oxalates and Ureteral-Calculi

Topics: Allopurinol; Calcium, Dietary; Female; Humans; Kidney Calculi; Male; Oxalates; Recurrence; Ureteral Calculi; Urinary Calculi

We studied the relationship of stone frequency and composition to age, sex and stone weight.. A retrospective study was performed of all 15,624 stones submitted for analysis with infrared and wet chemical methods in Newfoundland and Labrador from 1979 to 1998.. There were 1,067 bladder stones of which 216 contained magnesium ammonium phosphate. The remaining 14,557 stones were from the kidney and ureter, and 11,707 were composed only of calcium oxalate and/or phosphate. Of the remaining 2,850 kidney and ureter stones magnesium ammonium phosphate was present in 573, uric acid/urate without magnesium ammonium phosphate in 1,109 and other compounds in 1,168. The 11,707 oxalate phosphate group was subdivided by infrared peak analysis based on oxalate-to-phosphate ratio into phosphate-ratio 1 or less, intermediate-1 to 10 and oxalate-10+. Oxalate comprised 65% of the 11,707 stones compared to 16% for phosphate. Women submitted 52% of phosphate stones compared with 28% of oxalate stones. From the first (1980 to 1983) to the last (1995 to 1998) complete 4-year study periods, there was a relative increase in oxalate and decrease in phosphate stones, associated with increasing age from decades 5 to 6 for oxalate and phosphate stones, except that the age peak for phosphate stones in women remained in decade 3. Median weight of 1, 828 phosphate stones was 43 mg. (mean 234) compared with 25 mg. (mean 98) for 7,634 oxalate stones. Male-to-female ratio was 0.91 for phosphate stones compared with 2.62 for oxalate stones.. Phosphate stones were on average heavier and relatively more common in women, had an earlier age peak frequency in women than oxalate stones and became less frequent during our last 4-year study period. In contrast, oxalate stones were much more common, of lighter weight and became more frequent with time.

Topics: Adolescent; Adult; Age Factors; Aged; Child; Female; Humans; Kidney Calculi; Magnesium Compounds; Male; Middle Aged; Oxalates; Phosphates; Retrospective Studies; Sex Factors; Struvite; Ureteral Calculi; Urinary Bladder Calculi; Urinary Calculi

Oxalosis is a rare disorder, in which there are widely and evenly spread deposits of oxalate crystals in the kidneys with progressive renal failure. An inborn error of metabolism is the cause of oxalosis. The incidence of this disease in boys and girls is practically equal. Most patients do not survive their 20th year. In our case there were changes in the skeleton and extensive deposits of oxalates in the kidneys.

Topics: Child; Humans; Hyperoxaluria; Hyperoxaluria, Primary; Male; Metabolism, Inborn Errors; Nephrocalcinosis; Oxalates; Radiography; Ureteral Calculi

Urine chemistry of 42 normal subjects (NS) and 59 ureteric stone formers (SF) from Jodhpur region of Rajasthan, India is presented. Twenty four hour urinary levels of calcium, oxalic acid and uromucoids were significantly higher and levels of magnesium, citric acid and inorganic phosphorus were significantly lower in SF as compared to NS. No significant difference was observed in the uric acid, sodium and potassium levels in the two groups. Significant correlation was observed between calcium and magnesium; calcium and oxalic acid; calcium and citric acid; magnesium and oxalic acid; and oxalic acid and citric acid in NS on the basis of mmol/l but not on the basis of mmol/24 h. Calcium and oxalic acid correlation was uninfluenced by magnesium and citric acid levels. The log of risk factor index (RI) was higher (p less than 0.001) in SF (-1.652) as compared to NS (-2.103). The log of ion activity product (IAP) was also higher (p less than 0.001) in SF (-3.192 X 10(-3)) than in NS (-2.914 X 10(-1)). Based on RI and IAP, a scale has been devised for the prediction of the risk of stone formation and recurrence.

