The Prevention of Renal Phosphatic Calculi in the Presence of Infection by the Shorr Regimen

Lavengood, Russell W.; Marshall, Victor F.

doi:10.1016/s0022-5347(17)60743-2

Cited by 35 publications

(7 citation statements)

References 15 publications

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“…The recurrence rate of magnesium ammonium phosphate calculi may be decreased by elimination of urinary infection and/or urinary stasis. Lavengood and Marshall [8] have shown that there was known recurrence in 27% of patients with phosphate calculi over an average follow-up peri od of 4 years.…”

Section: Discussionmentioning

confidence: 99%

An Observation on the Composition and Recurrence of Urinary Calculi

Takasaki¹

1975

Urol Int

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Seven hundred patients with 735 urinary calculi were studied for the compositions of calculi by infrared analysis and for stone recurrence. Of these 700 cases, 422 cases were possible to follow up, and 250 cases have had no further stone; 138 cases experienced recurring stones, and 34 cases had multiple stones. The length of follow-up period was 1–19 years averaging 8 years, 8 months. 41.2% of patients with calcium oxalate-calcium phosphate calculi had stones recurrently, and although there was some variation of recurrence rates for patients with various proportions of oxalate to phosphate in the calculi, it was impossible to predict the tendency of recurrence by these proportions. The stone recurrence was noted in 38.6% of patients with magnesium ammonium phosphate calculi, in 38.9% with mixed magnesium ammonium phosphate-calcium oxalate calculi, in 55.6% with uric acid calculi, and in 50% with cystine calculi.

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Section: Discussionmentioning

confidence: 99%

An Observation on the Composition and Recurrence of Urinary Calculi

Takasaki¹

1975

Urol Int

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“…Given these considerations, AHA is probably useful only in very select circumstances where surgery is contraindicated. Use of a low-phosphorous, low-magnesium diet together with aluminum hydroxide gel (the Shorr regimen) may be able to reduce stone growth rates via substrate depletion [ 200 ] . However, this regimen is associated with signi fi cant side effects, including constipation, anorexia, bony pain, and hypercalciuria and is, therefore, not generally recommended.…”

Section: Infection Stonesmentioning

confidence: 99%

Evaluation and Medical Management of Kidney Stones

Humphreys

Lieske

2012

Essential Urology

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“…One strategy is to drastically reduce urinary levels of phosphate, one of the key substrates for struvite growth. The Shorr regimen accomplishes this using a low phosphate diet coupled with aluminum hydroxide capsules, an approach that can reduce intestinal phosphate absorption to very low levels, typically less than 300 mg per day [48]. Uncontrolled case series suggests that such an approach can potentially reduce struvite formation in highrisk patients [48].…”

Section: Medical Treatment Of Infection Stonesmentioning

confidence: 99%

Infection-Related Kidney Stones

Krambeck

Lieske

2011

Clinic Rev Bone Miner Metab

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Infection and stones can be associated in two ways. Stone disease can occur due to infection by an organism that expresses the urea-splitting enzyme urease (infection stones). Nephrolithiasis can also be complicated by urinary tract infection that in turn was caused by obstruction of the urinary tract by a stone and/or colonization of a pre-existing stone, in both cases by non-urease producing organisms. Although the incidence of infection stones appears to have declined over recent years in the United States, they remain a cause of significant morbidity and mortality. A strong index of suspicion is necessary to identify infection stones before they become large, damage kidneys, or lead to acute morbidity such as urosepsis. Surgery remains the mainstay of therapy for infection stones, combined with careful attention to antibiotic choice based upon appropriate culture results. Use of medical therapy alone is reserved for those relatively unusual cases in which there is a strong contraindication to surgery. Infection-related stones also require prompt recognition, often via use of non-contrast CT. Any obstruction that is present needs to be promptly relieved in order to decompress the kidney and allow the infection to be cleared by antibiotics chosen based upon culture results.

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The Prevention of Renal Phosphatic Calculi in the Presence of Infection by the Shorr Regimen

Cited by 35 publications

References 15 publications

An Observation on the Composition and Recurrence of Urinary Calculi

An Observation on the Composition and Recurrence of Urinary Calculi

Evaluation and Medical Management of Kidney Stones

Infection-Related Kidney Stones

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