oxalates and Dehydration

Historical studies have demonstrated that the prevalence of symptomatic nephrolithiasis is higher in patients with inflammatory bowel disease (IBD), compared to general population. The aim of the review was to analyze literature data in order to identify the main risk conditions described in literature and the proposed treatment.. A research on the databases PubMed, Medline, Embase and Google Scholar was performed by using the keywords "renal calculi/lithiasis/stones" and "inflammatory bowel diseases". A research on textbooks of reference for Pediatric Nephrology was also performed, with focus on secondary forms of nephrolithiasis.. Historical studies have demonstrated that the prevalence of symptomatic nephrolithiasis is higher in patients with inflammatory bowel disease (IBD), compared to general population, typically in patients who underwent extensive small bowel resection or in those with persistent severe small bowel inflammation. In IBD, kidney stones may arise from chronic inflammation, changes in intestinal absorption due to inflammation, surgery or intestinal malabsorption. Kidney stones are more closely associated with Crohn's Disease (CD) than Ulcerative Colitis (UC) in adult patients for multiple reasons: mainly for malabsorption, but in UC intestinal resection may be an additional risk. Nephrolithiasis is often under-diagnosed and might be a rare but noticeable extra-intestinal presentation of pediatric IBD. Secondary enteric hyperoxaluria the main risk factor of UL in IBD, this has been mainly studied in CD, whether in UC has not been completely explained. In the long course of CD recurrent urolithiasis and calcium-oxalate deposition may cause severe chronic interstitial nephritis and, as a consequence, chronic kidney disease. ESRD and systemic oxalosis often develop early, especially in those patients with multiple bowel resections. Even if we consider that many additional factors are present in IBD as hypomagnesuria, acidosis, hypocitraturia, and others, the secondary hyperoxaluria seems to finally have a central role. Some medications as parenteral vitamin D, long-term and high dose steroid treatment, sulfasalazine are reported as additional risk factors. Hydration status may also play an important role in this process. Intestinal surgery is a widely described independent risk factor. Patients with ileostomy post bowel resection may have relative dehydration from liquid stool, which, added to the acidic pH from bicarbonate loss, is responsible for this process. In this acidic pH, the urinary citrate level excretion reduces. The stones most commonly seen in these patients contain uric acid or are mixed. In addition, the risk of calcium containing stones also increases with ileostomy. The treatment of UL in IBD involves correction of the basic gastrointestinal tract inflammation, restricted dietary oxalate intake, and, at times, increased calcium intake. Citrate therapy that increases both urine pH and urinary citrate could also provide an additional therapeutic benefit. Finally, patients with IBD in a pediatric study had less urologic intervention for their calculosi

Topics: Bicarbonates; Child; Citrates; Dehydration; Disease Susceptibility; Humans; Inflammation; Inflammatory Bowel Diseases; Malabsorption Syndromes; Oxalates; Risk; Urolithiasis

Urolithiasis is a condition that can cause significant morbidity among patients. Dietary manipulations traditionally advised include fluid, protein, oxalate, calcium, citrate, and sodium changes in the diet. Evidence-based practice guidelines suggest that there is not ample evidence to confidently recommend dietary changes, since inadequate studies have been done to quantify the risks of diet in stone formation. While fluid intake patterns have the weightiest evidence in the literature, not even fluid intake meets the guidelines for evidence-based practice. Health care providers should recognize that current patient education is largely based on intuition. It behooves us as clinicians to look critically at all our practices, review the available literature, and question what we believe we know. A summary of available literature is provided to guide the clinician in educating patients in reducing their risk of recurrent calcium oxalate stone disease.

