Urolith Formation Research Articles

Plantas medicinais no controle de urolitíase

Plantas medicinais têm sido utilizadas mundialmente para o controle de urolitíases na medicina humana. A ocorrência desta afecção tem aumentado em humanos, ruminantes, cães e gatos. Nos animais, fatores patofisiológicos adquiridos, congênitos ou familiares podem estar envolvidos, havendo similaridade ao que se observa em seres humanos. Porém, apesar dos avanços nas pesquisas, o emprego de plantas medicinais na medicina veterinária, ainda é pouco utilizado. Dessa forma, objetivou-se apresentar uma revisão bibliográfica dos resultados do uso de plantas medicinais no controle de urolitíase. As plantas utilizadas são: Ammi visnaga, Bergenia ligulata, Cynodon dactylon, Herniaria hirsuta e Phyllanthus niruri. A atividade antilitogênica foi relacionada às alterações da composição iônica da urina, atividade diurética, inibição de cristalização e agregação de cristais. Destaca-se o uso de Phyllanthus niruri, pela eficácia na prevenção dos urólitos. Extratos de Phyllanthus niruri normalizaram níveis altos de cálcio urinário, desfavorecendo os estágios iniciais de formação dos urólitos. Adicionalmente, foram associados à elevação da filtração glomerular e excreção urinária de ácido úrico sugerindo utilização potencial não só como efeito lítico e preventivo das calculoses, mas também em pacientes hiperuricêmicos e portadores de insuficiência renal. A partir dos resultados relatados, pode-se concluir que os trabalhos apresentados pela literatura atual são capazes de comprovar os efeitos benéficos do uso de plantas medicinais no controle de urolitíase. Entretanto, ainda são escassos os estudos realizados em animais domésticos, predominando ensaios desenvolvidos em roedores.

EFEITO DE DIFERENTES FONTES ENERGÉTICAS NA PREDISPOSIÇÃO PARA UROLITÍASE EM CABRITOS

Six goats randomly divided into three groups were used in a 4 X 3 Youden Square design, using four distinct diets [control (C), citric pulp (CP), wheat meal (WM) and rice meal (RM)] in order to evaluate which diet will predispose the formation of uroliths. Serum calcium and phosphorous were determined, as well as urinary pH, density, calcium and phosphorous. The goats fed RM had the highest serum and urinary phosphorous values (5.34±1.71 and 156.9±85.5 mmol/L, respectively), while the animals that received CP had the lowest values for blood and urine phosphorous (2.29±0.36 and 2.02±1.24 mmol/L, respectively). The results of urine pH showed that CP diet caused alkaline urine (8.44±0.33), with higher values than WM and RM (6.27±0.29 and 6.37±0.54, respectively). The urine from one animal that received WM diet and from another that received RM diet presented triple phosphate crystals, while the urine from the goats receiving CP did not present any of these crystals. A determinant factor for crystal formation is the high phosphorous concentration in the urine. Acidic urine pH does not prevent the formation of crystals if urinary phosphorous concentrations are high. KEYWORDS: citrus pulp; goats; rice meal; urinary calculi; wheat meal.

Urinary oxalate and calcium excretion by dogs and cats diagnosed with calcium oxalate urolithiasis

Urine concentrations of oxalate and calcium play an important role in calcium oxalate (CaOx) urolith formation in dogs and cats, with high excretions of both substances increasing the chance of...

Determination of the cause of selected canine urolith formation by advanced analytical methods

The goal of this study was to determine the cause of selected canine urolith formation using less conventional but more advanced analytical methods. A routine laboratory specialising in urinary calculi analysis noticed a special type of core zone in some canine uroliths, which was typically made up of cylindrical holes. Of 4028 canine samples analysed, non-absorbable suture material was detected in 9 (0·22%) cases. A hollow cylindrical central area was found in a further 13 (0·32%) samples. X-ray microtomography (μCT) was utilised in order to reveal the channel structure inside this urolith sample. Matrix-assisted laser desorption-ionisation - time of flight mass spectrometry was used in order to assess the cause of this urinary stone formation. The diameter of the channel structure corresponded with the diameter of the previously utilised suture material and indicated that this urolith was formed around residual suture material. Further confirmation was provided by the comparative matrix-assisted laser desorption-ionisation - time of flight mass spectrometry chemical analysis. This channel structure is formed by a surgical thread that serves as a base for the urolith growth. Results of this study confirm the causative role of absorbable suture material in the pathogenesis of hollow channel structures in some canine compound uroliths.

