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Ocorrência de cálculo renal e/ou ureteral em gatos com doença renal crônica atendidos no Hospital Veterinário da Universidade de São Paulo; Nephrolithiasis and/or ureterolithiasis occurrence in cats with chronic kidney disease attended at the Veterinary Hospital of the University of São Paulo

Pimenta, Marcela Malvini
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 10/07/2013 PT
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Mais do que uma realidade na clínica de felinos, os cálculos renais em gatos tornaram-se motivo de grande preocupação para a especialidade. Em contraste aos cálculos de estruvita encontrados frequentemente na vesícula urinária, os cálculos de oxalato de cálcio (CaOx), localizados em rins e ou ureteres passaram a compor um novo perfil da urolitíase. Foi realizado um estudo clínico transversal com 96 gatos com o objetivo de determinar a ocorrência de cálculos de origem renal (nefrolitíase e ureterolitíase) em gatos portadores de DRC e uma possível associação entre essas duas doenças. Destes pacientes, 24 foram excluídos por não atenderem os critérios necessários para classificação entre os grupos. Assim, 72 gatos portadores de DRC foram divididos em dois grupos, DRC com evidências de nefrolitíase e ou ureterolitíase (n=47), e DRC sem evidências de nefrolitíase e ou ureterolitíase (n=25). Os grupos mostraram homogeneidade em relação à classificação da DRC segundo os estágios propostos pela IRIS - International Renal Interest Society (p= 0,5613), como também em relação à idade (p=0,274). Contudo, os gatos classificados no estágio II da DRC foram os mais representados em ambos os grupos. Apesar disso...

Ocorrência de cristais em plantas medicinais utilizadas no tratamento da nefrolitíase: Paradoxo?

Augusto Scardelato, Juhan; Pella Legramandi, Victor Hugo; do Sacramento, Luis Vitor Silva
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 161-168
ENG; POR
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Nephrolithiasis (kidney stones) can be seen as a common clinical condition responsible for substantial economic, social and psychological costs, due to its high morbidity, especially since it affects adults in their productive phase. Its development in the urinary tract is a complex and multifactorial process. The majority of kidney stones are made of calcium oxalate. A lot of plants are used to treat nephrolithiasis and they often exhibit calcium oxalate crystals in the parts that are employed for this medicinal purpose, representing a possible risk. In this light, we performed a literature review via the databases Scielo, PubMed and Medline and found 28 articles reporting the traditional use of plants in the treatment of nephrolithiasis. The occurrence of calcium oxalate crystals was indicated in 19 species. We argue that the use of these plants could give rise to adverse effects in people who are prone to form calcium oxalate stones in the kidney.; A nefrolitíase pode ser vista como uma condição clínica frequente responsável por importante ônus econômico, social e psicológico, decorrente de sua elevada morbidade, especialmente por se manifestar em adultos em fase produtiva. O seu desenvolvimento no sistema urinário é um processo complexo e multifatorial. Em sua maioria...

Nephrolithiasis is associated with an increased prevalence of cardiovascular disease

Domingos, F; Serra, MA
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Pré-impressão
Publicado em //2011 ENG
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Background: Nephrolithiasis has been associated with hypertension, obesity and diabetes Mellitus. The prevalence of adverse cardiovascular outcomes among kidney stone formers (KSF) is unknown. Methods: We examined the IV Portuguese National Health Survey for documenting possible associations between nephrolithiasis, cardiovascular diseases, diabetes and obesity in the Portuguese adult population. Results: We obtained 23,349 questionnaires from individuals with ≥ 15 year-old. The prevalence of kidney stone disease was 7.3%. The prevalence of hypertension was higher among KSF when compared with the general population (50.4% vs. 30.2%; p < 0,001). Age and obesity significantly increase the risk for nephrolithiasis. After adjusting for age and body mass index, KSF have higher prevalence of hypertension (odds-ratio: 1.841; 95% CI: 1.651 – 2.053), diabetes Mellitus (odds-ratio: 1.475; 95% CI: 1.283 – 1.696; p < 0.001), myocardial infarction (odds-ratio: 1.338; 95% CI: 1.003 – 1.786; p < 0.05), and stroke (odds-ratio: 1.330; 95% CI: 1.015 – 1.743; p < 0.05) as compared with non-stone formers. Conclusions: Kidney stone disease is associated with a higher prevalence of chronic diseases and adverse cardiovascular outcomes when compared with the general population.

