allopurinol and Hypercalcemia

Topics: Allopurinol; Chemical and Drug Induced Liver Injury; Diabetes Mellitus, Type 2; Diuretics; Fever; Furosemide; Gout Suppressants; Granuloma; Humans; Hypercalcemia; Hyperuricemia; Male; Middle Aged

Calcium stones arise from imbalances between urinary excretions of insoluble salts and water. Idiopathic hypercalciuria and hyperparathyroidism are the calcium disorders usually associated with elevated levels of calcium in the urine. Renal tubular acidosis is associated with a disordered acid-base status that results in low urine citrate. Hypocitraturia itself is a cause of calcium stones because it leaves urine calcium free to complex with either oxalate or phosphate. Elevated urine oxalate is commonly associated with dietary excesses, bowel disease, and, rarely, primary hyperoxaluria. Hyperuricosuria, usually of dietary origin, when reversed can cause a fall in new calcium stones.

Topics: Allopurinol; Antimetabolites; Benzothiadiazines; Clinical Trials as Topic; Diuretics; Humans; Hypercalcemia; Hyperparathyroidism; Prognosis; Sodium Chloride Symporter Inhibitors; Urinary Calculi

Calcium oxalate uroliths are commonly called metabolic uroliths because they are sequelae of a variety of metabolic abnormalities that alter the composition of body fluids and urine. Factors incriminated in the etiopathogenesis of calcium oxalate urolithiasis include hypercalciuria, hyperoxaluria, and hyperuricosuria. The predominant type of calcium oxalate urolith encountered in dogs is the monohydrate form; however, the dihydrate form may also occur. Male dogs have been more frequently affected than female dogs. Medical therapy should be formulated with the goal of reducing urine concentration of calculogenic substances.

Topics: Allopurinol; Animals; Benzothiadiazines; Calcium Oxalate; Cellulose; Citrates; Crystallization; Diuretics; Dog Diseases; Dogs; Hypercalcemia; Magnesium; Methylene Blue; Phosphates; Sodium Chloride Symporter Inhibitors; Uric Acid; Urinary Calculi

Kidney stones are common, and most of them are of the calcium oxalate type. Metabolic evaluation ranging from extensive to cursory has been recommended by different experts; however, some evaluation does seem warranted, even if only a single stone has occurred. Crystallographic analysis of the stone, if recovered, and measurement of urinary excretion of calcium and uric acid are indicated. Blood chemistries, measurement of urine pH, and measurement of urinary constituents besides calcium and uric acid are probably indicated as well, but controversy exists as to whether classification of hypercalciuria is necessary for management of most patients. Most, but not all, of the literature supports the use of thiazides to prevent calcium oxalate stones and the use of allopurinol in those calcium stone formers who have hyperuricosuria. In fact, allopurinol appears to be useful in patients with calcium stones even if no metabolic abnormality is discovered.

Topics: Allopurinol; Benzothiadiazines; Calcium Oxalate; Diuretics; Humans; Hydrogen-Ion Concentration; Hypercalcemia; Nephrocalcinosis; Phosphates; Sodium Chloride Symporter Inhibitors; Uric Acid

Topics: Acidosis; Acute Kidney Injury; Allopurinol; Aluminum Hydroxide; Burkitt Lymphoma; Child; Humans; Hypercalcemia; Hyperlipidemias; Hypertension, Renal; Hypoglycemia; Lymphoma; Male; Mannitol; Metabolic Diseases; Phosphorus Metabolism Disorders; Uric Acid; Xanthines

Topics: Acidosis, Renal Tubular; Bacterial Infections; Citrates; Crystallization; Cystinuria; Diphosphates; Female; Gastrointestinal Diseases; Humans; Hypercalcemia; Hyperparathyroidism; Magnesium; Male; Metabolism, Inborn Errors; Mucoproteins; Oxalates; Quaternary Ammonium Compounds; Sarcoidosis; Solubility; Uric Acid; Urinary Calculi; Vitamin D; Xanthine Oxidase

To evaluate, by means of a prospective randomized study, the efficacy of cinacalcet in the forms of nephrolithiasis associated with primary hyperparathyroidism in both the hypercalcemic and normocalcemic variant.. Ten patients suffering from active nephrolithiasis associated with primary hyperparathyroidism (4 hypercalcemics and 6 normocalcemics), equally divided between males and females, were randomly but not blindly addressed to treatment with potassium citrate and allopurinol, or to the same therapeutic regimen in combination with cinacalcet. The dosage of cinacalcet was optimized for each patient in order to obtain a reduction of parathyroid hormone (PTH) within normal limits while enabling the maintenance of adequate calcemic values. All study participants were given the same diet based on a reduction in sodium intake, oxalate-rich foods and animal protein with standardized intake of calcium and an increase in hydration. After a follow up period of 10 months , cinacalcet was associated to standard therapy and diet in patients who were not taken it, conversely cinacalcet was withdrawn in the remaining patients who remained on standard therapeutic regimen and diet. Follow up was continued for a second period of observation of the same duration of the first.. At the end of the period of treatment with cinacalcet, for both variants of hyperparathyroidism, a statistically significant reduction in the overall number and in the diameter of renal stones was found.. This prospective randomized study shows the effectiveness of cinacalcet used in combination with a diet with normalized calcium intake, in reducing the number and size of urinary stones in hypercalemic and normocalcemic forms of primary hyperparathyroidism.

Topics: Aged; Allopurinol; Calcimimetic Agents; Cinacalcet; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Hypercalcemia; Hyperparathyroidism, Primary; Male; Middle Aged; Naphthalenes; Nephrolithiasis; Pilot Projects; Potassium Citrate; Prospective Studies; Treatment Outcome

In clinical oncology emergency situations are either manifestations of the underlying disease or effects of the treatment. The successful treatment of emergency situations is not only important in diseases in which cure is possible. It contributes also essentially to an optimal palliation for not curable disease states in oncology. Some special examples from the point of view of internal medicine are briefly discussed.

Topics: Allopurinol; Bacterial Infections; Bleomycin; Cyclophosphamide; Emergencies; Fever; Fluid Therapy; Granulocytes; Humans; Hypercalcemia; Leukopenia; Lymphoma; Neoplasms; Spinal Cord Compression; Spinal Injuries; Spinal Neoplasms; Tetracyclines

Topics: Adenocarcinoma; Adult; Allopurinol; Antineoplastic Agents; Calcium; Cyclophosphamide; Fluorouracil; Humans; Hypercalcemia; Kidney Neoplasms; Liver Neoplasms; Lung Neoplasms; Lymphoma; Male; Middle Aged; Neoplasms; Plicamycin; Vincristine

Topics: Acute Kidney Injury; Adult; Aged; Allopurinol; Breast Neoplasms; Carcinoma; Emergencies; Estradiol; Female; Humans; Hypercalcemia; Male; Neoplasm Metastasis; Neoplasms; Uric Acid

Topics: Acidosis, Renal Tubular; Acute Kidney Injury; Aged; Allopurinol; Amyloidosis; Bence Jones Protein; Blood Viscosity; Bone Neoplasms; Diuretics; Humans; Hypercalcemia; Kidney; Kidney Diseases; Middle Aged; Multiple Myeloma; Myeloma Proteins; Pyelonephritis; Uremia; Uric Acid

Topics: Allopurinol; Antineoplastic Agents; Bone Resorption; Calcinosis; Humans; Hypercalcemia; Leukemia, Lymphoid; Male; Middle Aged; Parathyroid Glands; Pulmonary Alveoli; Pulmonary Edema; Spleen