oxalates and Gout

Selective medical therapy of nephrolithiasis is highly effective in preventing new stone formation. A remission rate of greater than 80% and an overall reduction in individual stone formation rate of greater than 90% can be obtained in patients with nephrolithiasis. In patients with mild to moderate severity of stone disease, virtually total control of stone disease can be achieved with a remission rate of greater than 95%. The need for stone removal may be dramatically reduced by an effective prophylactic program (Fig 6). Selective pharmacological therapy of nephrolithiasis also encompasses the advantages of overcoming nonrenal complications as well as averting certain side effects that may be caused by nonselective medical therapy. Despite these advantages, it is clear that selective medical therapy cannot provide total control of stone disease. A satisfactory response requires continued, dedicated compliance by patients to the recommended program and a commitment by the physician to provide long-term follow-up and care.

Topics: Calcium; Citrates; Citric Acid; Combined Modality Therapy; Diagnosis, Differential; Diuretics; Gout; Humans; Kidney Calculi; Magnesium; Magnesium Compounds; Oxalates; Oxalic Acid; Parathyroidectomy; Phosphates; Struvite; Uric Acid

Topics: Calcium Pyrophosphate; Crystallization; Gout; Humans; Inflammation; Lipid Metabolism; Oxalates; Oxalic Acid; Rheumatic Diseases; Synovial Fluid

Topics: alpha 1-Antitrypsin Deficiency; Amyloidosis; Bone Marrow Transplantation; Fabry Disease; Gaucher Disease; Genetic Diseases, Inborn; Gout; Granulomatous Disease, Chronic; Hemoglobinopathies; Hemophilia A; Hepatolenticular Degeneration; Humans; Immunologic Deficiency Syndromes; Kidney Transplantation; Leukodystrophy, Metachromatic; Liver Transplantation; Lymphocytes; Metabolism, Inborn Errors; Mucopolysaccharidoses; Nephritis, Hereditary; Niemann-Pick Diseases; Osteopetrosis; Oxalates; Oxalic Acid; Transplantation; Tyrosine; Uremia

Topics: Acidosis, Renal Tubular; Alkaptonuria; Cystinuria; Diabetes Insipidus; Female; Glycine; Gout; Humans; Hyperlipidemias; Hyperparathyroidism; Kidney Diseases; Lesch-Nyhan Syndrome; Male; Metabolism, Inborn Errors; Nephritis, Hereditary; Oxalates; Porphyrias; Uric Acid; Urologic Diseases; Xanthines

Topics: Adolescent; Adult; Age Factors; Aged; Allopurinol; Child; Child, Preschool; Female; Gout; Humans; Infant; Male; Middle Aged; Oxalates; Oxalic Acid; Reference Values; Sex Factors

Topics: Adult; Diagnosis, Differential; Gout; Hand; Humans; Joint Diseases; Male; Metabolism, Inborn Errors; Oxalates; Radiography

The excretion of uricine or yellowish-red pigment from uric acid stones and its binding by uric acid seems to affect the precipitation of uric acid. Uricine was determined by ion exchange chromatography followed by measurement of the alkaline fluorescence emission. The uricine urinary excretion and the uricine-uric acid potential binding were determined in 11 control subjects, 20 recurrent uric acid stone formers, seven calcium stone formers with hyperuricuria, and five gouty patients without urinary stone formation. Uricine excretion was increased in 11 uric acid stone formers, whereas it was normal in the rest of the patients. Uricine-uric acid potential binding was increased in many uric acid stone formers, despite the absence of uric acid urinary hyperexcretion, whereas it was normal in most of the calcium stone formers and was moderately increased in the gouty patients.

Topics: Adult; Aged; Binding Sites; Calcium Phosphates; Female; Gout; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Oxalates; Pigments, Biological; Uric Acid; Urinary Calculi

A review of the problems associated with extensive jejunoileal bypass for morbid obesity in a series of 175 carefully selected patients is presented. Five postoperative deaths occurred (3%). Nonfatal complications occurred in 21%, with wound infections (14 patients) being the most common. Good results marked by weight reduction to the range of ideal weight without significant electrolyte or metabolic aberrations was observed in 82% of the patients receiving the current dimensional modificatiom of end-to-end jejunoileal bypass (30 cm to 20cm). An additional 13% had fair results and only 5% had poor results. There were six deaths during follow-up: liver failure in four patients (secondary to alcohol abuse in two), myocardial infarction in one, and one from unknown causes. Bypass reversal was necessary for refractory liver failure in three patients (two from alcohol abuse), and for persistent diarrhea with secondary electrolyte depletion in two patients. One of these patients was complicated by severe emotional instability. This experience suggests that the majority of carefully selected patients will have a good response to jejunoileal bypass.

