Renal and Ureteral Damage Following Clinical Use of Renacidin

Auerbach, Sidney; Mainwaring, Rosser L.; Schwarz, Frank

doi:10.1001/jama.1963.63700010030020a

Cited by 31 publications

(6 citation statements)

References 5 publications

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“…Clinical success [9,10], however, went along with a series of major complications [11][12][13][14][15]. Some cases of death obviously associated with the use of renacidin [16][17][18][19], caused the US Food and Drug Adminis tration (FDA) to withdraw hemiacidrin from use in the upper urinary tract in the USA. Nemoy and Stamey [20] reviewed these cases of death and proved that complica-tions were caused by high intrapelvic perfusion pressure in cases of bacterial infection of the renal pelvic system.…”

mentioning

confidence: 99%

When Is the Indication of Percutaneous Chemolysis Justified?

Heimbach¹,

Winter²,

Hesse³

1995

Urol Int

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Persistent residual stone fragments after extracorporeal Shockwave lithotripsy (ESWL), percutaneous nephrolitholapaxy (PNL) as well as pyelo- and nephrolithotomy represent a great problem in the treatment of stones. The choice of therapy for patients with insufficient renal drainage, poor renal function, and a high anesthetic risk also remains quite difficult. Between 1991 and 1993, 5 patients underwent percutaneous antegrading chemolysis with ‘Suby G’ solution. Two patients, presenting struvite and apatite stones, were free of stones afterwards. In 1 patient, where stone analysis revealed a predominant brushite component, a large decrease in stone size could be observed. In 2 other cases, with stones mainly consisting of whewellite and weddelite, chemolysis proved ineffective. Evaluating our own clinical experience and relevant medical literature, the present study goes on to prove that the indication of percutaneous chemolysis in risk patients as described above is dependent on stone analysis, and must be regarded as an effective adjuvant treatment.

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confidence: 99%

When Is the Indication of Percutaneous Chemolysis Justified?

Heimbach¹,

Winter²,

Hesse³

1995

Urol Int

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“…Deep venous thrombosis prophylaxis was considered mandatory because of patient immobility during therapy. 28,31,42 In 1979, Dretler and colleagues 28 (Table 4) chronicled these concerns by reporting frequent irrigation cessations for elevated intrapelvic pressures, repeated fluoroscopy trips to radiology, and psychologically taxing lengths of immobility and hospitalization in patients on Renacidin irrigation.…”

Section: Declining Popularitymentioning

confidence: 99%

“…He described postmortem renal infarction, necrosis, and 29 Finally, Auerbach and associates 31 followed with a case of severe pyelonephritis, ureteritis, and chemical pyelitis in a patient with bilateral renal calculi. The patient's ultimate cause of death was ruled pulmonary embolus, but the striking renal findings were attributed to Renacidin.…”

Section: Development and Introduction Of Hemiacidrin (Renacidin)mentioning

confidence: 99%

“…The patient's ultimate cause of death was ruled pulmonary embolus, but the striking renal findings were attributed to Renacidin. 31 Based on these six deaths, on June 13, 1963, the FDA banned the use of Renacidin irrigation for the upper urinary tract and bladder. 28,32 The FDA acknowledged that inconsistencies in protocols and user mistakes likely led to the Renacidin mortalities and pointed to sepsis, rather than direct toxicity of the agent, as the cause of death in all cases.…”

Section: Development and Introduction Of Hemiacidrin (Renacidin)mentioning

confidence: 99%

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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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“…Initial laboratory values were as follows: white blood cells, 15,900/cu mm; hematocrit, 46.5%; platelets, 275,000/cu mm; serum sodium, 147 mEq/L; serum potassium, 4.2 mEq/L; serum chloride, 107 mEq/L; serum carbon dioxide, 17 mmole/L; serum glucose, 115 mg/dL; serum urea nitrogen, 15 fEach kit contains Evac-Q-Mag, Evac-Q-Tabs, and Evac-Q-Sert sup¬ positories.…”

mentioning

confidence: 99%