Topics: Adult; Calcium; Citrates; Citric Acid; Humans; Magnesium; Mucoproteins; Oxalates; Oxalic Acid; Phosphorus; Potassium; Sodium; Ureteral Calculi; Uromodulin

Principally the formation of urinary calculi in children is not very different from that of grown-ups. For children some factors, however, are of special relevance namely recurrent urinary tract infections and malformations in the area of the urinary tract. In western countries nowadays the incidence rate of urinary stones in children is 3-5% of all patients suffering from this disease, in the underdeveloped countries we have rates of about 30%. A clear sex preference in children wasn't found, the age distribution shows that for half of the children suffering from calculi, diagnosis has been made until they've reached school age. Stone localisation is shifting towards the upper urinary tract, in the past we had mainly urinary bladder stones. Concrements containing oxalate are being found more often today. For children we have a high proportion of mixed concrements. The rate of recurrence for children is 15-25%. Diagnostically we have to search out especially for malformations respectively obstructions of the urine flow, disturbances in metabolism in consideration of metaphylaxis possibilities, however, must not be taken out of account either. Promotory and inhibitory factors of stone formation are presented and their significance is explained by means of selected cases of our own patients. Modern techniques of operative resp. instrumental removal of urinary calculi are presented, especially the relevance of modern strategies as e.g. the extracorporal shock wave lithotripsy, percutaneous litholapaxy and ureterorenoscopy are discussed. Adequate metaphylaxis (general, dietetic, medicamentous) can lower the rate of recurrence of stone formation. This is only possible, however, on condition of a consequent diagnosis to find possible causes of stone formation to be able to choose the right measures of metaphylaxis.

Topics: Calcium; Child; Chronic Disease; Humans; Kidney; Kidney Calculi; Oxalates; Oxalic Acid; Pressure; Urea; Ureteral Calculi; Uric Acid; Urinary Tract Infections; Urodynamics

As calcium oxalate stones are the most important component in urolithiasis, an experimental model has to be designed to clarify the pathogenesis and aid in their prevention. Hyperoxaluria as well as hypercalciuria were produced in rats by administering ethylene glycol (0.5%, in drinking water administered ad libitum) and 1-alpha (OH) D3 (0.5 micrograms/rat given every other day), respectively, for three to four weeks. Neither drug alone produced stones efficiently as did the combination regimen of these two compounds. The occurrence of stones was 77.3%, and with only a moderate degree of renal functional impairment. Biochemical and histological data were obtained using this model.

Topics: Animals; Calcium; Calcium Oxalate; Ethylene Glycols; Hydroxycholecalciferols; Kidney; Kidney Calculi; Magnesium; Male; Oxalates; Phosphates; Rats; Rats, Inbred Strains; Ureteral Calculi; Urinary Calculi

Patients with recurrent kidney stone disease or stone formers at increased risk of recurrence deserve a thorough metabolic workup. This should be based on a careful history and include urinalysis, serum chemistry studies, and analysis of 24-hour urine collections. Measures to prevent recurrent stone formation are aimed at correcting the metabolic imbalances detected in the workup. A variety of drugs are available that target one or more of the metabolic abnormalities that may be involved. For "surgically active" renal and ureteral stone disease, newer techniques make surgery unnecessary in most cases. Extracorporeal shock wave lithotripsy is becoming the preferred technique for disintegration of upper urinary tract stones. Percutaneous ultrasonic lithotripsy and electrohydraulic disintegration also are widely used. For lower urinary tract stones, the ureteroscope permits either extraction under visualization or ultrasonic disintegration.

Topics: Allopurinol; Benzothiadiazines; Calcium; Cellulose; Citrates; Citric Acid; Cystoscopy; Diuretics; Fluid Therapy; Fluoroscopy; Humans; Kidney Calculi; Lithotripsy; Medical History Taking; Minerals; Oxalates; Phosphates; Pyridoxine; Sodium Chloride Symporter Inhibitors; Ureteral Calculi; Uric Acid; Urine

In 117 male patients with proven calcium oxalate renal calculi, adults of all ages were affected. There was a low incidence of urinary tract obstruction and infection and a high incidence of recurrence and bilateral disease. The group of patients could not be characterized as to a specific abnormality of blood or urine. There were no differences between all patients, a subset with multiple stones and normals with regard to the mean urinary excretions of calcium, magnesium and oxalic acid. There were no differences between the frequency distribution of patients with high excretions of both calcium and oxalic acid or low excretions of both calcium and oxalic acid. Mean supersaturation ratios and the frequency distribution of supersaturation ratios in 31 stone patients were the same as in 32 normal men. The data suggest that the difference between calcium oxalate stone patients and normals lies in the process of initiation.