Analysis of 14,008 uroliths from dogs in theUKover a 10‐year period

To identify breed-associated risk factors for urolithiasis in dogs from the UK. Records of all canine uroliths submitted to Hills Pet Nutrition UK for analysis at the University of Minnesota Urolith Centre over 10 years (1997 to 2006) were reviewed. The results, along with the request forms completed by the submitting veterinarian, were analysed. The most commonly affected breeds, age and gender of the dogs were identified for each of the most common types of uroliths (struvite, calcium oxalate, urate, cystine and mixed). Pearson's chi-squared tests were performed to assess whether certain breeds of dogs were over-represented relative to a reference population (from an insurance database). The records of 14,008 urolith submissions were analysed. The relative frequency of struvite remained stable over time, whereas calcium oxalate decreased over the study period. Breeds found to be significantly over-represented for calcium oxalate uroliths included the Chihuahua, miniature poodle and Yorkshire terrier. Staffordshire bull terriers and English bulldogs were at increased risk for cystine uroliths. Associations between breed, gender, age and urolith formation were similar to those reported elsewhere. However, temporal trends and novel breed predispositions were identified.

Impact of two types of complete pelleted, wild ungulate feeds and two pelleted feed to hay ratios on the development of urolithogenic compounds in meat goats as a model for giraffes

Urolith formation has been documented in giraffes and goats. As research in giraffes poses logistical challenges, 16 buck goats were used as a model. The impact of two commercially available, pelleted feeds used for giraffes, ADF-16 and Wild Herbivore (WH), as well as the impact of alfalfa hay and pellet proportions (20% hay:80% pellets, 80P or 80% hay:20% pellet, 20P) on the formation of urolithogenic precursors in goat urine was accomplished in a 2 × 2 factorial balance study. Complete diets contained 0.60, 0.32, 0.35 and 0.26% phosphorus (P) with calcium:P ratios of 1.60, 4.16, 3.06 and 5.23, for 80P-ADF-16, 20P-ADF-16, 80P-WH and 20P-WH respectively. Total faeces and urine were collected over two 5-day periods to assess N and mineral balance. Fresh urine samples were collected and evaluated microscopically for urolithic crystal content. Urinary nitrogen (N) was lower and N retention was higher in goats fed 80P diets (p < 0.05). Intake of P was greatest for goats fed 80P-ADF-16; however, urinary P excretion and P retention were not affected by treatment. Crystal scores were higher in animals receiving 80P diets (p = 0.08), with crystals being composed predominantly of calcium phosphate. Urine pH was alkaline (>8) for all treatments. Urinary P concentration, a risk factor for urolithiasis, was highest (p ≤ 0.06) in the 80P-ADF-16 treatment (0.38 vs. 0.01, 0.02 and 0.04 mg/dl for 20P-ADF-16, 80P-WH and 20P-WH respectively), reflecting its highest dietary P level. Further investigation is recommended to determine the long-term effects of these diets on urolithogenic compound formation.

Presence of Oxalobacter formigenes in the intestinal tract is associated with the absence of calcium oxalate urolith formation in dogs

The incidence of calcium oxalate (CaOx) urolithiasis in dogs has increased steadily over the last two decades. A potential mechanism to minimize CaOx urolithiasis is to reduce enteric absorption of dietary oxalate by oxalate-metabolizing enteric bacteria. Enteric colonization of Oxalobacter formigenes, an anaerobe which exclusively relies on oxalate metabolism for energy, is correlated with absence of hyperoxaluria or CaOx urolithiasis or both in humans and laboratory animals. We thus hypothesized that decreased enteric colonization of O. formigenes is a risk factor for CaOx urolithiasis in dogs. Fecal samples from dogs with CaOx uroliths, clinically healthy, age-, breed- and gender-matched dogs, and healthy non-stone forming breed dogs were screened for the presence of O. formigenes by quantitative PCR to detect the oxalyl CoA decarboxylase (oxc) gene, and by oxalate degrading biochemical activity in fecal cultures. Prevalence of O. formigenes in dogs with CaOx uroliths was 25%, compared to 50% in clinically healthy, age-, breed- and gender-matched dogs, and 75% in healthy non-stone forming breeds. The presence of oxc genes of O. formigenes was significantly higher in healthy non-stone forming breed dogs than in the dogs with CaOx stones. Further, dogs with calcium oxalate stones and the stone-forming breed-matched controls showed comparable levels of biochemical oxalate degrading activity. We conclude that the absence of enteric colonization of O. formigenes is a risk factor for CaOx urolithiasis.

