No abstract available.
Humans ; Nephrolithiasis

No abstract available.
Nephrolithiasis* ; Uric Acid*

Medullary sponge kidney is a relatively common, congenital lesion of the renal medulla, which was first described by Lenarduzzi in 1939. Many urologists have been interested in its unknown pathogenesis and complications, such as nephrolithiasis and infection. We report 5 cases of medullary sponge kidney, diagnosed by excretory urography and the literature has been reviewed briefly.
Medullary Sponge Kidney* ; Nephrolithiasis ; Urography

Background. Despite being a clean-contaminated procedure, performed only in patients with sterile urine preoperatively, percutaneous nephrolithotripsy (PCNL) is associated with significant infectious perioperative complications. A local antibiogram is of paramount importance in optimizing antibiotic prophylaxis in PCNL because of the substantial variation in bacterial distribution and antibiotic sensitivity worldwide.

Objectives. The incidence of post-PCNL infectious complications, microorganism distribution, and antibiotic sensitivities from patients admitted for PCNL was determined. The risk factors associated with positive cultures and the development of fever and bacteremia were also analyzed.

Methods. A retrospective study of 102 patients who underwent PCNL under a surveillance protocol was done. The susceptibility of isolates from different specimens was evaluated against the most common antibiotics in the hospital. Chi-square and Student's t-test were used to determine differences in the frequencies and means for other risk factors for those who developed fever and urosepsis and those who did not.

Results. The incidence of fever and urosepsis was 25% and 4%, respectively. The most common organism on urine specimens was Escherichia coli which showed high sensitivity to aminoglycosides. The most common isolate on stones was Pseudomonas aeruginosa, which showed higher sensitivities to the fluoroquinolones. The isolates showed nearly consistent resistance to ceftriaxone. No significant association was found between the clinical variables studied and the occurrence of infectious complications.

Conclusion. There are comparable rates of infectious complications to published literature. A change in antibiotic prophylaxis was warranted, given the high resistance to ceftriaxone and the predominance of Pseudomonas aeruginosa on stone isolates. Further surveillance is required to identify significant risk factors for the development of post-PCNL infectious complications.

Topiramate is an antiepileptic drug widely used to treat various seizures, mood disorders and migraine based on its various pharmacological mechanisms. Even though nephrolithiasis is listed as one of its side effects, there have been no cases reporting nephrolithiasis caused by use of topiramate on Korean pediatric patients. Since the use of topiramate is increasing in many patients, the possibility of nephrolithiasis after the treatment needs to be considered. Here, we report our experience in correcting neprholithiasis by simply discontinuing topiramate without administering any additional treatments.
Anticonvulsants ; Fructose ; Humans ; Migraine Disorders ; Mood Disorders ; Nephrolithiasis ; Seizures

Eleven patients with uric acid nephrolithiasis(Five with uric acid stones alone and six with both uric acid and calcium stone) underwent long-term treatment(0.5 to 3.75 years, mean of 2.33 years) with potassium citrate(30 to 80 mEq/day. usually 60mEq/day). Urinary pH increased from low(5.0-6.0) to normal(6.5-7.0) during treatment. Urinary content of uric acid which was 584+/-150 mg, day. slightly increased to 595+/-163 mg/day following treatment. Serum content of uric acid which was 6.45+/-0.9 mg%, slightly decreased to 6.1+/-0.8 mg%. The protein matrix was round in all 11 cases. And 4 types of nucleus were found. which were ca. oxalate, ca. phosphate, dried blood and suture material During the period' (Jan. 1987-Mar. 1990) of preventive management(enough fluid intake. restiction of animal protein and Polycitra-K), no new stones were found.
Animals ; Calcium ; Humans ; Hydrogen-Ion Concentration ; Nephrolithiasis* ; Potassium Citrate* ; Potassium* ; Sutures ; Uric Acid*

Hypercalciuria is the most common metabolic abnormality in patients with calcium nephrolithiasis and oral calcium tolerance test (OCTT) has been developed to diagnose various forms of hypercalciuria. 71 patients with calcium nephrolithiasis who had been admitted to the Dept. of Urology, Pusan National University Hospital during the period of 11/2years from Jan. 1984 to Jun. 1985, were studied for urinary calcium excretion by OCTT constituted of rigorous calcium restriction for 3 days, fasting and calcium loading. The following results were obtained. 1. Of the 71 patients, hypercalciuria was found in 43 cases (61%) and hyperuricosuria in 24 cases (33.8%). Hyperuricosuria was found more frequently in patients with hypercalciuria than patients with normocalciuria. 2. Of 43 cases with hypercalciuria, 11 cases (15%) were classified as absorptive type I, 14 cases (2O %) as absorptive type II 9 cases (13%) as renal hypercalciuria, and 3 cases (4%) as primary hyperparathyroidism. In the other 6 cases, the etiology of the hypercalciuria could not be defined by our simple OCTT. 3. In fasting, urinary Ca/Cr ratio was 0.052+/-0.025 in normocalciuria group, 0.068+/-0.018 in absorptive type I, 0.068+/-0.025 in absorptive type II group, and all these values were in normal limit. In renal hypercalciuria and primary hyperparathyroidism group, the ratios were 0.167+/-0.033 and 0.149+/-0.029, and these values were significantly higher than normal range. 4. After calcium loading, urinary Ca/Cr ratio was 0.105+/-0.041 in normocalciuria group, but in hypercalciuria groups, the ratios were markedly increased to 0.244+/-0.035 in absorptive type I, 0.288+/-0.042 in absorptive type II, 0.263+/-0.068 in renal hypercalciuria, 0.290+/-0.041 in primary hyperparathyroidism group. 5. In renal hypercalciuria, the ratio of renal calcium reabsorption was 97.8+/-O.9%, and tend to be lower than other subgroups of hypercalciuria and normocalciuria group. The ratio of renal phosphorus reabsorption did not show the difference of the values among the subgroups of hypercalciuria and normocalciuria group. OCTT using rigorous calcium restriction for 3 days is recommended as a relatively simple and reliable method of defining the etiology of hypercalciuria.
Busan ; Calcium* ; Diagnosis* ; Fasting ; Humans ; Hypercalciuria* ; Hyperparathyroidism, Primary ; Metabolism ; Nephrolithiasis* ; Phosphorus ; Reference Values ; Urolithiasis ; Urology