Topics: Adolescent; Adult; Anemia; Avitaminosis; Body Weight; Cholelithiasis; Diarrhea; Electrolytes; Fatty Liver; Female; Follow-Up Studies; Gout; Humans; Hypoproteinemia; Ileum; Jejunum; Kidney Calculi; Liver Diseases; Male; Middle Aged; Obesity; Oxalates; Postoperative Complications

Topics: Adolescent; Adult; Amyloidosis; Child; Cystinosis; Diabetic Nephropathies; Fabry Disease; Female; Gout; Humans; Kidney Diseases; Kidney Failure, Chronic; Kidney Transplantation; Male; Metabolic Diseases; Middle Aged; Nephritis; Nephritis, Hereditary; Oxalates; Renal Dialysis; Retrospective Studies; Transplantation, Homologous

Topics: Adolescent; Adult; Anemia, Hypochromic; Avitaminosis; Cholelithiasis; Diarrhea; Female; Follow-Up Studies; Gout; Humans; Ileum; Jejunum; Kidney Calculi; Liver Diseases; Male; Middle Aged; Obesity; Oxalates; Postoperative Complications

After World War II the incidence of urolithiasis increased consistently among the general population in this country. Nearly 25% of all examined renal calculi contain uric acid, sodium acid urate or ammonium acid urate as constituents. There are two peaks in lifespan of occurring urate stones: in the adolescence and in the age between 40 and 60 years. The following conditions are due to the formation of uric acid-containing stones: 1. Gout and primary hyperuricemia; 2. secondary hyperuricemia; 3. idiopathic cases with normal renal excretion of uric acid and normouricemia, but with a higher degree of acidity of the urine than normal considering the total renal excretion of acid products; 4. iatrogenic hyperuricemia during insufficient uricosuric therapy. Up to more than 30% of all the patients with recurrent formation of oxalate stones show a clear association with hyperuricemia, hyperuricosuria and increased renal excretion of calcium. In the presence of sodium urate a considerable promotion of precipitation of crystals consisting of calcium oxalate from a meta-stable solution may occur (so-called epitaxy). Frequently the existence of uric acid stones is without any symptoms. Modern views with regard to prophylactic procedures, diet, general and specific medical management including surgical intervention are presented.

Topics: Calcium; Gout; Humans; Kidney Calculi; Oxalates; Uric Acid

Crystal identification is made with a polarizing, color-compensated light microscope. Most microscopes can be easily and inexpensively adapted for crystal identification. The color compensator allows differentiation between the monosodium urate crystals of gout and the crystals of pseudogout, or calcium pyrophosphate deposition disease. All synovial fluid specimens should be examined. The observation of phagocytosis of crystals establishes that they are the etiologic agent responsible for an ongoing acute attack of arthritis.

Topics: Betamethasone; Calcium Phosphates; Cholesterol; Chondrocalcinosis; Color; Crystallography; Diphosphates; Edetic Acid; Gout; Humans; Light; Lipids; Microscopy; Microscopy, Polarization; Oxalates; Physical Phenomena; Physics; Synovial Fluid; Uric Acid

The results of kidney transplantation in a variety of renal diseases have been analyzed. The diseases causing end-stage kidney failure in recipients were Alport syndrome, amyloidosis, cystinosis, diabetes mellitus, Fabry disease, familial nephritis, gout, medullary cystic disease, oxalosis, and systemic lupus erythematosus. The data indicate that renal transplantation is justifiable and parallels functional results for the more common causes of end-stage renal disease in all but Fabry disease and oxalosis. Although Fabry disease did not recur in any grafted kidney, only three patients have a functioning graft one year after transplantation. From a group of ten patients with oxalosis who received a total of 14 kidneys, only one survives. In no other metabolic disease, except one instance of primary amyloidosis, did the metabolic disease notably affect the transplant as it did in oxalosis.

Topics: Adolescent; Adult; Amyloidosis; Cystinosis; Diabetes Complications; Evaluation Studies as Topic; Fabry Disease; Female; Follow-Up Studies; Gout; Humans; International Cooperation; Kidney Diseases; Kidney Transplantation; Lupus Erythematosus, Systemic; Male; Middle Aged; Nephritis; Nephritis, Hereditary; Oxalates; Registries; Transplantation, Homologous

Topics: Gout; Humans; Oxalates; Uric Acid; Urinary Calculi

Topics: Adult; Allopurinol; Calcium; Gout; Humans; Male; Oxalates; Urinary Calculi

Topics: Acids; Adult; Aged; Carbon Dioxide; Chromatography, Gas; Citrates; Citric Acid Cycle; Fumarates; Glomerular Filtration Rate; Gout; Humans; Hydrogen-Ion Concentration; Ketoglutaric Acids; Lactates; Malates; Male; Middle Aged; Osmolar Concentration; Oxalates; Pyruvates; Succinates; Tricarboxylic Acids; Uric Acid

Topics: Adult; Calcinosis; Crystallography; Gout; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infarction; Kidney; Male; Metabolism, Inborn Errors; Methods; Microscopy, Electron; Middle Aged; Oxalates; Uric Acid

Topics: Acid-Base Equilibrium; Gout; Humans; Hydrogen-Ion Concentration; Kidney Calculi; Oxalates; Urinary Bladder Calculi

Topics: Gout; Humans; Hydrogen-Ion Concentration; Oxalates; Phosphorus; Urea; Uric Acid; Urinary Calculi

Topics: Allopurinol; Benzofurans; Colchicine; Diuretics; Gout; Humans; Mineral Waters; Oxalates; Tromethamine; Uric Acid; Uricosuric Agents; Vasodilator Agents

Topics: Adult; Aldehydes; Animals; Disulfiram; Enzymes; Glyoxylates; Gout; Humans; In Vitro Techniques; Kinetics; Liver; Male; Middle Aged; Milk; Oxalates; Rats; Xanthine Oxidase

Topics: Complementary Therapies; Gout; Humans; Oxalates