Symptoms Of Urolithiasis Research Articles

Hereditary urolithiasis at a young age on the example of a clinical case

To study the clinical features and course of urolithiasis in a young female patient, to suggest the cause of the simultaneous sudden formation of kidney stones in the patient and her mother within a year. Main provisions: urolithiasis (KSD) is one of the most common diseases of the urinary tract. The relevance of effective treatment of this problem arises from the steady increase in the number of patients around the world, especially in Russia. According to many researchers, this trend is due to the increase in life expectancy, changes in lifestyle and nutrition, as well as changes in the composition of water and climate conditions. Approximately two thirds of patients, develop the disease at the age from 30 to 60. Characteristic features of urolithiasis are repeated recurrence and a high incidence of complex forms, which complicates the treatment of such patients significantly. Diagnostic algorithm and treatment of urolithiasis are demonstrated in this article on the example of a medical history of a young patient with rapidly progressing urolithiasis. A similar disease with the same symptoms of urolithiasis was revealed in the patient’s parent a week later, which suggests a hereditary predisposition factor or manifestation of urolithiasis being dependent on the hard drinking water. The simultaneous sudden formation of kidney stones within a year in a patient at a young age and her mother emphasizes the hereditary nature of the disease. Probably, the peculiarities of national cuisine or the individual preferences of patients played a significant role in the development of the pathology. The composition of drinking water is extremely important. The patient is from the Republic of Bashkortostan, where water hardness is 7.8–8.0, which does not meet the standard.

FEATURES OF THE CLINICAL DEPICTION OF UROLITHIASIS IN CHILDREN URGENTLY HOSPITALIZED IN A HOSPITAL

It follows from the literature data that the absence of obvious clinical symptoms of urolithiasis and calculous pyelonephritis in children can lead to diagnostic errors in 8-32% of cases. The purpose of this study was to identify the features of the clinical course of urolithiasis in children hospitalized for emergency indications. In the course of the work, the results of clinical and laboratory diagnostics of 158 children with emergency pathology of the kidneys and urinary tract were analyzed. In accordance with the data obtained, the main clinical signs of urolithiasis in children were identified during their emergency hospitalization.

Ultrasound Diagnosis of Urolithiasis

Urolithiasis is a metabolic disease caused by various exogenous or endogenous factors, often has a hereditary nature and is determined by the presence of a stone in the urinary system. The causes and mechanism of stone formation remain open in urology. There is still no definitive theory for the development of urolithiasis. The main symptoms of urolithiasis are pain, hematuria, dysuria and stone passage. Urolithiasis (UCD) is one of the most common urological diseases and ranks second in the world after inflammatory nonspecific diseases of the kidneys and urinary tract.

Urolithiasis in children: modern possibilities of diagnosis and treatment

The incidence and prevalence of urolithiasis have been increased over the last decade. Most kidney stones in children are composed of either calcium oxalate or calcium phosphate and often associated with metabolic disorders. Typical symptoms of urolithiasis in children include abdominal or lower back pain, hematuria, and in acute cases dysuria, fever, or vomiting also occur. Ultrasound of the urinary tract is the first choice for children urolithiasis because it can be used to detect most of symptomatic stones. X-rays or computed tomography are also used. Treatment for kidney stones includes diet, drug therapy, and surgery. Surgical treatments for urolithiasis in children include extracorporeal shock wave lithotripsy, contact lithotripsy, percutaneous nephrolithotomy and open lithotomy. This review describes the epidemiology, etiology, pathogenesis, and clinical symptoms and treatment of urolithiasis in children.

Urolithiasis Symptoms and Risk Factors Among the General Population of Alahsa, Saudi Arabia.

