Crystal , in urine

Hartel, R.W. and Randolph, A.D., 1986. Mechanisms and kinetic modelling of calcium oxalate crystals in urine-like liquor Part II kinetic modelling. American Institution of Chemical Engineers Journal, 32, 1186-1195. 

Gastric distress (nausea and vomiting) is one of the most frequently reported adverse reactions. Bladder irritation (e.g., dysuria, polyuria, hematuria, and urgency) may occur. The mandelic salt can crystallize in urine if there is inadequate urine flow and should not be given to patients with renal failure. Patients with preexisting hepatic insufficiency may develop acute hepatic failure due to the small quantities of ammonia formed during methenamine hydrolysis. 

Derivation Hydrolysis of protein (keratin), organic synthesis. Occurs as small hexagonal crystals in urine. 

Cystinuria la. Type I (kidney 4- gut) lb. Type II (kidney -f gut) lc. Type III (kidney 4" gut) (reoesBive ) Cystine 4 dibasic amino acids Cystine + dibasic amino acids Cystine 4- dibasic anuno adds Cystine and dibasic amino acids 1 Dibasic amino acids / Normal absorption 1 Renal calculi usually containing cystine (treatment with high water intake or penicillamine administration) Chromato phy, cystine crystals in urine urinary nitro-prusside test is podtive (B6, E5, H17, H18, K12, M8. P12, H6, R8, T3a)... 

The last theory on stone formation comprises the matrix theory in which proteins may play an important role in urolithiasis (FI). This theory is based on analyses of many stones, which revealed that the core of these stones contained protein. It had been shown in vitro that certain proteins bind calcium and even induce the calcification process (Rl). These proteins, also called promoters, were therefore considered to be able to activate the initial crystallization process. However, these results could not be verified (FI). Recently it has been shown that in vitro calcium oxalate crystals do contain protein and that the crystallization in urine is not a random event, but rather a selective phenomenon (M4). This supports an earlier statement that stones contain about 1.6% of their weight in nondialyzable extractable protein and that the composition is the same for all stones, regardless of their mineral composition (S7). 

Nausea, vomiting, and diarrhea Allergy (including skin rashes) Crystals in urine (rare)... 

Antifreeze (ethylene glycol) Renal failure, crystals in urine, anion and osmolar gap, initial CNS excitation eye examination normal... 

Orotic aciduria insufficient levels of the enzyme orotidylic pyrophosphorylase orotidylic decarboxylase. Very rare appears first year or so of life severe megobiestic anemia rosisiam to usual treatments mental and physical retardation excreta large quantities of ortic acid in urine needle-shaped crystals in urine. Dietary supplementation with large doses of uridine improves eoemia and mental and physical development. Lady diagnosis essential. 

Schwille PD, SchmiedI A, Herrmann U, Fan J, Gottlieb D, Manoharan M, Wipplinger J (1999) Magnesium, citrate, magnesium citrate and magnesium-alkali citrate as modulators of calcium oxalate crystallization in urine observations in patients with recurrent idiopathic calcium urolithiasis. Urol Res 27 117-126... 

Two nucleation processes important to many people (including some surface scientists ) occur in the formation of gallstones in human bile and kidney stones in urine. Cholesterol crystallization in bile causes the formation of gallstones. Cryotransmission microscopy (Chapter VIII) studies of human bile reveal vesicles, micelles, and potential early crystallites indicating that the cholesterol crystallization in bile is not cooperative and the true nucleation time may be much shorter than that found by standard clinical analysis by light microscopy [75]. Kidney stones often form from crystals of calcium oxalates in urine. Inhibitors can prevent nucleation and influence the solid phase and intercrystallite interactions [76, 77]. Citrate, for example, is an important physiological inhibitor to the formation of calcium renal stones. Electrokinetic studies (see Section V-6) have shown the effect of various inhibitors on the surface potential and colloidal stability of micrometer-sized dispersions of calcium oxalate crystals formed in synthetic urine [78, 79]. 

Litholytic agents in current use are classified as direct or indirect. Indirect type drugs decrease the C.P. of urine, thus inhibiting calculus formation. An example is citrate which helps prevent insoluble salts from crystallizing in the urinary tract. Potassium citrate is administered in pill form as a preventive drug. Direct type drugs dissolve renal calculi which have already formed. 

Cry stalluria (crystals in the urine) may occur during administration of a sulfonamide, although this problem occurs less frequently with some of the newer sulfonamide preparations. This potentially serious problem often can be prevented by increasing fluid intake during sulfonamide therapy. 