Topics: Adult; Aged; Calcium; Calcium Oxalate; Humans; Magnesium; Middle Aged; Oxalates; Phosphorus; Ureteral Calculi; Urinary Calculi

Topics: Ammonia; Carbonates; Child; Child, Preschool; Cystine; Female; Humans; Infant; Kidney Calculi; Male; Minerals; Oxalates; Ureteral Calculi; Uric Acid; Urinary Bladder Calculi; Urinary Calculi

Effects of standard mineral, free, and low calcium--low oxalate diets on the urinary excretion of calcium and oxalate were studied in 153 consecutive patients with single or recurrent renal/ureteral stone. The patients were divided into four groups: 78 men with single stone (MS), 40 men with recurrent stone (MR), 30 women with single stone (WS), and 5 women with recurrent stone (WR). The urine volume was altered significantly (p less than 0.001) by the diet. The sex and the diet had a significant influence on the urinary excretion of calcium. The urinary excretion of oxalate was altered significantly by the diet (p less than 0.001), but not by sex nor by the number of stones. The goal for the low calcium--low oxalate diet (the simple concentration product under 26) was reached in MS and WS. The excretion of urinary calcium and oxalate increased and urine volume decreased in the samples collected at home when compared with the samples collected in the hospital. This was interpreted as a failure of the dietary regimen at home.

Topics: Adolescent; Adult; Aged; Calcium; Diet; Female; Humans; Kidney Calculi; Male; Middle Aged; Oxalates; Recurrence; Sex Factors; Ureteral Calculi

Topics: Adolescent; Apatites; Child; Child, Preschool; Cystine; Female; Humans; Infant; Infant, Newborn; Kidney Calculi; Male; Oxalates; Phosphoranes; Radiography; Ureteral Calculi; Uric Acid; Xanthines

The clinical features of eight cases of primary hyperoxaluria have been summarized. The possibility of different phenotypes is discussed. A reduction, but no normalization, of the oxalate formation during pyridoxine therapy was found. A renal transplantation performed in one of the patients failed because of the formation of nephrocalcinosis.

Topics: Adolescent; Adult; Child; Child, Preschool; Female; Follow-Up Studies; Glycolates; Glyoxylates; Humans; Infant; Kidney Calculi; Male; Middle Aged; Nephrocalcinosis; Oxalates; Pedigree; Uremia; Ureteral Calculi

The first case of an obstructing stone composed of a pure metabolite of the sulfamethoxazole-trimethoprim combination is reported. Its coincident occurrence with an obstructing calcium oxalate stone, producing oligura and acute azotemia, is noteworthy.

Topics: Aged; Calcium; Drug Combinations; Humans; Male; Oxalates; Sulfamethoxazole; Trimethoprim; Ureteral Calculi

Topics: Humans; Kidney Calculi; Minerals; Oxalates; Phosphoric Acids; Recurrence; Ureteral Calculi; Uric Acid

The diangosis, clinical manifestations and management of 11 children with nephrocalcinosis encountered in a 20-year period are presented. Renal tubular acidosis, primary hyperoxaluria, primary hyperparathyroidism, exogenous hyperadrenocorticism and idiopathic hypercalcemia of infancy were the principal causes of nephrocalcinosis in this series. In the presence of normal or near-normal renal function, a 55 per cent or better cure rate can be expected. Children with significantly diminished renal function have a poor prognosis and should be considered for renal transplantation.