Metabolic and endocrinological factors related to nephrolithiasis pre and post multiple techniques of bariatric surgery: a sistematic review

SANTOS,Marcos Vinicius Ribeiro dos; FERREIRA,Gustavo Enrique Correia; OLIVEIRA,Eduardo Cirne Pedrosa de; KREIMER,Flavio; CAMPOS,Josemberg Marins; FERRAZ,Alvaro Antonio B.
Fonte: Colégio Brasileiro de Cirurgia Digestiva Publicador: Colégio Brasileiro de Cirurgia Digestiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 EN
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INTRODUCTION: Despite of benefits of bariatric surgery for obesity treatment, the procedure may be related to some complications. AIM: Analyze studies to address the relation between nephrolithiasis and bariatric surgery. METHODS: Ten papers about this theme were selected from 2005-2013 in Pubmed, describing the relation of nephrolithiasis or their risk factors with several types of bariatric surgery. RESULTS: Retrospective studies with minimal follow-up of three years demonstrated 7,65% in surgery patients and 4,63% non-surgery with nephrolithiasis (p<0,05). Prospective studies (8 of 10) revealed large percentage of calculi appearing and significant increase in oxaluria. CONCLUSION: There is correlation between obesity surgery and nephrolithiasis.

Species differences in Cl− affinity and in electrogenicity of SLC26A6-mediated oxalate/Cl− exchange correlate with the distinct human and mouse susceptibilities to nephrolithiasis

Clark, Jeffrey S; Vandorpe, David H; Chernova, Marina N; Heneghan, John F; Stewart, Andrew K; Alper, Seth L
Fonte: Blackwell Science Inc Publicador: Blackwell Science Inc
Tipo: Artigo de Revista Científica
EN
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The mouse is refractory to lithogenic agents active in rats and humans, and so has been traditionally considered a poor experimental model for nephrolithiasis. However, recent studies have identified slc26a6 as an oxalate nephrolithiasis gene in the mouse. Here we extend our earlier demonstration of different anion selectivities of the orthologous mouse and human SLC26A6 polypeptides to investigate the correlation between species-specific differences in SLC26A6 oxalate/anion exchange properties as expressed in Xenopus oocytes and in reported nephrolithiasis susceptibility. We find that human SLC26A6 mediates minimal rates of Cl− exchange for Cl−, sulphate or formate, but rates of oxalate/Cl− exchange roughly equivalent to those of mouse slc2a6. Both transporters exhibit highly cooperative dependence of oxalate efflux rate on extracellular [Cl−], but whereas the K1/2 for extracellular [Cl−] is only 8 mm for mouse slc26a6, that for human SLC26A6 is 62 mm. This latter value approximates the reported mean luminal [Cl−] of postprandial human jejunal chyme, and reflects contributions from both transmembrane and C-terminal cytoplasmic domains of human SLC26A6. Human SLC26A6 variant V185M exhibits altered [Cl−] dependence and reduced rates of oxalate/Cl− exchange. Whereas mouse slc26a6 mediates bidirectional electrogenic oxalate/Cl− exchange...

Evaluation of Nephrolithiasis in Autosomal Dominant Polycystic Kidney Disease Patients

Nishiura, José L.; Neves, Rodrigo F.C.A.; Eloi, Samara R.M.; Cintra, Susan M.L.F.; Ajzen, Sergio A.; Heilberg, Ita P.
Fonte: American Society of Nephrology Publicador: American Society of Nephrology
Tipo: Artigo de Revista Científica
Publicado em /04/2009 EN
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Background and objectives: Nephrolithiasis (LIT) is more prevalent in patients with autosomal dominant polycystic kidney disease (ADPKD) than in the general population. Renal ultrasonography may underdetect renal stones because of difficulties imposed by parenchymal and/or cyst wall calcifications.

