Calcium Oxalate ; Humans ; Kidney Calculi ; etiology ; therapy

Kidney stone is one of the common diseases of the urinary system. About 80% of kidney stones are mainly composed of calcium oxalate. As a huge bacterial network, the interaction of gut microbes is complex. Intestinal microbes may play a role in the pathogenesis and prevention of kidney stones. The intestinal flora of patients with calcium oxalate stones possess unique distribution of gut microbes.
Calcium Oxalate ; Gastrointestinal Microbiome ; Humans ; Kidney Calculi/etiology* ; Oxalobacter formigenes ; Urinary Calculi

In this paper, we report on a 5-year-old girl who developed a renal stone while following the ketogenic diet to treat refractory seizure disorder. Three months after initiating the ketogenic diet, she developed severe abdominal pain and vomiting. The spot urine calcium-to-creatinine (Ca/Cr) ratio and 24-hour urine evaluation showed hypercalciuria. Computed tomography (CT) imaging revealed a stone in the right ureteropelvic junction, resulting in hydronephrosis of the right kidney. The renal stone disappeared 5 days after conservative treatment; the patien's microscopic hematuria resolved concurrently. In light of this case report, we recommend regularly monitoring the urine Ca/Cr ratio with ultrasonography for further development of renal stones in patients following the ketogenic diet. If these patients exhibit evidence of symptomatic hypercalciuria or cyristalluria, liberalization of fluid restriction and urine alkalization using oral potassium citrate should be considered.
Child, Preschool ; Epilepsy/*diet therapy ; Female ; Humans ; Ketogenic Diet/*adverse effects/methods ; Kidney Calculi/*etiology

Aged ; Foreign-Body Migration ; complications ; Hemostasis, Surgical ; instrumentation ; Humans ; Kidney Calculi ; etiology ; Kidney Pelvis ; pathology ; Male ; Nephrectomy ; adverse effects

No abstract available.
Bone Marrow/*metabolism/pathology ; Calcium Oxalate/chemistry/metabolism ; Humans ; Hyperoxaluria/*etiology ; Kidney Calculi/etiology ; Male ; Middle Aged ; Nephrectomy/*adverse effects ; Pancytopenia/*pathology ; Recurrence ; Renal Insufficiency/etiology ; Thyrotropin/blood

OBJECTIVE: To compare the outcome of mini-tract vs standard-tract percutaneous nephrolithotomy (PCNL) in staghorn calculi. METHODS: Between May 2009 and May 2011, 122 patients with renal staghorn calculi were treated by PCNL. Fifty-six patients underwent mini-PCNL and the others underwent standard-PCNL. The therapeutic effect and complication of the 2 groups were compared. RESULTS: The two groups had comparable demographic conditions. Although the operation time was significantly longer in mini-PCNL group [(126±24.5) min vs (98±18.9) min], there was no striking difference in hospital stay [(5.7±1.3) d vs (5.3±1.1) d], hemoglobin drop [(9.5±3.2) g/L vs (10.5±3.3) g/L], stone-free state before charge (91.1% vs 89.4%) and complications. CONCLUSION The efficacy and safety of mini-PCNL and standard-PCNL are not significantly different.
Adult ; Humans ; Kidney Calculi ; surgery ; Male ; Middle Aged ; Miniaturization ; Nephrostomy, Percutaneous ; methods ; Postoperative Complications ; etiology ; Retrospective Studies

OBJECTIVE: To evaluate the therapeutic effect and safety of holmium:YAG laser lithotripsy for treating ureteral calculi combined with acute renal failure. METHODS: Ureteroscopic holmium: YAG laser lithotripsy was used in 13 cases of ureteral calculi. RESULTS: After the operation the serum Bun and Cr levels in the patients decreased to different degrees or returned to normal and the stone free rate was up to 92.3% (12/13). CONCLUSION The ureteroscopic holmium:YAG laser lithotripsy can be the first choice for the upper urinary tract obstruction associated with acute renal failure,due to its safety and efficiency. It can also deal with the double sites of ureteral diseases.
Acute Kidney Injury ; etiology ; therapy ; Adult ; Aged ; Female ; Holmium ; Humans ; Lithotripsy, Laser ; methods ; Male ; Middle Aged ; Ureteral Calculi ; complications ; Ureteroscopy