Topics: Acidosis, Renal Tubular; Adolescent; Child; Child, Preschool; Cushing Syndrome; Female; Humans; Hypercalcemia; Hyperparathyroidism; Kidney Calculi; Kidney Transplantation; Male; Nephrocalcinosis; Oxalates; Prognosis; Transplantation, Homologous; Ureteral Calculi

Out of a group of 979 patients with urinary calculi, 175 had passed their stone(s). Comparison of data for stones which had been passed with data for the whole group shows many significant differences. Calculi composed entirely of calcium oxalate are more likely to be expelled than any other composition variety. The chance of this happening is 1 in 3 and it is even higher when the person is under 50 years of age. The probability of calculi composed of calcium oxalate+calcium phosphate being expelled is 1 in 5 and this also increases for younger patients. Infection stones consisting of calcium phosphate+struvite have only 1 in 19 chance of being passed. Many of the stones passed (130) are under 0.10 g in weight. However, there is a similar relationshp between composition and weight among both the stones that were passed and the whole group. In both groups, pure oxalate stones are the lightest, infection stones are the heaviest and stones composed of calcium phosphate and calcium phosphate+calcium oxalate are of intermediate weight.

Topics: Adolescent; Adult; Age Factors; Aged; Calcium Phosphates; Child; Child, Preschool; Female; Humans; Kidney Calculi; Male; Middle Aged; Oxalates; Sex Factors; Ureteral Calculi; Uric Acid; Urinary Calculi

On about one fourth of the patients ureteral colics caused by oxalate and phosphate calculi lead to a reversible hyperuricemia. This result seems to be important, because we might wrongly diagnose a uric acid calculus. The reason for hyperuricemia is a temporary diuretic disturbance of the uric acid. It cannot be explained by the functional loss of the obstructed kidney, because a nephrectomy does not change the uric acid level. As a possible reason we suppose a ketose by food deficiency and vomiting caused by renal colic.

Topics: Blood Urea Nitrogen; Colic; Creatinine; Female; Humans; Ketosis; Kidney Function Tests; Male; Oxalates; Phosphates; Ureteral Calculi; Uric Acid

Topics: Acidosis, Renal Tubular; Acute Disease; Analgesics; Calcium; Chronic Disease; Cystinuria; Female; Humans; Hyperparathyroidism; Infrared Rays; Kidney Calculi; Male; Oxalates; Radiography; Spectrum Analysis; Ureteral Calculi; Urinary Calculi; Urinary Tract Infections; X-Ray Diffraction

Randall described a pre-calculus lesion of the renal papilla in the 1930s and this was substantiated by others during the next decade and then largely ignored. This insignificant subepithelial calcification of the renal papilla. Randall's plaque type I, becomes the nucleus of at least 15% of calcium oxalate calculi, as demonstrated by apatite nuclei existing in papillary depression on the external stone surface. Cross section study of the stone demonstrates the peripheral nucleus with eccentric lamination postulating a mural origin. Contrariwise, study of the stone developing upon a nucleus originating in the papillary ducts (without producing obstruction) or out in the calix demonstrates a central nucleus surrounded by concentric laminations or lack of a mural origin, the more common type of calcium oxalate stone structure. Obstruction of the papillary ducts by hyperexcretion of stone salt may result in anemic infarction and sloughing of the apex of the papilla. Data concerning the prevalence of Randall's plaques in the population have been reviewed. Evidence of the incidence of calcium oxalate calculi that have developed upon Randall's plaques has been presented. A plea for further study of the pathology of the renal papilla has been voiced.

