Conversion of Calcium Oxalate to Calcium Phosphate With Recurrent Stone Episodes

Mandel, Neil S.; Mandel, Ian; Fryjoff, Kathy; Rejniak, Tammy; Mandel, Gretchen S.

doi:10.1097/01.ju.0000065592.55499.4e

Cited by 101 publications

(64 citation statements)

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“…Some data suggest that calcium phosphate stones have increased in prevalence. If true, the reasons are uncertain and have been attributed to treatment with citrate supplements (see below) or adverse effects of extracorporeal shockwave lithotripsy (3,4). Lithotripsy has been hypothesized to lead to defective urinary acidification, but this effect is highly speculative.…”

Section: Overview Of Calcium Phosphate Stonesmentioning

confidence: 99%

“…A higher urine pH distinguishes calcium phosphate stone formers from calcium oxalate stone formers, although there is overlap. At higher urine pH values, monobasic phosphate (H 2 PO 4 2 ) gives up a proton and becomes dibasic phosphate (HPO 4 = ). This species is much more prone to combine with the divalent cation calcium.…”

Section: Defective Renal Tubular Acidificationmentioning

confidence: 99%

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A Woman with Recurrent Calcium Phosphate Kidney Stones

Goldfarb

2012

Clinical Journal of the American Society of Nephrology

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SummaryKidney stones composed predominantly (50% or more) of calcium phosphate constitute up to 10% of all stones and 15%-20% of calcium stones, 80% of which are composed of calcium oxalate. Calcium phosphate is a minor component of up to 30% of calcium oxalate stones as well. The cause of calcium phosphate stones is often obscure but most often related to a high urine pH. Some patients with calcium phosphate stones may have incomplete renal tubular acidosis. Others have distal renal tubular acidosis characterized by hyperchloremic acidosis, hypocitraturia, and high urine pH. The use of carbonic anhydrase inhibitors such as acetazolamide, topiramate, and zonisamide leads to a similar picture. Treatment options to specifically prevent calcium phosphate stone recurrence have not been tested in clinical trials. Increases in urine volume and restriction of sodium intake to limit calcium excretion are important. Citrate supplementation is probably effective, although the concomitant increase in urine pH may increase calcium phosphate supersaturation and partially offset the inhibition of crystallization resulting from the increased urine citrate excretion and the alkali-associated reduction in urine calcium excretion. Thiazides lower urine calcium excretion and may help ensure the safety of citrate supplementation.

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Section: Overview Of Calcium Phosphate Stonesmentioning

confidence: 99%

Section: Defective Renal Tubular Acidificationmentioning

confidence: 99%

A Woman with Recurrent Calcium Phosphate Kidney Stones

Goldfarb

2012

Clinical Journal of the American Society of Nephrology

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“…Calcium phosphate kidney stones include apatite (carbapatite or hydroxyapatite (HAP)), brushite (Bru) and octacalcium phosphate (OCP) with the occurrence rate of apatite, 4-10%; Bru, 2-6%; and octacalcium phosphate, less than 1% (14). A recent study has reported that the occurrence of calcium phosphate containing stones has increased over time (18). Calcium phosphate occurs in stones in several different forms: amorphous calcium phosphate (ACP), HAP,…”

Section: Commentsmentioning

confidence: 99%

Effect of biomolecules from human renal matrix of calcium oxalate monohydrate (CaOx) stones on in vitro calcium phosphate crystallization

Pathak

Singh²,

Tandon

2010

Int. braz j urol.

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Purpose: Investigate the activity of high and low molecular weight biomolecules present in the matrix of human calcium oxalate (CaOx) stones not only on the initial mineral phase formation of calcium and phosphate (CaP) but also on its growth and demineralization of the preformed mineral phase. Materials and Methods: Surgically removed renal stones were analyzed by Fourier Transform Infra Red (FTIR) specFourier Transform Infra Red (FTIR) spec-(FTIR) spec-spectroscopy and only CaOx stones were extracted with 0.05M EGTA, 1 mM PMSF and 1% β-mercaptoethanol. Renal CaOx and only CaOx stones were extracted with 0.05M EGTA, 1 mM PMSF and 1% β-mercaptoethanol. Renal CaOx stone extract was separated into > 10 kDa and < 10 kDa fractions by dialysis. Activity of both the fractions along with whole extract was studied on the three mineral phases of CaP assay system. Results: It was interesting to observe that both high and low molecular weight biomolecules extracted from human renal matrix of calcium oxalate (CaOx) stones exhibited different roles in the three mineral phases of CaP. Whole extract exhibited inhibitory activity in all the three assay systems; however, mixed (stimulatory and inhibitory) activity was exhibited by the > 10 kDa and < 10 kDa fractions. SDS-PAGE analysis showed bands of 66 kDa, 80 kDa, 42 kDa in whole EGTA extract lane and > 10 kDa fraction lane. Conclusion: Both high and low molecular weight biomolecules extracted from human renal matrix of calcium oxalate (CaOx) stones have a significant influence on calcium and phosphate (CaP) crystallization.