SUTURAS COM POLIGLACTINA 910 E GRAMPOS DE TITÂNIO: ASPECTOS URINÁRIOS E UROLITOGÊNICOS NA ILEOCISTOPLASTIA EXPERIMENTAL EM CÃES

Urinary disorders are an important finding in ileocystoplasty, especially uroliths and crystalluria, and partly related to the type of suture material involved in this procedure. The aim of this study was to determine whether there are differences in the formation of uroliths and urinary crystalloid after ileocystoplasty in dogs, performed by suturing with nonabsorbable titanium staples and suture with polyglactin 910, noting their impact on renal function and urinary changes in the constitution difference in surgical time. Twelve healthy dogs were used and divided into two groups. In each animal was selected a segment of terminal ileum for bladder augmentation. In group A the suture of the detubelized ileal segment to the bladder was made with polyglactin 910 and in group B and the suture was made with titanium clips. We observed the presence of struvite crystals in 11 animals and the formation of large amounts of mucus in urine in all of them. In conclusion, no significant differences between groups in the formation of urinary crystals and uroliths after surgery, group A showed longer duration of surgery and no evidence of change in renal function in both groups. KEYWORDS: Cystectomy; mechanical suture; sutures; urinary calculi.

Epidemiology of struvite uroliths in ferrets: 272 cases (1981–2007)

To confirm that the predominant mineral type in naturally occurring uroliths in ferrets is struvite; to determine whether age, breed, sex, reproductive status, geographic location, season, and anatomic location are risk factors associated with urolith formation in ferrets; to compare features of struvite uroliths in cats with those in ferrets; and to determine whether there is a logical evidence-based rationale for clinical trials of the safety and efficacy of diet-induced dissolution of struvite uroliths in ferrets. Retrospective case-control study. 408 ferrets with uroliths (272 struvite uroliths) from the Minnesota Urolith Center, and 6,528 control ferrets from the Veterinary Medical Database. Historical information was obtained about each ferret. The association between proposed risk factors and outcome (struvite urolith formation) was assessed. Sterile struvite was the predominant mineral in uroliths in ferrets. Neutered male ferrets had a significantly increased risk of developing sterile struvite uroliths. A significant association was also found between increasing age and the detection of struvite uroliths. Struvite uroliths in ferrets were more likely to be retrieved from the lower urinary tract than from the upper urinary tract. Knowledge of predominant mineral type in uroliths along with insight into etiologic, demographic, and environmental risk and protective factors for urolithiasis may facilitate development of surveillance strategies that result in earlier detection of uroliths in ferrets. Modification of risk factors, including dietary risk factors, may help to minimize urolith formation, dissolve existing uroliths, and minimize urolith recurrence.

Vaginal Calculi in a Juvenile Harbor Porpoise (Phocoena phocoena)

A large number of vaginal calculi were observed in a juvenile harbor porpoise (Phocoena phocoena) stranded on Whidbey Island, Washington. Vaginal calculi have been reported in other species, but not in harbor porpoises. Histologic examination of the urinary tract revealed mucosal hyperplasia most likely attributable to the calculi. The calculi were numerous (>30), composed completely of struvite (magnesium ammonium phosphate), and on culture yielded Enterococcus spp., a bacterium not usually associated with struvite urolith formation in domestic animals. The only other lesion of note was severe hepatic lipidosis, and its relationship to the development of the vaginal calculi is unknown.

The role of urease activity on biofilm and urolith formation by Staphylococcus sp. T-02 that was isolated from a toilet bowl

The role of urease activity on biofilm and urolith formation by Staphylococcus sp. T-02 that was isolated from a toilet bowl

Analysis of nutrient concentrations in the diet, serum, and urine of giraffe from surveyed North American zoological institutions

The objectives of the present research were to conduct a survey to investigate the health history and feeding practices of giraffe in captivity in North America and to obtain samples of hay, concentrate, browse, urine, and serum to compare across zoos, possible factors relating to the development of urolithiasis. Forty-one out of 98 institutions contacted responded, representing 218 giraffe. All responding zoos fed concentrate and alfalfa hay was the primary forage. Sixty-five percent of zoos fed browse and 43 different species of browse were listed. Six zoos reported a history of urolithiasis, seven reported wasting syndrome, and 10 reported sudden death. The median daily amount (as fed) of concentrate and hay offered were 5.45 kg (range of 2.73-9.55 kg) and 6.82 kg (range of 2.53-12.50 kg), respectively. The concentrate:hay ratio of the offered diet ranged from 0.22 to 3.47 with a median value of 0.79. Forty-three percent of the institutions offered a ratio greater than 1:1. Samples of concentrate and hay (six zoos), serum (five zoos), and urine (seven zoos) were obtained for chemical analyses. Analyzed nutrient content of the consumed diet, measured by weighing feed and orts for three consecutive days, met recommendations for giraffe, but was excessive for crude protein and P. Concentrate:hay and serum P were positively correlated (r=0.72; P<0.05). High dietary P content and a high level of concentrate relative to hay may be contributing factors to urolith formation and warrant further investigation.

