Urinary tract stones

Painful, bloody urine due to urinary tract stone use Hai Jin Sha [Lygodii spora) and Jin Qian Cao [Lysimachiae herba) to clear heat and remove the tiny stones, which are often referred to as sand. 

Bilateral hydronephrosis and acute renal insufficiency due to urinary tract stones predominantly composed of ciprofloxacin has been reported (42). 

Mandel NS, MandeIGS. Urinary tract stone disease In the United States veteran population. II. Geographical analysis of variations In composition. J.Urol. 1989,142 1516-21. 

When the recommended daily allowance (RDA) for calcium is not met by the diet is (particularly in women), supplementation in the form of calcium salts is recommended. Calcium salts vary widely in calcium content by weight, calcium gluconate has 9%, calcium lactate has 13%, and calcium carbonate has 40% calcium. Absorption of calcium from salts may vary calcium carbonate is the most poorly absorbed. Bone meal and dolomite are not recommended sources of calcium, since they may contain lead, arsenic, mercury, and other toxic metals. A potential complication of excessive calcium intake is formation of urinary tract stones this risk may be reduced by ample fluid intake. 

The occurrence of renal stone formation might well date back to early man. The oldest urolith ever recovered, from an Egyptian grave, has been estimated as 6000 years old. Although stone formation seems to have been common during medieval times, surgical treatment, performed by the stone cutters, was difficult if not deadly. Bladder stone formation, as opposed to upper urinary tract stone formation, appears to have been the dominant form of disease during ancient times the last century has seen a shift in dominance. 

Endemic bladder stone disease still occurs in the western population, but a clear relationship exists between a decreasing incidence of bladder stone development and growing prosperity (Bl). An increase in the incidence of upper urinary tract stone formation has been seen during recent decades. The diet of an affluent lifestyle induces metabolic changes that increase the risk of calcium-containing stones forming in the urinary tract. Because protein-rich food is more readily available to affluent persons, their urinary excretion of calcium, oxalate, and urate is increased whereas urinary pH and excretion of citrate are reduced (Bl). The... 

Patients with this disorder often have urinary tract stones, which are caused by the limited solubility of cystine. A related disorder found in other people is characterized by the appearance of ornithine, lysine, and arginine in the urine, although the levels of urinary cystine are normal. 

In a study of cranberry juice (1 liter daily for 7 days) on urinary tract stone formation risk in normal subjects and in subjects with a history of calcium oxalate stone formation, significant increases in urinary calcium and oxalate levels and a decrease in urinary pH were observed. These results suggest that cranberry juice may increase the risk of calcium oxalate and uric acid stone formation but reduce the risk of brushite stone formation (Gettman et al. 2005). 

C. was first isolated from urinary tract stones and can be obtained from the hydrolysates of keratin-rich proteins such as horse hair (content 8%). C. is reductively cleaved by 2-mercaptoethanol or 1,4-dithiothreitol (Cleland s reagent) and oxidized by peroxyformic acid to cysteic acid. 

A carboxylic acid, normally excreted in the urine in small amounts. It is a constituent of many urinary tract stones. High levels of oxalic acid are excreted in the urine in the rare inborn error of metabolism, primary hyperoxaluria. In this disorder renal stones composed of oxalate are formed and death results from progressive renal failure. The increase in the urinary excretion of oxalic acid appears to be derived from glycine as a result of deficient glyoxylic acid-glycine transamination. 

The comparison between non-contrast-enhanced CT and IVU in adults suspected of a ureteric obstruction by stone demonstrated that non-con-trast-enhanced CT is more effective than IVU in precisely identifying ureteric stones (Smith et al. 1995). Spiral CT underscores the concept that the radiolucent calculus is a thing of the past-virtu-ally all urinary calculi are visible on CT (Mindell and Cochran 1994). Because of the sedation and the radiation dose, spiral CT is very seldom used for detecting urinary tract stones in children, and then only in late childhood as low-dose CT (Fig. 20.7) (Kluner et al. 2006 Poletti et al. 2007). 

Nephrolithiasis and/or nephrocalcinosis may be additional findings on sonography and can be confirmed on plain abdominal radiograph. Renal or urinary tract stones are found in uropathies caused by recurrent urinary infections and urine stasis. Nephrocalcinosis may be the consequence of acid-base disturbance and hypercalciuria in congenital tubulopathies. The presence of nephrocalcinosis and nephrolithiasis favors primary hyperoxaluria type 1 (PH 1) as diagnosis. This autosomal recessive inherited disease is caused by a deficiency of the liver-specific peroxisomal enzyme alanine-gly-... 

