struvite and Cystinuria

Childhood urolithiasis remains endemic in certain parts of the world, namely, Turkey and the Far East. The prevalence of nephrolithiasis in North American children varies widely among geographic regions and accounts for 1 per 1000 to 1 per 7600 pediatric hospital admissions. Stones occur in children of all ages. The clinical manifestations of stone disease are often more subtle in children when compared with the dramatic adult presentation. This article discusses the evaluation and medical management of pediatric stone disease.

Topics: Calcium; Child; Cystinuria; Humans; Hyperoxaluria, Primary; Magnesium Compounds; Phosphates; Struvite; Uric Acid; Urinary Bladder Calculi; Urinary Calculi

Topics: Calcium; Citric Acid; Cystinuria; Humans; Kidney Calculi; Magnesium Compounds; Oxalates; Phosphates; Struvite; Uric Acid

The cause of urinary stone disease can now be detected in approximately 80% of patients. Effective treatment can substantially reduce the recurrence of urinary calculi. Proper therapy depends on a thorough understanding of the physiology of calcium, oxalate, uric acid, cystine, and struvite formation and the medication developed for prevention. This article reviews the physiologic basis of urinary stone management in a straightforward, understandable fashion.

Topics: Acetazolamide; Calcium; Carbonic Anhydrase Inhibitors; Citrates; Cystinuria; Humans; Hyperoxaluria; Magnesium Compounds; Phosphates; Struvite; Urease; Uric Acid; Urinary Calculi

Urinary stone disease is a common affliction in our society and may affect 1 to 5 per cent of the population. The physician involved in caring for the stone-forming patient must have a thorough understanding of the metabolic as well as anatomic abnormalities that may lead to repeat stone formation. The authors review the common metabolic abnormalities frequently seen in the stone-forming patient and present the current medical management of these problems. Ongoing changes in the surgical approach to urinary stones are also discussed.

Topics: Calcium; Crystallization; Cystine; Cystinuria; Humans; Kidney Calculi; Magnesium; Magnesium Compounds; Phosphates; Physical Examination; Struvite; Tomography, X-Ray Computed; Ultrasonography; Uric Acid; Urinary Calculi; Urinary Tract Infections; Urine; Urography

Advances in renal lithiasis research have contributed to a better understanding of the many varied factors that contribute to renal calculus formation. Utilizing the newer techniques of ambulatory metabolic evaluation, we can establish a specific diagnosis in 95% of recurrent stone-formers. Since a significant percentage of initial stone-formers will never have a second episode, it is essential to establish the natural history of the patient's stone disease prior to initiating potentially life-long medical therapy. The majority of initial stone-formers can be managed with education concerning modest dietary restrictions and increased fluid intake. For the recurrent stone-former with metabolically active stone disease, it is probably best to design medical therapy to treat the specific urinary chemical abnormality or disease process.

Topics: Acidosis, Renal Tubular; Bacterial Infections; Calcium; Crystallography; Cystinuria; Diuresis; Fluid Therapy; Humans; Intestinal Absorption; Kidney; Kidney Calculi; Magnesium; Magnesium Compounds; Oxalates; Patient Education as Topic; Phosphates; Recurrence; Risk; Struvite; Uric Acid; Urography

Topics: Acidosis, Renal Tubular; Calcium; Cystinuria; Humans; Hydrogen-Ion Concentration; Hyperparathyroidism; Kidney Calculi; Magnesium; Magnesium Compounds; Phosphates; Proteus Infections; Struvite; Urine

Topics: Acidosis, Renal Tubular; Allopurinol; Benzothiadiazines; Calcium; Calcium, Dietary; Cystinuria; Diuretics; Humans; Hyperparathyroidism; Kidney Calculi; Magnesium; Magnesium Compounds; Oxalates; Penicillamine; Phosphates; Quaternary Ammonium Compounds; Sodium Chloride Symporter Inhibitors; Struvite; Uric Acid