This study aims to assess the awareness and attitudes about urolithiasis among the general population of Alahsa, Saudi Arabia. A cross-sectional study was conducted in September 2022 in Alahsa, Saudi Arabia, using a validated questionnaire that was distributed to the general population. Inclusion criteria include male and female citizens of Saudi Arabia who were living in Alahsa, older than 18 years old, and willing to participate in the study. Exclusion criteria include non-Saudi citizens or Saudi citizens who did not live in Alahsa. Data were analyzed using SPSS Statistics. The results showed there were 1023 participants. The results showed the awareness level of symptoms associated with kidney stones at 29%, complications at 34%, diagnosis at 51%, and treatment at 16%. The results showed there was a significant association between a history of kidney stones and having no complications (p-value = 0.002) or inflammation (p-value = 0.009). However, there was no significant association between kidney stone symptoms and the participants' comorbidities. According to our findings,there was a low level of knowledge about the condition and the methods to prevent it, like dietary and lifestyle modifications. Regardless of the low level of general knowledge, there was some awareness of urolithiasis in some elements. Therefore, it is advised to increase health awareness campaigns.

Factors Associated With Urolithiasis: A Hospital-Based Case-Control Study.

Urolithiasis is a common preventable ailment. Previous studies showed that there are a lot of factors, such as dietary, health and environmental factors, which are likely to develop this condition. Only a few research have been conducted on urolithiasis in the UAE. Therefore, our study aimed to identify the factors associated with urolithiasis in the country, identify the symptoms of urolithiasis among the cases and identify the most common diagnostic methods. It was a case-control study design. The study population was adults above 18 years attending a tertiary care centre. Those who have confirmed diagnosis of urolithiasis and gave informed consent were considered cases and those who have not confirmed diagnosis of urolithiasis as controls. Patients with renal, bladder or urinary tract impairment or anomaly were excluded from the study. Ethical approval was obtained for the study. Crude odds ratio (OR) showed that age, gender, past treatment for urinary stones, and lifestyle factors such as diet and smoking are risk factors while exercising is a protective factor. Age-adjusted OR found that past treatment for the urinary disease (OR=10.4), consumption of oily food (OR=11.5), consumption of fast food (OR=11.0)and consumption of energy drinks (OR=5.9) were the significant risk factors for urolithiasis. We found that past urinary disease treatment and diet are vital in developing urinary stones. Higher consumption of salty, oily, sugary and protein foods increases the odds of urinary diseases. Public awareness programs are essential to educating people about urolithiasis risk factors and preventive measures.

Predictors for Distinguishing Renal Infarction From Urolithiasis in the Emergency Department: A Randomly Matched Retrospective Case-Control Study

BackgroundEmergency department (ED) clinicians may misdiagnose renal infarction (RI) as urolithiasis because RI is a rare disease with presenting symptoms similar to the symptoms of urolithiasis. However, earlier diagnosis of RI can improve patient prognosis. ObjectivesWe investigated potential predictors for distinguishing RI from urolithiasis based on clinical findings and laboratory results. MethodsThis randomly matched retrospective case-control study included patients who had been diagnosed with acute RI or acute urolithiasis between January 2016 and March 2020. Patients were excluded if they were aged under 18 years, had a history of trauma, or had incomplete medical records. Using a matching ratio of 1:4, RI patients were randomly matched to urolithiasis patients. Multivariable logistic regression was performed to identify factors that could distinguish RI from urolithiasis. ResultsIn total, 48 patients were included in the RI group and 192 patients were included in the urolithiasis group. Multivariable logistic regression showed that age ≥ 65 years (odds ratio [OR] 6.155; p = 0.022), atrial fibrillation (OR 18.472; p = 0.045), current smoking (OR 17.070; p = 0.001), costovertebral angle tenderness (OR 0.179; p = 0.037), aspartate aminotransferase level ≥ 27.5 U/L (OR 6.932; p = 0.009), sodium level ≥ 138.5 mEq/L (OR 0.079; p = 0.004), and hematuria (OR 0.042; p = 0.001) were significant predictors that could distinguish RI from urolithiasis. Based on these results, a nomogram was constructed. ConclusionAge ≥ 65 years, atrial fibrillation, current smoking, absence of costovertebral angle tenderness, aspartate aminotransferase level ≥ 27.5 U/L, sodium level < 138.5 mEq/L, and absence of hematuria were predictors that can distinguish between RI and urolithiasis.