Melamine Related Bilateral Renal Calculi in 50 Children: Single Center Experience in Clinical Diagnosis and Treatment

We investigated the clinical diagnosis and treatment features of bilateral renal calculi in young children who ingested melamine tainted infant milk formula. We retrospectively analyzed clinical data on 50 children (mean +/- SE age 23.4 +/- 3.1 months) with a history of ingesting melamine tainted infant milk formula and suffering from bilateral renal calculi. All patients underwent ultrasound and renal function evaluation. Treatment included cessation of melamine tainted formula consumption, hydration, urine basification and hemodialysis if necessary. Bilateral renal calculi peaked in 6 to 18-month-olds (58% of cases). The male-to-female ratio was 3.1:1.0. Calculi ranged in diameter from 4 to 10 mm in 33 patients (66%) and 2.5 to 4 mm in 17 (34%). Of the 11 patients with renal failure 8 underwent 1 to 4 sessions of hemodialysis. Of the 9 bilateral obstruction cases with renal failure 8 did not require surgical intervention but 1 required ureteral catheterization to drain the renal pelvis. All children experienced a good outcome and were discharged home after a mean +/- SE hospitalization of 8.1 +/- 0.7 days. Melamine related urinary calculi were most often seen in patients 6 to 18 months old. Conservative management has been sufficient in most cases. However, these children need to be monitored for long-term effects of melamine tainted milk formula consumption.

Effect of Drinking Water on Formation of Renal Calculi

The environmental impact on human health is of increasing concern mainly due to the complex interaction between various hazardous factors both on environment and within human organism. The aim of this paper is to investigate possible correlations between the quality parameters of drinking water and the formation of uroliths. The constituents of some kidney calculi sampled after surgery from 90 patients coming from the Horezu – Valcea area have been analysed, this region being identified as having the most cases of kidney lithiasis and that might be related with hard drinking waters. The study has been made during the period of 2004 – 2008. Physical – chemical methods specific for characterization of the quality of drinking waters have been used in parallel with determination of composition and structural characterization by X-ray diffraction, thermal analysis TG, ATD, FT-IR spectroscopy, optical microscopy. Four groups of uroliths have been identified: multiphase oxalate and urate, phosphate (hydroxiapatite) and carbonate, monohydrated oxalate (whewellite), and urate stones. Such research might be useful, from both chemical and biochemical point of view, for identifying the conditions that cause the inhibition of the processes related to kidney calculi formation.

Dietary management of canine urolithiasis

ALTHOUGH a number of different types of urolith have been reported in dogs, including those associated with drugs and toxins such as sulphonamides, struvite (magnesium ammonium phosphate hexahydrate) accounts for...

Different inflammatory responses are associated with Ureaplasma parvum-induced UTI and urolith formation

BackgroundEpidemiologic studies show a strong association between Ureaplasmas and urogenital tract disease in humans. Since healthy humans can be colonized with Ureaplasmas, its role as a pathogen remains controversial. In order to begin to define the role of the host in disease, we developed a rodent model of urinary tract infection (UTI) using Fischer 344 (F344) rats. Animals were inoculated with sterile broth, 101, 103, 105, 107, or 109 log CFU of a rat-adapted strain of Ureaplasma parvum.ResultsInfected animals exhibited two distinct profiles, asymptomatic UTI and UTI complicated with struvite urolithiasis. Inoculum dose of U. parvum affected the incidence of UTI, and 50% to 57% of animals inoculated with ≥ 107 CFU of U. parvum remained infected (p < 0.04). However, inoculum dose did not influence immune response to U. parvum. Asymptomatic UTI was characterized by a minimal immune response that was predominantly monocytic and lymphocytic, with limited lesions, and elevated urinary levels of IFN-γ, IL-18 and MCP-1 (P ≤ 0.02). UTI complicated with struvite formation was characterized by an exaggerated immune response that was mostly neutrophilic (P ≤ 0.0001), with lesions that showed extensive uroepithelial hyperplasia (P ≤ 0.0001), and a predominance of IL-1α, IL-1β, and GRO/KC in the urine (P ≤ 0.02). Animals with asymptomatic UTI also had a significantly high rate of kidney infection (P ≤ 0.0005).ConclusionComplications associated with U. parvum infection are primarily dependent upon host-specific factors rather than Ureaplasma microbial load. The immune response in F344 rats is similar to that which occurs in humans with ureaplasmal associated disease. Therefore, this model of infection is a useful tool for elucidating U. parvum-host interactions that confer UTI and disease.

