struvite and Hyperuricemia

The prevalence of urolithiasis in humans is increasing worldwide; however, non-surgical treatment and prevention options remain limited despite decades of investigation. Most existing laboratory animal models for urolithiasis rely on highly artificial methods of stone induction and, as a result, might not be fully applicable to the study of natural stone initiation and growth. Animal models that naturally and spontaneously form uroliths are an underused resource in the study of human stone disease and offer many potential opportunities for improving insight into stone pathogenesis. These models include domestic dogs and cats, as well as a variety of other captive and wild species, such as otters, dolphins and ferrets, that form calcium oxalate, struvite, uric acid, cystine and other stone types. Improved collaboration between urologists, basic scientists and veterinarians is warranted to further our understanding of how stones form and to consider possible new preventive and therapeutic treatment options.

Topics: Animals; Biomedical Research; Calcium Oxalate; Cats; Cystine; Disease Models, Animal; Dogs; Dolphins; Ferrets; Genetic Predisposition to Disease; Hyperuricemia; Otters; Risk Factors; Struvite; Uric Acid; Urolithiasis

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