The effect of Avapeedaksnehapan by using Kulatthadi Ghrita in the management of Mutrashmari with special reference to Urolithiasis: A case study

Urolithiasis is very common now a day. The disease occurs in all age groups. Males are more commonly affected than females with male:female ratio of 3:1. The peak age for developing stones is between 30 to 50 yrs and recurrence is common. The symptoms of Urolithiasis can be co-relate with the symptoms of Mutrashmari in Ayurveda. Mutrashmari is one of disease occur in Mutravaha Strotasa. Ashmari comprises of two words that is Ashma and Ari. Ashmameans a stone and Ari means the enemy hence Mutrashmari means the disease which gives tremendous pain to the body like enemy. Acharya Sushruta explained the 4 types of Mutrashmari. The treatment principle of Urolithiasis in modern science is hydrotherapy in case of calculi less than 5 m.m. in large stones, the treatment like Extacorporeal Shock Wave Lithotripsy (ESWL) Percutaneous Nephrolithotomy (PCNL), Pyelolithotomy, Nephrolithotomy, Nephrostomy etc. are done. But these procedures have their own disadvantages as they may leads to complications and there is more chances of recurrence in the disease. Similarly Sushruta said that newly formed Ashmari is Aushadhisadhya while chronic, big sized Mutrashamari is Shastrakarmasadhya. There are 3 types of treatment are mentioned for Ashmari i.e. Ausahadhi Chikitsa, Ksharachikitsa, and Shastrakarma. Shastrachikitsa is expensive and may have some complications &amp; Aushadhichikitsa used in all types of Mutrashmari situated anywhere in Mutravaha strotas are less expensive, easily available and have less complications. The present study was undertaken to evaluate the efficacy of Avapeedaksnehapan by using Kulatthadi Ghrita in the management of Mutrashmari with special reference to Urolithiasis. A patient was selected. In this particular case study we used the Avapeedaksnehapan of Kulatthadighrita administration given for 1 month and after completion of course follow up taken for 3 months to check the recurrence of the disease. The results found in this study is encouraging enough. The study was completed in Sumatibhai Shah Ayurved Mahavidyalaya and Sane Guruji Ayurved Hospital, Hadapsar, Pune – 411028.

Phytotherapy in urological benign disease: A systematic review

AbstractWhat is the state of knowledge on the use of phytotherapy in the following urological benign diseases: prostatic hyperplasia, erectile dysfunction, male infertility, urolithiasis and low‐urinary tract symptoms? Supplements derived from natural products are used in medicine alone or in combination with drugs. In urology, there are many products used for symptom management in benign conditions. The aim of this review was to investigate the use of herbal medicines to treat benign urological diseases. A systematic review was conducted using the PubMed, CINAHL, Cochrane Library, Embase and Scopus (2010–2021) databases. The inclusion criteria were studies describing the use of phytotherapeutic strategies to treat adult patients with urological diseases. Quality assessments were performed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Nineteen studies were included in this systematic review: 13 randomized controlled trials, 3 pilot studies, 1 quasi‐experimental study, 1 retrospective observational study and 1 post hoc analysis. Phytotherapeutic agents used to treat benign prostatic hyperplasia included royal jelly, Viola odorata, Echium amoenum, Physalis alkekengi, soy isoflavones, Serenoa repens, Trigonella foenum‐graecum, lycopene and selenium. Tribulus terrestris is widely used to treat erectile dysfunction and male infertility. Lycopene, Korean ginseng berries, Indian ginseng and Curcuma improve sperm characteristics and motility. Lupeol therapy reduces kidney stone size, improving urolithiasis symptoms and accelerating the expulsion of small stones. No standard of care has been established for the use of phytotherapeutic agents to manage patients with symptomatic urological disorders. Although randomized controlled trials were the most common study type in our review, the sample sizes were limited, and the study duration and follow‐up periods were often very short.