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“…5 Extra corporeal shock wave lithotripsy may be used to people with kidney stone between 4mm to 2cm in diameter 6 or renal calculi less than 3cm in size. 7,8 ESWL was recommended for some <2 cm. This size limit was recommended because of problems with high treatment failure rates and steinstrase for longer calculi.…”

Section: Introductionmentioning

confidence: 99%

Eswl; Extra Corporeal Shock Waves Lithotripsy With and Without Doublej-Ureteric Stent

Bhatti

Memon

Khalid³

2017

TPMJ

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ABSTRACT… Objectives: Objectives of the study are to evaluate extracorporeal shock waves lithotripsy (ESWL) with and without double-J-ureteric stent in 2-3 cm renal stone. Study Design: Comparative study. Place and Duration of Study: This study was out conducted at Lithotripsy Center, Department of Urology & Renal Transplantation, KEMU/ Mayo Hospital, Lahore, from June 2015to May 2016."Methodology: This study consisted of 60 patients admitted. All patients were divided into two equal groups. Thirty patients of kidney stones were included in group A, who were treated by ESWL without double-j-ureteric stent. Group B, who were treated by ESWL with prior double-j-ureteric stent insertion. Detailed History was taken from all the patients with special regard to the renal stone pain. Detailed Clinical examination of the patient was done and recorded in proforma. Systemic review was also done to see any co-morbidity. All patients underwent for base line and specific investigations" like Urinalysis Pre-ESWL and at monthly intervals post ESWL, mid-stream urine examination for Gram's staining; culture and sensitivity were performed in selected patients, renal ultrasonography, Plain X-Ray KUB and intravenous Urography. Inclusion criteria were that all patients from both sexes between the ages of 15-45 years suffering from renal stones 2-3cm will be included in the study. In Exclusion criteria; patients are unfit for general anesthesia, advance cardiac diseases, bleeding disorders, pregnant women, lower ureteral stones, malignancy and severe urinary infection. Results: 60 patients, there were 40 males and 20 females, with male to female ratio of 2:1. Minimum of 15 year to 45 years in both group. Mean age was 32+ 2.1years. 38(63.33%) of patients has 2.5 -3 cm stone and 22(36.66%) patients has 2-2.5cm stone. Commonest location of stone was 34(57%) cases were lying in calyces followed by pelvis stones which accounted for 26(43%) stones. The average number of retreatment sessions was 2 to 3 sessions, ranged 1 to 5 sessions. The majority 39 (65%) patients needed one & two sessions. Three & four sessions were used in 17 (28.33%) and in five session 04(06%) cases needed. Stone clearance observed 5 to 45days in 2 to 2.5 cm stone. Means clearance were seen 35+4.6 days in without Double-J-Ureteric Stent while 29+3.8 days in with Double-J-Ureteric Stent. Conclusion: In conclusion our study revealed that The extra corporeal shock waves lithotripsy with double-j-ureteric stent is safe, effective and with less complication rate then without double-j-ureteric stent. Key words:Double-J-Ureteric Stent, Urolithiasis, extracorporeal shock waves lithotripsy (ESWL).

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Conversion of Calcium Oxalate to Calcium Phosphate With Recurrent Stone Episodes

Abstract: Our study suggests a strong trend for the conversion of stone disease from calcium oxalate to calcium phosphate containing stones, which could influence the progression and severity of disease.

Cited by 101 publications

References 5 publications

A Woman with Recurrent Calcium Phosphate Kidney Stones

A Woman with Recurrent Calcium Phosphate Kidney Stones

Effect of biomolecules from human renal matrix of calcium oxalate monohydrate (CaOx) stones on in vitro calcium phosphate crystallization

Eswl; Extra Corporeal Shock Waves Lithotripsy With and Without Doublej-Ureteric Stent

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