BACKGROUND: The formation of urinary tract stones following renal transplantation is a rare complication. The clinical features of stones after transplantation differ from those of non-transplant patients. Renal colic or pain is usually absent and rarely resembles acute rejection. METHODS: We retrospectively studied 849 consecutive kidney transplant patients in The Rogosin Institute/The Weill-Cornell Medical Center, New York who were transplanted between 1980 and 1997 and had functioning grafts for more than 3 months, to determine the incidence of stone formation, composition, risk factors and patient outcome. RESULTS: At our center, urinary stones were diagnosed in 15 patients (1.8%) of 849 functioning renal grafts for 3 or more months. Of the 15 patients, 10 were males and 5 were females in their third and fourth decade. Eight patients received their transplant from living donors and 7 from cadaveric donors. The stones were first diagnosed between 3 and 109 months after transplantation (mean 17.8 months) and 5 patients had recurrent episodes. The stones were located in the bladder in 11 cases (73.3%), transplanted kidney in 3 cases and in multiple sites in one case. The size of stones varied from 3.4 mm to 40 mm (mean 12 mm). The composition of stones was a mixed form of calcium oxalate and calcium phosphate in 5 cases and 4 patients had infected stones consisting of struvite or mixed form of struvite and calcium phosphate. Factors predisposing to stone formation included tertiary hyperparathyroidism (n=8), hypercalciuria (n=5), recurrent urinary tract infection (n=5), hypocitraturia (n=4), and obstructive uropathy (n=2). Many cases had more than one risk factor. Clinically, painless hematuria was observed in 6 patients and dysuria without bacteriuria in 5 patients. None had renal colic or severe pain at any time. There were no changes in graft function at diagnosis and after removal of stones. Five patients passed stones spontaneously and 8 patients underwent cystoscopy for stone removal. CONCLUSION: Urinary stone formation following kidney transplantation is a rare complication (1.8%). Hyperparathyroidism, hypercalciuria, recurrent urinary tract infection and hypocitraturia are the most common risk factors, but often there are multiple factors which predispose to stone formation. To detect stones and determine their location and size, ultrasonography appears to be the most useful diagnostic tool. Prompt diagnosis, the removal of stones and stone-preventive measures can prevent adverse effects on renal graft outcome.
Adult ; Age Distribution ; Aged ; Calculi/chemistry ; Female ; Human ; Incidence ; Kidney Failure, Chronic/surgery ; Kidney Transplantation/*adverse effects/methods ; Korea/epidemiology ; Male ; Middle Age ; Prognosis ; Risk Assessment ; Sex Distribution ; Urinary Calculi/*epidemiology/etiology

Aged ; Female ; Humans ; Kidney Pelvis ; pathology ; surgery ; Rupture, Spontaneous ; diagnosis ; etiology ; surgery ; Ureteral Calculi ; complications ; diagnosis ; surgery ; Ureteral Obstruction ; complications ; diagnosis ; surgery

BACKGROUNDInfants in some areas of China developed urinary lithiasis after being fed with powdered milk that was tainted with melamine in 2008 and very small proportion of the infants developed acute renal failure caused by urinary tract calculus obstruction. The aim of this article was to summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus and acute renal failure developed after being fed with melamine tainted formula milk.

METHODSData of infant patients with urinary calculus and acute renal failure due to melamine tainted formula milk admitted to the Beijing Children's Hospital Affiliated to the Capital Medical University and the Xuzhou Children's Hospital in 2008 were used to analyze the epidemiological characteristics, clinical manifestations, imaging features as well as effects of 4 types of therapies.

RESULTSAll the 34 infants with urinary calculus were complicated with acute renal failure, their blood urea nitrogen (BUN) was (24.1+/-8.2) mmol/L and creatinine (Cr) was (384.2+/-201.2) micromol/L. The chemical analysis on the urinary calculus sampled from 15 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for the four types of therapies for returning Cr to normal was (3.5+/-1.9) days for cystoscopy group, (2.7+/-1.1) days for lithotomy group, (3.8+/-2.3) days for dialysis group, and (2.7+/-1.6) days for medical treatment group, which had no statistically significant difference (P=0.508). Renal failure of all the 34 infants was relieved within 1 to 7 days, averaging (3.00+/-1.78) days.

CONCLUSIONSMelamine tainted formula milk may cause urinary calculus and obstructive acute renal failure. It is suggested that firstly the patients with urinary calculus complicated with acute renal failure should be treated with dialysis or medication to correct electrolyte disturbance, in particular hyperkalemia, and then relieve the obstruction with available medical and surgical methods as soon as possible. It was observed that the short-term prognosis was satisfactory.

Acute Kidney Injury ; diagnosis ; etiology ; pathology ; therapy ; Child, Preschool ; Cystoscopy ; Female ; Humans ; Infant ; Male ; Peritoneal Dialysis ; Retrospective Studies ; Treatment Outcome ; Triazines ; poisoning ; Urinary Calculi ; complications ; diagnosis ; pathology ; therapy