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

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

Epidermoid cysts in the kidney have rarely been reported, and in most cases its pathogenesis has not been well understood. We report a case of an epidermoid cyst in a kidney with nephrolithiasis in a 61-year-old man. A pyelonephrolithotomy was performed on the patient four years ago to treat nephrolithiasis of the left kidney. During the follow-up, a newly developed mass was discovered three years ago and the mass has recently increased in size. A unilateral nephrectomy was performed under the clinical impression of renal cell carcinoma. Gross examination revealed a well encapsulated cystic mass measuring 3.0 x 2.0 x 2.0 cm and containing lumps of soft whitish material, in the upper pole of the left kidney. This location was the same as that of previous nephrolithiasis. Microscopic examination revealed typical findings of an epidermoid cyst. We suspect that the chronic irritation induced by renal stones may be associated with the development of the epidermoid cyst in this case.
Carcinoma, Renal Cell ; Epidermal Cyst* ; Follow-Up Studies ; Humans ; Kidney* ; Middle Aged ; Nephrectomy ; Nephrolithiasis*

PURPOSE: Kidney stones (nephrolithiasis) are a widespread disease. Thus, blocking stone formation and finding new therapeutic methods is an important area of study. Diosmin (a major component of the bile) is known to have antioxidant as well as renoprotective effects. The present investigation aimed to evaluate the effect of diosmin on renal tissue protection in rats with ethylene glycol-induced nephrolithiasis. MATERIALS AND METHODS: The rats were randomly divided into three groups. Group one (control) did not receive any treatments. In groups two and three, nephrolithiasis was induced by 2.5% (V/V) ethylene glycol + 2.5% (W/V) ammonium chloride (2 mL/d). The second and the third groups received distilled water or diosmin (80 mg/kg/d) by gavage for 21 days. RESULTS: Stereological estimation of the renal structures revealed that the average volume of calcium oxalate (CaOx) in the nephrolithiasis+diosmin rats was -63% less than in the rats with untreated nephrolithiasis (p<0.01). The volume of the glomeruli, proximal and distal convoluted tubules, Henle's loop, collecting ducts, and vessels was reduced -32% to 58% after the induction of nephrolithiasis (p<0.001). In the nephrolithiasis+diosmin rats, on average, -70% to 96% of the glomeruli, proximal convoluted tubules, Henle's loop collecting ducts, and vessels remained intact (p<0.01). Degeneration of the cortical tissue was 5-fold that of the medulla. In the nephrolithiasis+diosmin rats, degeneration in the renal cortical tissue and medulla was reduced -70% and 44%, respectively, compared with that in the untreated nephrolithiasis group (p<0.01). CONCLUSIONS: Diosmin reduces CaOx deposition and the degeneration of glomeruli and tubules in a rat model of nephrolithiasis.
Ammonium Chloride ; Animals ; Calcium ; Calcium Oxalate ; Diosmin ; Ethylene Glycol ; Ethylenes ; Kidney Calculi ; Nephrolithiasis ; Rats ; Water

PURPOSE: To assess the reliability of percutaneous nephrolithotomy (PNL) in pediatric patients by comparing complications between pediatric patients and adults by use of the modified Clavien grading system. MATERIALS AND METHODS: The data of 74 pediatric (0 to 16 years) and 535 adult (17 years and older) patients who underwent PNL owing to kidney stone disease between January 2005 and December 2011 were analyzed retrospectively. The complications in the pediatric and adult patients were classified in five grades according to the modified Clavien system. RESULTS: The most frequent cause of grade I complications was fever requiring antipyretics, which was seen in 4 pediatric patients (5.4%) and 30 adult patients (5.6%). Grade II complications (blood transfusions, <12 hours urinary leakage) were observed in 11 pediatric patients (14.8%) and 80 adult patients (14.9%). Grade III complications were also seen in 6 pediatric patients (8.1%) (grade IIIb; D-J catheter implantation under general anesthesia) and 78 adult patients (14.5%) (grade IIIa; D-J catheter implantation and angio-embolization under local anesthesia). There was no statistically significant difference between the two groups in terms of grade I, II, or III complications (p>0.05). Colonic injury occured in one patient (1.3%) in the pediatric group (grade IVa). In the adult group, one patient (0.2%) died as the result of myocardial infarction (grade V). CONCLUSIONS: Thanks to technological developments and minimalization of the equipment used, when indicated, pediatric patients can be safely treated with PNL with low complication rates similar to those in adult patients.
Adult ; Antipyretics ; Catheters ; Colon ; Fever ; Humans ; Kidney Calculi ; Myocardial Infarction ; Nephrolithiasis ; Nephrostomy, Percutaneous ; Retrospective Studies

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*