Genetic causes of hypercalciuric nephrolithiasis

Stechman, Michael J.; Loh, Nellie Y.; Thakker, Rajesh V.
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
EN
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Renal stone disease (nephrolithiasis) affects 3–5% of the population and is often associated with hypercalciuria. Hypercalciuric nephrolithiasis is a familial disorder in over 35% of patients and may occur as a monogenic disorder that is more likely to manifest itself in childhood. Studies of these monogenic forms of hypercalciuric nephrolithiasis in humans, e.g. Bartter syndrome, Dent’s disease, autosomal dominant hypocalcemic hypercalciuria (ADHH), hypercalciuric nephrolithiasis with hypophosphatemia, and familial hypomagnesemia with hypercalciuria have helped to identify a number of transporters, channels and receptors that are involved in regulating the renal tubular reabsorption of calcium. Thus, Bartter syndrome, an autosomal disease, is caused by mutations of the bumetanide-sensitive Na–K–Cl (NKCC2) co-transporter, the renal outer-medullary potassium (ROMK) channel, the voltage-gated chloride channel, CLC-Kb, the CLC-Kb beta subunit, barttin, or the calcium-sensing receptor (CaSR). Dent’s disease, an X-linked disorder characterized by low molecular weight proteinuria, hypercalciuria and nephrolithiasis, is due to mutations of the chloride/proton antiporter 5, CLC-5; ADHH is associated with activating mutations of the CaSR...

Hypocitraturia in Common Bottlenose Dolphins (Tursiops truncatus): Assessing a Potential Risk Factor for Urate Nephrolithiasis

Venn-Watson, Stephanie K; Townsend, Forrest I; Daniels, Risa L; Sweeney, Jay C; McBain, Jim W; Klatsky, Leigh J; Hicks, Christie L; Staggs, Lydia A; Rowles, Teri K; Schwacke, Lori H; Wells, Randall S; Smith, Cynthia R
Fonte: American Association for Laboratory Animal Science Publicador: American Association for Laboratory Animal Science
Tipo: Artigo de Revista Científica
EN
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Numerous cases of urate nephrolithiasis in managed collections of common bottlenose dolphins (Tursiops truncatus) have been reported, but nephrolithiasis is believed to be uncommon in wild dolphins. Risk factors for urate nephrolithiasis in humans include low urinary pH and hypocitraturia. Urine samples from 94 dolphins were collected during April 2006 through June 2009 from 4 wild populations (n = 62) and 4 managed collections (n = 32). In addition, urine uric acid and pH were tested in a subset of these animals. Our null hypothesis was that wild and managed collection dolphins would have no significant differences in urinary creatinine, citrate, and uric acid concentrations and pH. Among urine samples from all 94 dolphins, the urinary levels (mean ± SEM) for creatinine, citrate, uric acid, and pH were 139 ± 7.6 mg/dL, 100 ± 20 mg citrate/g creatinine, 305 ± 32 mg uric acid/g creatinine, and 6.2 ± 0.05, respectively. Of the 4 urinary variables, only citrate concentration varied significantly between the 2 primary study groups; compared with wild dolphins, managed collection dolphins were more likely to have undetectable levels of citrate in the urine (21.0% and 81.3%, respectively). Mean urinary citrate concentrations for managed collection and wild dolphin populations were 2 and 150 mg citrate/g creatinine...

Nephrolithiasis-associated bone disease: pathogenesis and treatment options

Sakhaee, Khashayar; Maalouf, Naim M.; Kumar, Rajiv; Pasch, Andreas; Moe, Orson W.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
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Nephrolithiasis remains a formidable health problem in the United States and worldwide. A very important but underaddressed area in nephrolithiasis is the accompanying bone disease. Epidemiologic studies have shown that osteoporotic fractures occur more frequently in patients with nephrolithiasis than in the general population. Decreased bone mineral density and defects in bone remodeling are commonly encountered in patients with calcium nephrolithiasis. The pathophysiologic connection of bone defects to kidney stones is unknown. Hypercalciuria and hypocitraturia are two important risk factors for stone disease, and treatments with thiazide diuretics and alkali, respectively, have been shown to be useful in preventing stone recurrence in small prospective trials. However, no studies have examined the efficacy of these agents or other therapies in preventing continued bone loss in calcium stone formers. This manuscript reviews the epidemiology, pathophysiology, and potential treatments of bone disease in patients with nephrolithiasis.

