Dissolution of Struvite Calculi by Hemiacidrin Solution

Massaro, Frank J.; Weiner, Bruce; Sant, Grannum R.; Meares, Edwin M.

doi:10.1002/j.1875-9114.1983.tb03300.x

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…Urologic chemolysis has been variably employed as a treatment option for renal calculi for many decades . Renacidin (United Guardian), also known as hemiacidrin, contains citric acid, magnesium carbonate, and glucono‐delta‐lactone, and has been reported to be clinically effective for the dissolution of struvite calculi . The clinical efficacy of this agent is based on its ability to lower pH surrounding the stone and by forming soluble complexes with calcium and phosphate present in the stone .…”

Section: Discussionmentioning

confidence: 99%

An Unusual yet “Mg”nificent Indication for Hemodialysis

Bansal

Negoianu

Warburton

2016

Seminars in Dialysis

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Hypermagnesemia is an uncommon electrolyte abnormality, due to the fact that magnesium toxicity is only seen in the setting of a massive exposure to exogenous magnesium, often in the setting of renal insufficiency. Here, we report a case of severe hypermagnesemia that resulted in complete paralysis that was secondary to Renacidin administration, a rarely used agent used for intra-renal pelvic or intra-vesicular instillation dissolution of struvite stones. The patient also had concurrent acute kidney injury (AKI). The patient’s magnesium was as high as 16.7 mg/dL, and he initially received hemodialysis followed by continuous venovenous hemodialysis. These therapies resulted in a rapid reduction in magnesium levels and eventual resolution of the muscular weakness. The case discussion highlights several key aspects of magnesium homeostasis, the limited mechanistic understanding of Renacidin-induced hypermagnesemia, and the role of renal replacement therapies in the treatment of hypermagnesemia.

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Section: Discussionmentioning

confidence: 99%

An Unusual yet “Mg”nificent Indication for Hemodialysis

Bansal

Negoianu

Warburton

2016

Seminars in Dialysis

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“…First, because Renacidin solution contained high levels of magnesium and phosphate, its use was contraindicated in patients with advanced renal disease (creatinine clearance < 10 mL/min). [21][22][23][24][25][26][27] Second, as if foreshadowing future catastrophies, Mulvaney reported in 1960 that debris and sand tended to obstruct single ureteral catheters, resulting in patient discomfort and obstruction. 15 Years later, the development of percutaneous nephrostomy puncture techniques would lead to improved irrigation and drainage ( Fig.…”

Section: Development and Introduction Of Hemiacidrin (Renacidin)mentioning

confidence: 99%

The History of Kidney Stone Dissolution Therapy: 50 Years of Optimism and Frustration With Renacidin

González

Whiting²,

Canales³

2012

Journal of Endourology

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Background and Purpose: Over the last 50 years, chemolysis as a primary or adjuvant treatment for urinary stones has fallen in and out of favor. We review the literature for a historical perspective on the origins and chronology of Renacidin therapy, focusing on landmark studies and impracticalities that have seemingly condemned it to history. Materials and Methods: A MEDLINE search was performed on the topic of chemolysis of urinary calculi. Historical literature was reviewed with regard to stone composition, treatment modalities, outcomes, and complications. Results: A total of 61 articles were reviewed, 40 of which were case series, representing a total of 817 patients studied. Mulvaney first introduced Renacidin in 1959 as a modification of Suby and Albright's 1943 solution.Because of an overabundance of nonstandardized irrigation protocols, six deaths were reported in the early 1960s resulting in a Food and Drug Administration ban on the practice of upper urinary tract stone dissolution. Over time, Renacidin returned to the urologist's arsenal, appearing first as an adjunct to dissolve catheter and bladder calculi and later (1990) as an approved agent for renal pelvis and ureter use. This feat was almost singlehandedly the result of a successful hemiacidrin case series published in 1971 by Nemoy and Stamey. By using daily urine cultures, prophylactic antibiotics, and meticulous intrarenal pressure monitoring, Nemoy and Stamey virtually eliminated all major irrigation complications, paving the way for a flurry of studies. More importantly, they established the link between residual struvite stones, persistent infection, and recurrent staghorn stone formation. Conclusions: Dissolution of urinary calculi by chemolysis has been shown to be safe and effective if performed with sterile urine cultures, prophylactic antibiotics, and low intrapelvic pressures. The pioneers of this therapy are remembered for their attempts to develop an alternative to open surgery, and, in the process, solidified the ''stone-free'' concept for infection-based stones.

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Dissolution of Struvite Calculi by Hemiacidrin Solution

Cited by 2 publications

References 20 publications

An Unusual yet “Mg”nificent Indication for Hemodialysis

An Unusual yet “Mg”nificent Indication for Hemodialysis

The History of Kidney Stone Dissolution Therapy: 50 Years of Optimism and Frustration With Renacidin

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