Antiviral drugs are given systemically or as topical dragp. When used systemically these dm may be administered orally or intravenously (IV). Rapid IV administration can result in crystalluria (presence of crystals in the urine). The most common adverse reactions when these drugp are administered systemically... 

ACYCLOVIR When given IV, acyclovir can cause crystal-luria (presence of crystals in the urine) and mental confusion. The nurse helps the patient maintain adequate hydration to prevent crystalluria by encouraging the patient to drink 2000 to 3000 mL of fluid each day (if the disease condition permits). In addition, the nurse should give careful attention to assessing the mental status of the patient. 

Calcium oxalate (723) occurs as the monohydrate (whewellite, the thermodynamically stable form under ambient conditions (724)), the dihydrate (weddellite) in plant calcium stores and in sap, or the trihydrate (725). Calcium oxalate also plays a structural role in plants. Oxalate, for example from excessive amounts of rhubarb or spinach, inhibits absorption of Ca2+ from the GIT precipitation of calcium oxalate is the reason for the toxicity of oxalates. Calcium oxalate may also occur in man, where it can appear as minute star-shaped crystals in the urine. It is the main constituent of the majority of urinary calculi in man (726,727). The relationships between dietary calcium... 

A 3-year-old boy consumed a liquid from a container in the family garage He shows central nervous system (CNS) depression, acidosis, suppressed respiration, and oxalate crystals in the urine. Besides supportive and corrective measures, ethanol was administered to the child. 

In acute uric acid nephropathy, acute renal failure occurs as a result of blockage of urine flow secondary to massive precipitation of uric acid crystals in the collecting ducts and ureters. This syndrome is a well-recognized complication in patients with myeloproliferative or lymphopro-liferative disorders and results from massive malignant cell turnover, particularly after initiation of chemotherapy. Chronic urate nephropathy is caused by the long-term deposition of urate crystals in the renal parenchyma. 

The low solubility of uric acid has unfortunate consequences since at higher than normal concentrations it can crystallise in the body. For example, when the urine is unusually acid, calcium urate stones can form in the kidney and bladder. High levels of uric acid in the blood can result in the formation of urate crystals in the joints, which causes a very painful condition, since it results in inflammation in these joints. Gout is unlikely to develop if the urate concentration remains low (<0.4 mmol/L) but any factor that increases the rate of production or decreases that of elimination by the... 

These solid phases are connected to the components in Fig. 4, with which they are in reversible equilibrium. For example, if magnesium ion were added to a complex solution containing solid calcium oxalate monohydrate (COM), the magnesium would compete with calcium for an increased share of the oxalate this would reduce the amount of the calcium oxalate complex, and finally a small amount of calcium oxalate sohd would dissolve to restore the complex concentration to its equilibrium value. In urine, this picture must be extended to account for the molecular substances that coat crystals and reduce access of the solution to the surface coated crystals do not redissolve readily. 

Harvey, J. A., Zobitz, M. M., and Pak, C. Y. (1985). Calcium citrate Reduced propensity for the crystallization of calcium oxalate in urine resulting from induced hypercalduria of calcium supplementation. /. Clin. Endocrinol. Metab. 61,1223-1225. 

For patients who have ingested more than 30 ml of (pure) methanol or ethylene glycol, dialysis is recommended, and haemodialysis is more effective than peritoneal dialysis. Dialysis both removes the alcohols and their metabolites, and corrects the renal and metabolic disturbances and so is the preferred treatment in severe poisoning. The maintenance dose of ethanol required may be tripled during haemodialysis as ethanol is also removed. Early treatment is indicated if ethylene glycol concentrations are above 20 mg/100 ml (200 mg/1), if the arterial pH is below 7.3, if serum bicarbonate concentrations are less than 20 mM/1, and when there are oxalate crystals in the urine. 

Three stages of ethylene glycol overdose occur. Within the first few hours after ingestion, there is transient excitation followed by CNS depression. After a delay of 4-12 hours, severe metabolic acidosis develops from accumulation of acid metabolites and lactate. Finally, delayed renal insufficiency follows deposition of oxalate in renal tubules. The key to the diagnosis of ethylene glycol poisoning is recognition of anion gap acidosis, osmolar gap, and oxalate crystals in the urine in a patient without visual symptoms. 

Mordant or roughen crystal in the urine of a young boy and powdered alum, then dip it in quicksilver and woman s milk. 

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