A Genome-Wide Association Study of Nephrolithiasis in the Japanese Population Identifies Novel Susceptible Loci at 5q35.3, 7p14.3, and 13q14.1

Urabe, Yuji; Tanikawa, Chizu; Takahashi, Atsushi; Okada, Yukinori; Morizono, Takashi; Tsunoda, Tatsuhiko; Kamatani, Naoyuki; Kohri, Kenjiro; Chayama, Kazuaki; Kubo, Michiaki; Nakamura, Yusuke; Matsuda, Koichi
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN
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Nephrolithiasis is a common nephrologic disorder with complex etiology. To identify the genetic factor(s) for nephrolithiasis, we conducted a three-stage genome-wide association study (GWAS) using a total of 5,892 nephrolithiasis cases and 17,809 controls of Japanese origin. Here we found three novel loci for nephrolithiasis: RGS14-SLC34A1-PFN3-F12 on 5q35.3 (rs11746443; P = 8.51×10−12, odds ratio (OR) = 1.19), INMT-FAM188B-AQP1 on 7p14.3 (rs1000597; P = 2.16×10−14, OR = 1.22), and DGKH on 13q14.1 (rs4142110; P = 4.62×10−9, OR = 1.14). Subsequent analyses in 21,842 Japanese subjects revealed the association of SNP rs11746443 with the reduction of estimated glomerular filtration rate (eGFR) (P = 6.54×10−8), suggesting a crucial role for this variation in renal function. Our findings elucidated the significance of genetic variations for the pathogenesis of nephrolithiasis.

The -160C>A Polymorphism in e-Cadherin Is Associated with the Risk of Nephrolithiasis

Tan, Mingyue; Xia, Shengqiang; Zhang, Qi; Zhu, Jiang; Bao, Erdun
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 02/09/2013 EN
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Nephrolithiasis is a common disorder worldwide. E-cadherin (CDH1) is involved in epithelial cell-cell interactions and plays important roles in the etiology of nephrolithiasis. We hypothesized that variants in the CDH1 gene are associated with risk of nephrolithiasis. In a hospital-based case-control study of 127 nephrolithiasis patients and 152 controls frequency matched by age and sex, we genotyped the functional -160C>A (rs16260) polymorphism and assessed its associations with risk of nephrolithiasis in a Chinese population. We found that the CA/AA genotypes were associated with a significantly decreased risk of nephrolithiasis (OR = 0.53, 95%CI = 0.32-0.87), compared with the CC genotype, particularly among subgroups of BMI > 24 kg/m2 (OR = 0.38, 95%CI = 0.17-0.85), age ≤ 57 years (OR = 0.47, 95%CI = 0.24-0.93), and men (OR = 0.56, 95%CI = 0.29-0.99). Our results suggest that the CDH1 polymorphism is involved in the etiology of nephrolithiasis and thus may be a marker for genetic susceptibility to nephrolithiasis.

Comparison of Nephrolithiasis Prevalence in Two Bottlenose Dolphin (Tursiops truncatus) Populations

Smith, Cynthia R.; Venn-Watson, Stephanie; Wells, Randall S.; Johnson, Shawn P.; Maffeo, Natalie; Balmer, Brian C.; Jensen, Eric D.; Townsend, Forrest I.; Sakhaee, Khashayar
Fonte: Frontiers Media S.A. Publicador: Frontiers Media S.A.
Tipo: Artigo de Revista Científica
Publicado em 16/10/2013 EN
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In humans, ammonium urate (AU) nephrolithiasis is rare in the Western hemisphere and more common in Japan and developing countries. Among a variety of risk factors, insulin resistance has been associated with urate nephrolithiasis in people. Bottlenose dolphins (Tursiops truncatus) are susceptible to AU nephrolithiasis, and it is believed that some populations are more likely to develop nephrolithiasis compared to others. In an effort to better understand population-based risk factors for AU nephrolithiasis in dolphins and their comparative value to humans, sonographic evaluation was performed on dolphins from a managed collection in San Diego Bay, CA (n = 40) and dolphins from a free-ranging, nearshore population in Sarasota Bay, FL (n = 39) to look for evidence of nephrolithiasis. While 14 (35%) of San Diego Bay dolphins evaluated for the study had sonographic evidence of nephrolithiasis, none of the Sarasota Bay dolphins had evidence of disease. Presence or absence of stones was confirmed by computed tomography in a subset of the San Diego collection (n = 10; four dolphins with stones, six without stones). Age was identified as a risk factor, as dolphins with stones in the San Diego collection were significantly older than dolphins without stones (25.4 vs. 19.1 years...