A Comparative Study of Shigru Kwath and Yavak Kshara in the Management of Mutra Ashmari w.s.r to Urolithiasis

The formation/cause of Ashmari, according to Ayurved Srotovaigunya, is due to Dushit Kapha located in Basti in conjunction with Pradushit Vata and Pitta. Dosha vitiation begins in the Mutravaha Sansthan, is catalyzed by the presence of an incipient lesion, and is eventually blamed for the pathophysiology of Mutrashmari. Excruciating pain over Nabhi, Vasti, or at Sevani, Medra during micturition, sudden stoppage of urine flow, blood stained urine, twisting and slitting of urine, aggravation of pain during running, toileting, and other symptoms of Mutrashmari continue in accordance with symptoms of urolithiasis as defined by modern science. Urolithiasis is the third most prevalent urinary tract disease. Urolithiasis causes pain, lost work time, medical bills, hospitalization, and renal failure in the most productive years of life.

Evaluation of the effectiveness of non-invasive instrumental diagnostics in the detection of urolithiasis

Aim: To assess the effectiveness of non-invasive instrumental diagnostics in the detection of urolithiasis, particularly ultrasonography and computed tomography. Materials and methods. Ultrasonic diagnosis and computed tomography were performed in 78 and 104 patients, respectively. All patients were diagnosed with urolithiasis of different localization. The study was conducted at the Regional Clinical Hospital of Shymkent city for the period 2017-2018. Also, a study of medical documentation and questionary observations were carried out with subsequent statistical processing. Results. Various calculi were detected in 27 patients using ultrasonography in addition to the other symptoms of urolithiasis: change in the size and configuration of the kidney, the expansion of the pyelocaliceal complex and compaction of the parenchyma of the affected organ. 48.3% of the total number of stones were found on the right kidney, the remaining stones (51.7%) were found in the left kidney. In the upper, middle and lower groups of pyramids there were detected 10.7%, 32.2% and 28.6% of calculi, respectively. In the pelvis of the right and left kidneys, 17.8% and 10% calculi were found, respectively, and in the calyx-pelvis complex of the right (10.7%) and left (20%) kidneys. Conclusion. The analysis of the effectiveness of the ultrasound and computed tomography was demonstrated that the sensitivity, specificity and accuracy of computed tomography were higher than these parameters of ultrasound, which was also confirmed by the results of computation of the receiver operating characteristic curve and the area under this curve.

MANAGEMENT OF URINARY CALCULUS WITH HERBAL PREPARATION (MORINGA OLEIFERA AND TRIBULUS TERRESTRIS)

Urinary stones are a common disease that remains a significant health problem. It carries significant morbidity and imposes tremendous financial burden on healthcare system. Urolithiasis affects up to 5% of the population, with a recurrence rate of 50 to 80%. Males are more frequently affected than the females. Management includes both medicinal and surgical treatment which depends on size, type and location of stone. Larger stones which fail to pass through urinary system, needs treated by surgical interventional such as Extracorporeal shock wave lithotripsy (ESWL), Ureteroscopy, and Percutaneous Nephrolithotomy etc. For prevention and recurrence of stone, many herbal medicines have been used traditionally which are believed to cause the disintegration, dissolution and dislodgement and expulsion of urinary stones. In Ayurveda, there are references and comprehensive description of various herbal drugs regarding their anti-lithaitic properties. Role of Moringa oleifera (Shigru mool) and Tribulus terrestris (Gokshura phala) has been highly mentioned. In the present study, a total of 30 patients of Urolithiasis (Mutrashmari) with stone size up to 12mm were selected and all patients were randomly assigned to receive the designed herbal treatment i.e., decoction of Moringa oleifera and Tribulus terrestris for a maximum of 60 days. The study concluded that the herbal formulation is found significant in improving the symptoms of Urolithiasis in all patients and stones in 11 patients were also expelled out.