The Objective of this study is to analyze the difference in renal stone composition between Uyghur and Han children with urolithiasis in China and possible reasons. From May 2011 to September 2013, we analyzed the stone compositions of 274 Chinese children with urolithiasis, including 151 Uyghur children from Xinjiang Province and 123 Han children from Guangdong Province. All the stone components were determined by Infrared spectroscopy and the main components were recorded. We also evaluated the data, including age, gender and geographic region of the patients. The mean age of Uyghur children was less than Han children (5.3 ± 4.2 vs 8.6 ± 5.7 years, p < 0.001). Calcium oxalate (CaOx) was the main stone composition in both Uyghur (35.1 %) and Han (64.2 %) children, but was more common in Han children (p < 0.0001). Cystine stone was also more abundant in Han children (8.9 % vs 0.7 %, p = 0.001). While, both uric acid (20.5 % vs 3.3 %, p < 0.0001) and magnesium ammonium phosphate (16.6 % vs 2.5 %, p < 0.0001) stones were more common in Uyghur. Interestingly, the significant differences in stone composition between the two groups were only observed in males. When the pediatric patients were further divided into three age groups which were 0-5, 6-12 and >12, the prevalence of calcium oxalate stones increased with age in both groups and was higher in Han children at each age level. The compositions of urinary stones were significantly different between Uyghur and Han children with urolithiasis, factors such as diet habit, life style, genetic diversity, environmental and medical conditions may all contribute to the variances.

Topics: Adolescent; Age Factors; Calcium Oxalate; Child; Child, Preschool; China; Cystine; Cystinuria; Female; Humans; Infant; Male; Prevalence; Retrospective Studies; Sex Factors; Spectrophotometry, Infrared; Struvite; Uric Acid; Urinary Calculi

Topics: Acid-Base Equilibrium; Adult; Calcium Oxalate; Calcium Phosphates; Cystinuria; Diagnosis, Differential; Feeding Behavior; Guideline Adherence; Humans; Hyperuricemia; Kidney Calculi; Magnesium Compounds; Male; Phosphates; Prescription Drugs; Recurrence; Risk Factors; Struvite; Urinary Tract Infections; Water-Electrolyte Balance

To elucidate the factors contributing to staghorn stone formation in patients.. The records of 82 patients (44 men and 38 women) with complete staghorn calculi were reviewed retrospectively for clinical presentation, metabolic disturbances and anatomical abnormalities.. There were 79 unilateral and three bilateral cases. The patient performance of the activities of daily life was assessed with the modified Rankin scale (MRS) and it was found that 69 patients were functionally independent (84.1%, MRS 0-1) and 10 patients had a severe disability (12.2%, MRS 4-5). Seven patients had chronic indwelling catheters (8.5%). A positive urine culture was found in 24.4% of patients. Analysis of stone composition revealed magnesium ammonium phosphate and mixed calcium oxalate-phosphate were the most frequently identified types of stone (32.1% and 22.2%, respectively). Urinary pH was low in patients with uric acid stones (mean 5.4). Hyperuricemia, cystinuria and hypercalciuria were found in 14.6%, 2.4% and 37.8%, respectively. Hypercalciuria was found more frequently in calcium-stone cases. Eleven patients (13.4%) showed structural abnormalities of the kidney.. Our data show that the patients with severe disability, urinary tract infection and hypercalciuria could be recognized more frequently in staghorn calculi compared with common urolithiasis. However, in Western countries, the frequency of both urinary tract infection and struvite stones is much higher than in our data. Other Japanese authors have also reported the low frequency of struvite stones in staghorn calculi, suggesting that various factors other than urinary tract infection possibly contribute to the formation of staghorn calculi in Japan.

Topics: Activities of Daily Living; Adult; Aged; Calcium; Calcium Oxalate; Calcium Phosphates; Catheters, Indwelling; Cystinuria; Female; Humans; Hydrogen-Ion Concentration; Hyperuricemia; Kidney; Kidney Calculi; Magnesium Compounds; Male; Middle Aged; Phosphates; Retrospective Studies; Struvite; Uric Acid; Urinary Tract Infections; Urine

Detailed metabolic evaluation and prophylaxis for all patients presenting with a first renal stone seems inappropriate. The crucial clinical problem lies in predicting which patients are likely to have a recurrence. Stone composition is an important guide for the physician's decisions concerning investigation and a rational choice of treatment.