Nephrolithiasis in topiramate users

Maalouf, Naim M.; Langston, Joshua P.; Van Ness, Paul C.; Moe, Orson W.; Sakhaee, Khashayar
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
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Topiramate is a neuromodulatory agent increasingly prescribed for a number of neurological and non-neurological indications. Topiramate-treated patients are at risk for nephrolithiasis due to hypocitraturia and high urine pH. However, the prevalence of symptomatic stone disease in TPM users is generally perceived to be low. This study was undertaken to assess in topiramate-treated patients the prevalence of symptomatic nephrolithiasis (by history) and of asymptomatic nephrolithiasis by computed tomography (CT) scan. Topiramate users were identified from a database of patients with neurological disorders at a single university hospital. Among 75 topiramate-treated adult patients with a median daily dose of 300 mg and median treatment duration of 48 months, the prevalence of symptomatic nephrolithiasis was 10.7%. In a subset of topiramate-treated patients and no history of symptomatic stone disease, the prevalence of asymptomatic nephrolithiasis detected by CT scan was 20%. The prevalence of symptomatic nephrolithiasis with long-term topiramate use is higher than reported in short-term studies. Furthermore, clinical prevalence is underestimated due to asymptomatic nephrolithiasis.

Elevated Levels of miR-155 in Blood and Urine from Patients with Nephrolithiasis

Hu, Yang-Yang; Dong, Wei-Da; Xu, Yun-Fei; Yao, Xu-Dong; Peng, Bo; Liu, Min; Zheng, Jun-Hua
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
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Background. Both circulating and urinary miRNAs may represent a potential noninvasive molecular biomarker capable of predicting chronic kidney disease, and, in the present study, we will investigate the serum and urinary levels of miR-155 in patients with nephrolithiasis. Methods. Serum and urinary levels of miR-155 are quantified in 60 patients with nephrolithiasis; the result was compared to 50 healthy volunteers. Estimated glomerular filtration (eGFR) was calculated and, by simple regression analysis, the correlations of miR-155/eGFR and miR-155/CRP (C-reactive protein) levels were analyzed as well. Results. The median levels of serum and urinary levels of miR-155 are significantly higher in nephrolithiasis patients than in controls. eGFR inversely correlates with urinary level of miR-155; CRP positively correlates with urinary miR-155. Urinary level of miR-155 inversely correlates with urinary expression of interleukin- (IL-) 1β, IL-6, and tumor necrosis factor- (TNF-) α and positively correlates with urinary expression of regulated upon activation, normal T-cell expressed, and secreted (RANTES). Conclusion. Serum and urinary levels of miR-155 were significantly elevated in patients with nephrolithiasis, and the upregulation of miR-155 was correlated with decline of eGFR and elevation of CRP. Our results suggested that miR-155 might play important roles in the pathophysiology of nephrolithiasis via regulating inflammatory cytokines expression. Further study on the molecular pathogenic mechanism and larger scale of clinical trial are required.

Pathfast Presepsin Assay for Early Diagnosis of Systemic Inflammatory Response Syndrome in Patients with Nephrolithiasis

Hou, Yan-song; Wang, Hua; Chen, Hao; Wu, Ling-feng; Lu, Lin-feng; He, Yi
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
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It is relatively difficult to diagnose bacterial sepsis in nephrolithiasis patients. The aim of the study is to evaluate the diagnostic ability of presepsin in the differential diagnosis including SIRS, infection, or sepsis and to compare its diagnostic value with other markers, mainly as CRP, procalcitonin (PCT), and white blood cell (WBC) in patients of nephrolithiasis presenting with SIRS. 39 patients of nephrolithiasis who were diagnosed as SIRS were prospectively investigated. Plasma presepsin was detected by Pathfast presepsin assay system; CRP and PCT were measured as well. Additionally, 25 nephrolithiasis patients without SIRS were included. At all timing samples, patients were classified as SIRS or non-SIRS group. Median plasma presepsin levels were significantly increased in the SIRS group compared with non-SIRS group (452 pg/mL versus 178 ng/mL, P < 0.001), and presepsin was markedly elevated even in the early stage of SIRS (584 pg/mL 6 h, 660 pg/mL 24 h versus 452 pg/mL, P < 0.001). According to the receiver-operating characteristic (ROC) analysis, presepsin demonstrated a high diagnostic value compared with either PCT or CRP. In the early stage of SIRS, presepsin remained a highly sensitive (74.7%) and specific (88.4%) diagnostic marker compared with either PCT...