Topics: Calcium; Humans; Kidney Calculi; Oxalates; Ureteral Calculi

Topics: Adult; Apatites; Calcium; Drainage; Endoscopes; Endoscopy; Humans; Ileum; Magnesium; Male; Oxalates; Phosphates; Proteus Infections; Quaternary Ammonium Compounds; Radiography; Ureteral Calculi; Ureteral Obstruction; Urinary Catheterization; Urinary Diversion

Topics: Apatites; Calcium; Calcium Phosphates; Humans; Magnesium; Oxalates; Ureteral Calculi; Uric Acid

Topics: Adolescent; Adult; Age Factors; Child; Child, Preschool; Female; Hematuria; Hospitalization; Humans; Infant; Iran; Kidney Calculi; Male; Oxalates; Rectal Prolapse; Sex Factors; Socioeconomic Factors; Ureteral Calculi; Urinary Bladder Calculi; Urinary Calculi

Topics: Calcium; Carbonates; Humans; Kidney Calculi; Kidney Pelvis; Magnesium; Oxalates; Phosphates; Quaternary Ammonium Compounds; Sex Factors; Ureteral Calculi; Uric Acid; Urinary Bladder Calculi; Urinary Calculi; X-Ray Diffraction

Topics: Animals; Body Weight; Calcium; Castration; Citrates; Female; Kidney Calculi; Liver; Magnesium; Male; Nutritional Requirements; Oxalates; Pyridoxine; Sex Factors; Time Factors; Ureteral Calculi; Urinary Bladder Calculi; Urinary Calculi; Vitamin B 6 Deficiency; Xanthurenates

X-ray diffraction studies have shown that there are several different kinds of human urinary calculi, with different age, sex, period, and geographical distributions. Juvenile bladder stones are typically urate and oxalate in small boys in certain stone belts. They have disappeared in some areas, particularly in Britain, but are still common in Thailand. India. and Turkey. Their cause is unknown. Adult bladder stones, formerly common in elderly men, were largely of uric acid and were due to a faulty diet. Juvenile kidney stones are rare, except in Turkey where they are similar to juvenile bladder stones. Adult kidney stones are by far the most universally common, especially in technically developed communities. They are found in both sexes (equally at postmortem), and in the United States and in Czechoslovakia the average number of hospital entries for stones, relative to the whole population, is about 1 per 1000 per annum (increasing) although the incidence in different districts varies by 4 to 1 or more. Such stones are mainly calcium oxalates and calcium and MgNH(4) phosphates. The incidence among the administrative class is at least 20 times that among agricultural workers, relative to their numbers. Stones are reported also to be an occupational hazard for air pilots. It is probably that much more exercise and the drinking of more water to prevent kidney dehydration (spirits and coffee are not effective for this purpose) would lower the high rate of incidence. Moderate acidification would prevent phosphate supersaturation of the urine, but is not effective for oxalates. It seems certain that, once a suitable seed is formed, epitaxy is largely responsible for deposition from urines that would otherwise remain supersaturated until voided. This would explain the curioLls radial and layered texture of many stones. Laboratory experiments might suggest ways of preventing orientated overgrowth.

Topics: Calcium Phosphates; Calculi; Crystallization; Czechoslovakia; History, 18th Century; History, 19th Century; History, 20th Century; Humans; India; Italy; Kidney Calculi; Occupational Diseases; Oxalates; Spain; Thailand; Turkey; United Kingdom; Ureteral Calculi; Ureteral Obstruction; Uric Acid; Urinary Bladder Calculi; Urinary Calculi; X-Ray Diffraction; Zimbabwe

Topics: Adolescent; Adult; Age Factors; Aged; Apatites; Calcium Phosphates; Child; Child, Preschool; Cystine; Czechoslovakia; England; Female; Humans; Hydroxyapatites; India; Indonesia; Infant; Kidney Calculi; Male; Middle Aged; Minerals; Oxalates; Sex Factors; Spain; Thailand; Turkey; Ureteral Calculi; Uric Acid; Urinary Bladder Calculi; Urinary Calculi; X-Ray Diffraction

Topics: Adolescent; Adult; Calcium; Female; Humans; Magnesium; Male; Middle Aged; Oxalates; Phosphorus; Ureteral Calculi

Topics: Adolescent; Adult; Animals; Diuretics; Female; Humans; Kidney Calculi; Male; Mice; Middle Aged; Oxalates; Plant Extracts; Plants; Radiography; Ureteral Calculi

Topics: Humans; Kidney Calculi; Oxalates; Ureteral Calculi; Uric Acid