Nephrolithiasis and Pyelonephritis in Two West Indian Manatees (Trichechus manatus spp.)

Two West Indian manatees (Trichechus manatus spp.) were reported with severe emaciation. One animal was a Florida manatee from the Everglades; the other was an Antillean manatee from Cuba. On necropsy, both animals had nephrolithiasis, pyelonephritis, and moderate to severe renomegaly. Histopathology revealed multifocal to diffuse pyelonephritis, interstitial nephritis, and nephrocalcinosis. The stones were analyzed and consisted primarily of calcium carbonate. Serum chemistry values for the Florida animal revealed no renal abnormalities. The mechanism of calculus formation remains unclear in manatees. In horses, another hindgut fermenter, the most common urolith is also calcium carbonate. Urinalyses performed on manatees are very similar to those of horses (i.e., alkaline urine, low specific gravity, and calcium carbonate crystals). Formation of uroliths in manatees may have a pathogenesis similar to equine urolithiasis.

Energy of interaction of Ca2+ and C2O2− 4 Ions in multicomponent liquid systems: The inhibition of urolith formation

Energy of interaction of Ca2+ and C2O2− 4 Ions in multicomponent liquid systems: The inhibition of urolith formation

SLC7A9 cDNA cloning and mutational analysis of SLC3A1 and SLC7A9 in canine cystinuria

Cystinuria is a genetic disorder in the domestic dog that leads to recurrent urolith formation. The genetic basis of the disorder is best characterized in humans and is caused by mutations in one of the amino acid transporter genes SLC3A1 or SLC7A9, which results in hyperexcretion of cystine and the dibasic amino acids in the urine and subsequent precipitation of cystine due to its low solubility in urine. In this study we describe the cloning of the canine SLC7A9 cDNA and present a thorough mutation analysis of the coding SLC3A1 and SLC7A9 regions in cystinuric dogs of different breeds. Mutation analysis of the two cystinuria disease genes revealed one SLC7A9 mutation (A217T) and two SLC3A1 mutations (I192V and S698G) in French and English Bulldogs that affect nonconserved amino acid residues, arguing against functional impact on the proteins. The absence of deleterious mutations linked to cystinuria in the remainder of our panel of cystinuric dogs is surprising because SLC3A1 or SLC7A9 mutations explain approximately 70% of all human cystinuria cases studied. The present study, along with previous investigations of canine and human cystinuria, implies that regulatory parts of the SLC3A1 and SLC7A9 genes as well as other unknown genes may harbor mutations causing cystinuria.

Influence of the feed base excess on urine parameters in cats*

In this study the base excess (BE) was used as a method to predict the influence of the food on the urinary pH on cats. Nine cat foods (six dry and three canned) were consecutively fed to eight cats. The urine pH, volume, specific gravity and water and food intake were determined daily. The base excess [BE; mmol/kg dry matter (DM)] was calculated from the compounds in the food (BE = 49.9*Ca+82.3*Mg*+43.5*Na+25.6*K-64.6*P-13.4*Met-16.6*Cys-28.2*Cl). The BE of the tested foods was between -287.35 and 133.38 mmol/kg DM. The mean urine pH varied between 5.76 (SD = 0.13) and 7.16 (SD = 0.22). The BE correlated with the mean urine pH (pH = 6.25+0.0023*BE; r = 0.74**). The urine volume (ml/kg BW/day) correlated significantly positive with the K- (r = 0.71**) and significantly negative with the P-content (r = -0.67**), the Ca-content (r = -0.50**) followed by the Mg-content (r = -0.36**) of the food. The correlation coefficients between the anions/cations in the food and the urine pH was for K 0.36**, for P -0.61**, the Met+Cys -0.60** and Cl -0.27**. In practice the correlation between urine pH and BE would help to pre-estimate the effect of food on the urine pH and to prevent urolith formation.