Dyslipidemia is associated with an increased risk of nephrolithiasis

Masterson, James H.; Woo, Jason R.; Chang, David C.; Chi, Thomas; L’Esperance, James O.; Stoller, Marshall L.; Sur, Roger L.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
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The pathophysiology of nephrolithiasis is multifactorial. Obesity, diabetes mellitus and hypertension are implicated in its formation. Dyslipidemia (DLD) recently has received attention as well. Congruent with a vascular etiology in stone formation, DLD theoretically would predispose patients to nephrolithiasis. We investigated a possible association of DLD with nephrolithiasis. A random cohort of 60,000 patients was established by collecting the first 5,000 patient charts per month in the year 2000. After excluding pediatric patients, a retrospective study was performed by reviewing age, sex, comorbidities, and last patient follow-up. Median lipid laboratory levels also were reviewed. Descriptive statistics were performed as well as Cox proportional-hazards regression analysis, and univariate and multivariate analyses. 52,184 (22,717 women/29,467 men) patient charts were reviewed. The average age was 31.0 ± 15.2 years. On univariate analysis, DLD was associated with nephrolithiasis with a hazard ratio (HR) of 2.2 [Confidence Interval (CI), 1.9–2.5; p < 0.001] and on multivariate analysis HR = 1.2 (1.0–1.5; p = 0.033). Low-density lipoprotein and triglycerides had no association with stone disease. Patients with high-density lipoprotein (HDL) values <45 for men and <60 for women had an HR of 1.4 (1.1–1.7...

Nephrolithiasis, kidney failure and bone disorders in Dent disease patients with and without CLCN5 mutations

Anglani, Franca; D’Angelo, Angela; Bertizzolo, Luisa Maria; Tosetto, Enrica; Ceol, Monica; Cremasco, Daniela; Bonfante, Luciana; Addis, Maria Antonietta; Del Prete, Dorella;
Fonte: Springer International Publishing Publicador: Springer International Publishing
Tipo: Artigo de Revista Científica
Publicado em 15/09/2015 EN
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Dent disease (DD) is a rare X-linked recessive renal tubulopathy characterised by low-molecular-weight proteinuria (LMWP), hypercalciuria, nephrocalcinosis and/or nephrolithiasis. DD is caused by mutations in both the CLCN5 and OCRL genes. CLCN5 encodes the electrogenic chloride/proton exchanger ClC-5 which is involved in the tubular reabsorption of albumin and LMW proteins, OCRL encodes the inositol polyphosphate 5-phosphatase, and was initially associated with Lowe syndrome. In approximately 25 % of patients, no CLCN5 and OCRL mutations were detected. The aim of our study was to evaluate whether calcium phosphate metabolism disorders and their clinical complications are differently distributed among DD patients with and without CLCN5 mutations. Sixty-four male subjects were studied and classified into three groups: Group I (with CLCN5 mutations), Group II (without CLCN5 mutations) and Group III (family members with the same CLCN5 mutation). LMWP, hypercalciuria and phosphaturic tubulopathy and the consequent clinical complications nephrocalcinosis, nephrolithiasis, bone disorders, and chronic kidney disease (CKD) were considered present or absent in each patient. We found that the distribution of nephrolithiasis, bone disorders and CKD differs among patients with and without CLCN5 mutations. Only in patients harbouring CLCN5 mutations was age-independent nephrolithiasis associated with hypercalciuria...