Topics: Ascorbic Acid; Calcium Oxalate; Calcium, Dietary; Citrates; Dehydration; Diet, Protein-Restricted; Diet, Sodium-Restricted; Evidence-Based Medicine; Feeding Behavior; Fluid Therapy; Humans; Information Services; Internet; Kidney Calculi; Nurse's Role; Nutritional Sciences; Obesity; Oxalates; Patient Education as Topic; Phytotherapy; Practice Guidelines as Topic; Recurrence; Risk Factors

Topics: Amino Acids; Biological Transport; Calcium Oxalate; Cystinuria; Dehydration; Digestive System; Glutamine; Hartnup Disease; Humans; Kidney Calculi; Niacinamide; Oxalates; Solubility; Tryptophan

Topics: Adult; Aged; Calcium; Cross-Sectional Studies; Dehydration; Drinking; Female; Humans; Kidney Calculi; Male; Metallurgy; Middle Aged; Occupational Exposure; Osmolar Concentration; Oxalates; Pilot Projects; Prevalence; Risk Factors; Sodium; Uric Acid; Urine

In this study, ferrous oxalate dihydrate polymorph particles, α- and β-phases, with square bipyramidal and quadratic prismatic shapes, respectively, were synthesized. Thermal dehydration of the samples was subjected to kinetic study as a typical reaction that indicates a significant induction period and a sigmoidal mass-loss behavior. On the basis of the formal kinetic analysis of the mass-loss traces recorded under isothermal, nonisothermal, and constant transformation rate conditions and the morphological observations of the surface textures of the partially reacted sample particles, a combined kinetic model for the induction period-surface reaction-phase boundary reaction was developed. The sigmoidal mass-loss behavior after the significant induction period under isothermal conditions was satisfactorily simulated by the combined kinetic model. The kinetic parameters for the component processes of induction period, surface reaction, and phase boundary reaction were separately determined from the kinetic simulation. The differences in the kinetic behaviors of the induction period and the phase boundary reaction between α- and β-phase samples were well described by the kinetic parameters. The applicability of the combined kinetic model to practical systems was demonstrated through characterizing the physicogeometrical kinetics of the thermal dehydration of ferrous oxalate dihydrate polymorphs.

Topics: Dehydration; Ferrous Compounds; Kinetics; Models, Chemical; Oxalates; Particle Size; Polymers; Surface Properties; Temperature; Water

A study was made of 819 patients attending a metabolic stone clinic. A firm diagnosis was made in 708 (86%) and in 132 of these (19%) the diagnosis was thought to be chronic dehydration. The records were available for study for 87 males and 11 females in the chronic dehydration group. The mean age at presentation was 43 years. The causes of chronic dehydration were hot climate (62%), with hot occupation and low water intake almost equal in second place. In patients with a single cause of chronic dehydration, 57% also had a dietary risk factor for urolithiasis and this was most commonly high oxalate intake. Following dietary advice, the mean urinary volume increased from 1720 to 2475 ml/24 h. This was accompanied by a rise in mean urinary calcium from 6.02 to 6.96 mmol/24 h, presumably due to the calcium in the additional water drunk. Urinary oxalate did not change significantly. The mean follow-up time was 4.85 years and the stone recurrence rate was low. It was concluded that chronic dehydration is a common cause of urolithiasis; this can be treated satisfactorily by increasing water intake plus dietary advice in certain cases.

Topics: Adult; Calcium; Chronic Disease; Dehydration; Diet; Drinking; Female; Follow-Up Studies; Hot Temperature; Humans; Male; Occupations; Osmolar Concentration; Oxalates; Risk Factors; Sports; Urinary Calculi

Topics: Animals; Calcium; Calcium Oxalate; Calcium Phosphates; Cyclic AMP; Cystine; Cystinuria; Dehydration; Diet; Humans; Hydrogen-Ion Concentration; Hyperparathyroidism; Kidney Calculi; Male; Oxalates; Risk; Uric Acid; Urine

Topics: Acid-Base Equilibrium; Acute Disease; Aged; Anuria; Autopsy; Brain; Calcium; Dehydration; Glycols; Humans; Hydrogen-Ion Concentration; Kidney Tubules; Male; Oxalates; Peritoneal Dialysis; Poisoning