. An active anion-exchange process in the early proximal convoluted tubule reabsorbs most of it. Most urinary uricacid appears to be derived from tubular secretion, possibly from the S2 segment of the proximal tubule. Overall, 98-100% of filtered urate is reabsorbed; 6-10% is secreted, ultimately appearing in the final urine. Several factors influence the renal handling of urate. Many medications can affect the renal transport of uricacid through effects of proximal tubular absorption (...) calculi in the United States, also result from uricacid precipitation in the collecting system. Uricacid stones are related to uricacid exceeding its solubility in the urine; thus, patients with hyperuricosuria have an increased risk of uricacid nephrolithiasis. Urine oversaturation with uricacid and subsequent crystal formation is determined largely by urinary pH. Individuals who form uricacid stones tend to excrete less ammonium, which contributes directly to low urinary pH. In addition
, urinary excretion of hypoxanthine and xanthine increases. Hypoxanthine is highly soluble and does not cause clinical problems. Xanthine is less soluble than uricacid, and precipitated xanthine can be found in the urine of persons taking allopurinol. However, these precipitates do not correlate with renal failure, although well-documented cases of xanthine nephropathy do exist. Allopurinol has been used extensively in the prevention of acute uricacid nephropathy in patients with malignancy who (...) . If the patient is well hydrated and not maintaining the expected urine output, diuretics should be initiated. If the urine output remains low, adjust the fluid intake to match the output in order to avoid fluid overload. Although evidence confirming its role is lacking, urinary alkalinization should, theoretically, increase uricacid solubility. In animal studies, high tubular flow rates were the most important factor in preventing uricacid and urate crystallization, with urinary alkalinization playing only
precipitation in metastable urine concentrates (see ). Uricacid stones. The terms gouty nephropathy, urate nephropathy, and uricacid nephropathy are used to describe renal insufficiency due to uricacid precipitation within the renal tubules. Uricacid urolithiasis or uricacid 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 Uricacid is a weak acid, with an ionization constant of acid (pK (...) in urine exceeds its solubility at the urine pH, uricacid changes from a compound dissolved in solution to an insoluble precipitate. Urate stones are formed by 1 of 3 general mechanisms: overproduction, increased tubular secretion, or decreased tubular reabsorption. Uricacid results as a relatively insoluble end-product of purine metabolism. The concentration of uricacid in plasma depends on dietary ingestion, de novo purine synthesis, and uricacid elimination by the kidneys and intestine. Normal
Stones Treatment & Management Updated: Jun 11, 2018 Author: Sahar Fathallah-Shaykh, MD; Chief Editor: Craig B Langman, MD Share Email Print Feedback Close Sections Sections UricAcid Stones Treatment Medical Care The primary treatments are to alkalinize (citrate or bicarbonate) and dilute (large water intake) the urine. Sodium urate is 15 times more soluble than uricacid. At a urine pH level of 6.8, 10 times as much sodium urate as uricacid is present. At a urine pH level of 7.8, 100 times as much (...) if necessary. A urine Gram stain may guide in the selection of antibiotic coverage. Consultation with a pediatric urologist should be obtained because surgery may be necessary to provide drainage. A child with acute pain and large stones (>0.3 cm) is likely to require lithotripsy or surgical stone removal. Analgesics and adequate hydration should be provided. For smaller stones or incidental stones, allowing time for the stone to pass is appropriate. The primary treatment for uricacid stones includes