Nephrolithiasis in patients with inflammatory bowel disease in the community

Cury, Dídia Bismara; Moss, Alan C; Schor, Nestor
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
EN_US
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Background: Inflammatory bowel disease (IBD) has been associated with renal stone formation. The objective of this study was to determine prospectively the prevalence of nephrolithiasis in a community-based population of patients with IBD and to analyze factors associated with renal calculus formation. Methods: Screening renal ultrasound was performed in a well characterized cohort of patients seen between 2009 and 2012 at an IBD clinic. We enrolled 168 patients, including 93 with Crohn’s disease and 75 with ulcerative colitis. Clinical and phenotypic variables associated with asymptomatic nephrolithiasis were determined. Results: Nephrolithiasis was detected in 36 patients with Crohn’s disease and in 28 patients with ulcerative colitis (38% for both). Although none of the patients had been previously hospitalized for symptomatic nephrolithiasis, nine with Crohn’s disease and five with ulcerative colitis had recurrent urinary tract infections or hydronephrosis. In patients with Crohn’s disease, ileocolonic (L3) disease was associated with a greater risk of nephrolithiasis than was ileal (L1) or colonic (L2) disease (odds ratio [OR] 2.3, 95% confidence interval [CI] 1.8–7). Active ulcerative colitis (regardless of severity) represented a significant risk factor for formation of renal calculi (OR 4.2...

Response to an oral calcium load in nephrolithiasis patients with fluctuating parathyroid hormone and ionized calcium levels

Gomes,S.A.; Lage,A.; Lazaretti-Castro,M.; Vieira,J.G.H.; Heilberg,I.P.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2004 EN
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the response to an oral calcium load test was assessed in 17 hypercalciuric nephrolithiasis patients who presented elevated parathyroid hormone (PTH) irrespective of the ionized calcium (sCa2+) levels. Blood samples were collected at baseline (0 min) and at 60 and 180 min after 1 g calcium load for serum PTH, total calcium, sCa2+, and 1.25(OH)2D3 determinations. According to the sCa2+ level at baseline, patients were classified as normocalcemic (N = 9) or hypercalcemic (N = 8). Six healthy subjects were also evaluated as controls. Bone mineral density was reduced in 14/17 patients. In the normocalcemic group, mean PTH levels at 0, 60 and 180 min (95 ± 76, 56 ± 40, 57 ± 45 pg/ml, respectively) did not differ from the hypercalcemic group (130 ± 75, 68 ± 35, 80 ± 33 pg/ml) but were significantly higher compared to healthy subjects despite a similar elevation in sCa2+ after 60 and 180 min vs baseline in all 3 groups. Mean total calcium and 1.25(OH)2D3 were similar in the 3 groups. Additionally, we observed that 5 of 9 normocalcemic patients presented a significantly higher concentration-time curve for serum PTH (AUC0',60',180') than the other 4 patients and the healthy subjects, suggesting a primary parathyroid dysfunction. These data suggest that the individual response to an oral calcium load test may be a valuable dynamic tool to disclose a subtle primary hyperparathyroidism in patients with high PTH and fluctuating sCa2+ levels...

Long term effect of thiazides on bone mass in women with hypercalciuric nephrolithiasis

Spivacow,Francisco R; Negri,Armando L; del Valle,Elisa E
Fonte: Revista de nefrologia, dialisis y transplante Publicador: Revista de nefrologia, dialisis y transplante
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 EN
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Background: Decreased bone mineral density and increased prevalence of bone fractures have been found in patients with idiopathic hypercalciuria. It is not yet clear if thiazide treatment prevent these events. Methods: We retrospectively evaluated bone mass and biochemical markers of bone turnover in response to thiazide therapy in 52 consecutive female patients with idiopathic hypercalciuria and nephrolithiasis. Patients were divided in two subgroups according to their menopausal status: 25 were pre-menopausal (Group I) and 27 were postmenopausal (Group II). Results: Osteoporosis was found in 12 patients at baseline, 9 at the lumbar spine and 6 at the femoral neck. Two were pre-menopausal and 10 were postmenopausal. Patients with osteoporosis were analyzed separately (Group III). There was a significant and persistent reduction in urinary calcium with preservation of bone mass in all the groups after a median follow-up of 51 months. Few adverse effects were found using low doses of hydrochlorothiazide / amiloride. Only in the group III we found a statistically significant an increase in BMD at the lumbar spine of 9.5% and an increase in BMD at femoral neck of 4.4% that did not reach statistical significance. Conclusions: We conclude that correction of hypercalciuria during long term treatment with low-dose hydrochlorothiazide//amiloride in women with nephrolithiasis prevents bone loss and in those with osteoporosis can lead to a significant increa se in bone mineral density at the lumbar spine. Few adverse effects were seen during treatment and no interruption of therapy was necessary.