Topics: Calcium; Cystinuria; Humans; Kidney Calculi; Magnesium Compounds; Phosphates; Recurrence; Struvite; Uric Acid

Of 100 renal units which were made stone-free by percutaneous stone extraction in 1985, 86 (86.0%) were re-examined radiologically up to 5 years after operation. The re-examination was performed because of symptoms or as part of a regular check-up or after calling the patient. Intrarenal calcifications were diagnosed in 27 of 86 (31.4%) of the renal units, but only in 11 (12.8%) were there stones requiring treatment.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Calcium Oxalate; Calcium Phosphates; Cystinuria; Female; Follow-Up Studies; Humans; Kidney Calculi; Lithotripsy; Magnesium; Magnesium Compounds; Male; Middle Aged; Nephrostomy, Percutaneous; Phosphates; Radiography; Radioisotope Renography; Recurrence; Struvite; Urinary Tract Infections

Topics: Adult; Calcium Oxalate; Citrates; Cystinuria; Female; Humans; Kidney Transplantation; Magnesium; Magnesium Compounds; Male; Phosphates; Struvite; Transplantation, Homologous; Uric Acid; Urinary Calculi

This article contains an analysis of data compiled from 813 specimens of canine uroliths submitted to the Urinary Stone Analysis Laboratory at University of California School of Veterinary Medicine.

Topics: Animals; Apatites; Calcium Phosphates; Cystine; Cystinuria; Dog Diseases; Dogs; Magnesium; Magnesium Compounds; Minerals; Oxalates; Phosphates; Silicon Dioxide; Struvite; Uric Acid; Urinary Calculi

Crystalluria results from oversaturation of urine with crystallogenic substance. However, oversaturation may occur as a result of in vitro as well as in vivo events. The microscopic appearance of crystals only represents a tentative identification of their composition because variable conditions associated with their formation, growth, and dissolution may alter their appearance. Definitive identification is dependent on physical methods such as optical crystallography, x-ray diffraction, and electron microscopic analysis.

Topics: Animals; Bilirubin; Calcium Carbonate; Calcium Oxalate; Calcium Phosphates; Cholesterol; Crystallography; Cystinuria; Dog Diseases; Dogs; Hippurates; Leucine; Magnesium; Magnesium Compounds; Minerals; Phosphates; Quaternary Ammonium Compounds; Struvite; Tyrosine; Uric Acid; Urinary Calculi

A study was performed to compare qualitative test results of canine uroliths with quantitative test results. Qualitative test results were in agreement with quantitative test results in only 96 of 223 specimens (43 per cent). Lack of agreement was caused by false-negative qualitative test results (85 of 223), false-positive qualitative test results (15 of 233), and a combination of false-negative and false-positive qualitative test results (27 of 233). This study indicates that the veterinary profession should abandon exclusive use of qualitative chemical test kits for uroliths.

Topics: Animals; Calcium Oxalate; Calcium Phosphates; Cystine; Cystinuria; Dog Diseases; Dogs; Magnesium; Magnesium Compounds; Minerals; Phosphates; Quaternary Ammonium Compounds; Struvite; Uric Acid; Urinary Calculi

Over the last few years there have been marked advances in both the surgical and medical treatment of urinary stone disease. At present, we have expectations of decreasing the incidence of stone recurrence in a vast majority of patients with medical therapy alone. While there are still many patients who will continue to develop new stones, decreasing their rate of new stone formation will lessen the need for surgical intervention.

Topics: Calcium; Cystinuria; Fluid Therapy; Humans; Kidney Calculi; Magnesium; Magnesium Compounds; Phosphates; Risk; Struvite; Uric Acid; Urinary Calculi

Topics: Bicarbonates; Cystinuria; Humans; Kidney Calculi; Magnesium; Magnesium Compounds; Phosphates; Sodium Bicarbonate; Solubility; Struvite; Ultrasonic Therapy; Uric Acid; Urinary Bladder Calculi; Vibration

Topics: Adolescent; Adult; Aged; Calcium; Calcium Phosphates; Child; Cystinuria; Diet; Disease Susceptibility; Female; Humans; Magnesium; Magnesium Compounds; Male; Middle Aged; Oxalates; Phosphates; Risk; Struvite; Uric Acid; Urinary Calculi

Topics: Calcium Oxalate; Calcium Phosphates; Cystinuria; Humans; Hydrogen-Ion Concentration; Kidney Calculi; Magnesium; Magnesium Compounds; Phosphates; Struvite; Uric Acid