During the past decade, there has been an expanding research activity in the largely neglected problem of urolithiasis, and considerable progress has been made concerning physicochemical and physiologic basis for stone formation, development of improved diagnostic criteria, and formation of new regimen for treatment. Calcium is the principal constituent of most kidney stones and hypercalciuria is the most common metabolic abnormality found in patients with nephrolithiasis. Our understanding of these disorders and others that promote the formation of renal calculi is depend on a clear appreciation, of calcium homeostasis in humans. Since the hormone that primarily influence calcium homeostasis is parathyroid hormone, the investigation is undertaken to evaluate the changing of PTH, urinary and serum calcium levels in 104 urolithiasis patients, who has been admitted to Dept. of Urology Kyung Hee University Hospital, during the period of 2 years from March, 1981 to February, 1983. The following results were obtained: 1. Among the 104 patients, male was 76 cases and female was 28 cases, and the proportion of male to female was 2.7:1. The most common age group was 4th and 5th decade. 2. In urolithiasis patients, the range of serum calcium was 8.2-12.8 mg/dl (av.9.7+/-0.7 mg/dl). Hypercalcemia (10.1 mg/dl) was found in 23 cases, and hypercalcemia with elevated PTH level was found in 3 cases. 3. In urolithiasis patients, the range of urine calcium was 30-445mg/day (av.142+/-77mg/day). Hypercalciuria (200 mg/day) was found in 19 cases, and hypercalciuria with elevated PTH level was found in 6 cases. 4. Hypercalcemia with hypercalciuria was found in 6 cases. 5. Hypercalcemia with hypercalciuria and elevated PTH level was found in only 1 case.
Calcium* ; Female ; Homeostasis ; Humans ; Hypercalcemia ; Hypercalciuria ; Kidney Calculi ; Male ; Nephrolithiasis ; Parathyroid Hormone ; Urolithiasis ; Urology

PURPOSE: Hypocitraturia is cited as one of the risk factors promoting stone formation or recurrence of nephrolithiasis. We estimated the relationship between hypocitraturia and other metabolic abnormalities, such as hypercalciuria, hyperuricosuria and hyperoxaluria. The effects of potassium citrate medication were also investigated. MATERIALS AND METHODS: We selected 706 renal stone patients with hypocitraturia (<320mg/day), who had received extracorporeal shock wave lithotripsy (ESWL) treatment, and examined the relationship between hypocitraturia and other metabolic abnormalities according to sex and age. We also examined the increment effect of urinary citrate and stone-free rate following potassium citrate (Urocitra(R)) medication. RESULTS: Complicated hypocitraturia (coexistence with other metabolic abnormalities) was found in 332 of the 706 patients (47.0%). Of the 706 patients, 242 (34.3%), 112 (15.9%) and 33 (4.7%) had hyperoxaluria, hyperuricosuria and hypercalciuria, respectively. Complicated hypocitraturia was higher in the male than female subjects, and was statistically significant (50.4% vs. 39.8%). In 287 (77%) of the 373 patients who received potassium citrate treatment, the urinary citrate level was increased. The mean urinary citrate level was significantly increased (142.5 vs. 336.2 mg/day) (p<0.01), but the stone free rate was not following the citrate treatment. CONCLUSIONS: Potassium citrate was effective in increasing the urinary citrate level. However, prophylactic effects of potassium citrate against recurrent nephrolithiasis must be proved by appropriate comparative studies.
Citric Acid ; Female ; Humans ; Hypercalciuria ; Hyperoxaluria ; Lithotripsy ; Male ; Nephrolithiasis* ; Potassium Citrate ; Recurrence ; Risk Factors ; Shock

We present two cases of symptomatic lower pole moiety ureteropelvic junction obstruction (UPJO) in a partially duplicated collecting system that were successfully treated with minimally invasive endourologic procedures. In the first case, we performed retrograde endopyelotomy with the Acucise(R) ureteral cutting balloon device, and in the latter case, we performed percutaneous nephrolithotomy and antegrade endopyelotomy because of the presence of multiple renal stones. Subsequent intravenous pyelography confirmed marked resolution of the obstruction, and both patients remained asymptomatic during 1 year of follow-up.
Follow-Up Studies ; Humans ; Nephrolithiasis ; Nephrostomy, Percutaneous ; Surgical Procedures, Minimally Invasive ; Ureter ; Urography