Maintaining Adequate Fluid Intake and Output Because one adverse reaction of the sulfonamide dragp is altered elimination patterns, it is important that the nurse helps the patient maintain adequate fluid intake and output. The nurse can encourage patients to increase fluid intake to 2000 mL or more a day to prevent crystal-luria and stone formation in the genitourinary tract, as well as to aid in the removal of microorganisms from the urinary tract. It is important to measure and record the intake and output every 8 hours and notify the primary health care provider if the urinary output decreases or the patient fails to increase his or her oral intake... 

Many UTIs are treated on an outpatient basis because hospitalization usually is not required. UTIs may be seen in the hospitalized or nursing home patient widi an indwelling urethral catiieter or a disorder such as a stone in the urinary tract. 

From a therapeutic point of view, it is essential to confirm the presence of bacteriuria (a condition in which there are bacteria in the urine) since symptoms alone are not a reliable method of documenting infection. This applies particularly to bladder infection where the symptoms of burning micturition (dysuria) and frequency can be associated with a variety of non-bacteriuric conditions. Patients with symptomatic bacteriuria should always be treated. However, the necessity to treat asymptomatic bacteriuric patients varies with age and the presence or absence of underlying urinary tract abnormalities. In the pre-school child it is essential to treat all urinary tract infections and maintain the urine in a sterile state so that normal kidney maturation can proceed. Likewise in pregnancy there is a risk of infection ascending from the bladder to involve the kidney. This is a serious complication and may result in premature labour. Other indications for treating asymptomatic bacteriuria include the presence of underlying renal abnormalities such as stones which may be associated with repeated infections caused by Proteus spp. 

Urinary tract abnormalities (infections, obstruction, stones) Progression... 

Upper and lower urinary tract infection, urosepsis, urinary incontinence refractory urinary retentions chronic, renal failure, bladder diverticuli, bladder stones, or recurrent gross hematuria. 

Uncomplicated UTIs are not associated with structural or neurologic abnormalities that may interfere with the normal flow of urine or the voiding mechanism. Complicated UTIs are the result of a predisposing lesion of the urinary tract such as a congenital abnormality or distortion of the urinary tract, a stone, indwelling catheter, prostatic hypertrophy, obstruction, or neurologic deficit that interferes with the normal flow of urine and urinary tract defenses. 

D-penidllamine can promote the elimination of copper (e.g., in Wilson s disease) and of lead ions. It can be given orally. Two additional uses are cystinu-ria and rheumatoid arthritis. In the former, formation of cystine stones in the urinary tract is prevented because the drug can form a disulfide with cysteine that is readily soluble. In the latter, penicillamine can be used as a basal regimen (p. 320). The therapeutic effect may result in part from a reaction with aldehydes, whereby polymerization of collagen molecules into fibrils is inhibited. Unwanted effects are cutaneous damage (diminished resistance to mechanical stress with a tendency to form blisters), nephrotoxicity, bone marrow depression, and taste disturbances. 

Atropine is used for stomach ulcers, pylorospasms, cholesystis, kidney stones, spasms of the bowels and urinary tract, and bronchial asthma. 

National Kidney and Urologic Diseases Information Clearing House (NKUDIC) (2005). What you should know about kidney stones. In "Urinary Tract and Kidney Diseases and disorders Sourcebook" 1. L. Alexander (ed.), (2005). pp. 348-360. Omnigraphics Inc., Detroit, MI. 

N.A. Dianthus caryophyllus L. Eugenol, benzyl benzoate, methyl salicylate.99 Treat kidney stones, urinary tract infections, blood in the urine. 

The inability to reabsorb cystine leads to accumulation and subsequent precipitation of stones of cystine in the urinary tract. 

Cranberry has been used to prevent and treat urinary tract infections since the 19th century. Today, cranberry juice is widely used for the prevention, treatment, and symptomatic relief of urinary tract infections. Cranberry juice is also given to patients to help reduce urinary odors in incontinence. Another potential benefit of cranberry is a decrease in the rate of formation of kidney stones. 

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