Ureteral calculi associated with high-altitude polycythemia

Abstract

Rationale: High-altitude polycythemia (HAPC) is a common disease in high-altitude areas characterized by excessive erythrocyte proliferation and severe hypoxemia. Recently, the incidence of ureteral calculi has risen. However, cases of ureteral calculi associated with HAPC have not been reported. Patient concerns: We present the cases of 2 patients (26-year-old female, Case 1; 31-year-old male, Case 2) with HAPC who were born in the lowlands and worked in areas of high altitudes. Both patients were admitted to the hospital with acute severe pain in the ureter as the first symptom. Diagnoses: Urological examinations confirmed the presence of a ureteral stone. Interestingly, the biochemical tests showed elevated serum uric acid levels, and the calculous component analysis suggested anhydrous uric acid. Interventions: In the first case, the patient underwent extracorporeal shock wave lithotripsy. In the second case, the patient underwent right ureteroscopy and right ureteral stenting. The patient received postoperative anti-inflammatory, hemostatic, and rehydration therapy. Outcomes: Both patients recovered well with no recurrences observed upon regular re-examinations. Lessons: Recently, extensive research has demonstrated a significant correlation between hyperuricemia and HAPC. Therefore, we speculated that the occurrence of ureteral calculi among immigrants to the plateau might be related to hyperuricemia associated with HAPC. This case report and literature review highlights that the prevention of ureteral calculi in patients with polycythemia who immigrate to the plateaus from high-altitude areas should be considered. Additionally, the serum uric acid levels and urine pH should be monitored regularly.

Effects of Stone Removal via Different Approaches in the Treatment of Incarcerated Upper Ureteral Calculi: A Comparative Study

“…When the stones are larger in diameter and irregular in shape, they are easily incarcerated in the upper ureter, forming incarcerated upper ureter stones. It can cause ureteral obstruction, urinary tract infection, hydronephrosis, etc., and eventually lead to the loss of renal function [6]. erefore, ureteral calculi should be removed in time, the obstruction should be relieved, and the renal function of the affected side should be protected.…”

Prooxidant effects of high dose ascorbic acid administration on biochemical, haematological and histological changes in Cavia porcellus (Guinea pigs): a Guinea pig experimental model

“…Such a scenario could be triggered by conditions like pulmonary fibrosis or kidney diseases. A surge in RBC levels might also prelude kidney stone formation due to the accumulation of uric acids in the form of sodium urate crystals in supersaturated blood [ 28 ]. Hb, a heme-carrying protein in RBCs, also witnessed a substantial increase, consistent with Biobaku et al .…”