A Randomized, Open label, Comparative Clinical Study to Evaluate the Efficacy and Safety of Cystone Forte Tablet in Urolithiasis

The aim of the study was to evaluate the efficacy and safety of Cystone forte tablet in urolithiasis. A randomized, open-label, comparative clinical study was conducted in sixty-two subjects presenting with urolithiasis as diagnosed clinically with calculi measuring 5 to 12mm in size and subjects aged between 18-50 years of either sex. Sixty-two subjects were randomized into trial group and comparator group. Trial group subjects received Cystone forte tablet in the dose of 2 tablets twice daily for a period of 6 weeks while the comparator group received Tamsulosin tablet in the dose of 1 tablet once daily for a period of 6 weeks. The trial group subjects treated with Cystone forte tablets showed comparable results with the improvement of clinical parameters in urolithiasis and with the expulsion of kidney stones as compared to Tamsulosin group. The trial group receiving Cystone forte tablet was found to be effective and was beneficial in the management of urolithiasis. At the end of the study, mild occasional adverse events were reported in both the groups which were resolved. This clinical study demonstrates that, oral administration of Cystone forte tablets at the recommended dose is safe and effective in relieving the symptoms of urolithiasis.

Thlaspi Bursa Pastoris in Treatment of Urinary Stones: A Case Series.

Urinary stones are the most common cause of acute ureteral obstruction. The homeopathic medicine Thlaspi bursa pastoris (TBP) has many symptoms similar to the typical symptoms of urolithiasis, yet its clinical usefulness has not been well documented. In this study, the clinical symptoms of each of five patients, along with ultrasonographic evidence, were taken for the assessment of the outcome. TBP was prescribed in potency 30c and/or 200c to each patient on the basis of the main symptoms, typically dysuria, retention of urine and haematuria. Each case was followed for up to 6 months. Assessment of causal attribution of treatment effect was performed using the Modified Naranjo Criteria. There was full recovery of all five patients and post-treatment ultrasonography showed no calculi remaining. The Modified Naranjo Criteria total score for each patient was either +8/13 or +9/13. TBP was observed to be effective in eliminating renal stones within a short span of time and without any complications.

Lower urinary tract lithiasis of cats in Algeria: Clinical and epidemiologic features.

Aim:This study aims to describe the clinical symptoms, diagnosis, and treatment of urolithiasis of the lower urinary tract and to determine the main risk factors involved in the occurrence of urinary lithiasis in cats in Algeria from 2016 to 2018.Materials and Methods:During the study period, 465 cats were examined and 32 cases of urolithiases were selected and investigated by conducting physical examinations, blood analyses, urinalysis, X-ray radiography, and ultrasonography. Parameters such as breed, age, or sex were studied and reported in a farm return to analyze risk factors involved in the formation of lower urinary urolithiasis.Results:The most clinically relevant symptoms of urolithiasis observed in cats were dysuria, pollakiuria, hematuria, and stranguria. Urinalysis and blood analysis revealed a significant presence of urinary crystals and acute kidney failure in nine cats. The ultrasonography and radiography confirmed the diagnosis of urolithiasis with the incidence of 43.75% and 31.25%, respectively. The lower urinary tract urolithiasis appeared to be more frequent in European and Siamese cats. In addition, cats aged between 4 and 8 years old were the most affected. Male cats (87.50%) were more affected than female cats. Finally, the lower urinary tract urolithiasis was more frequent in cats consuming the commercial pet food, previously castrated, and confined inside the house.Conclusion:Complete clinical assessments, in addition to complementary examinations, are necessary and beneficial in treating the animal and preventing possible complications. Whether the choice of therapy is surgical or treatment with drugs, it is crucial to understand that the elimination of the stone is not an end, but the beginning of a series of investigations. Because of their impact on both the formation and elimination of metabolites, it has been found that factors, such as race, gender, age, diet, and lifestyle, should be considered as potential risk factors for urolithiasis.

High Rate of Occult Urolithiasis in Normocalcemic Primary Hyperparathyroidism

Introduction: Normocalcemic primary hyperparathyroidism (NPHPT) is characterized by elevations in serum parathyroid hormone levels in the presence of normal serum calcium concentrations after exclusion of secondary hyperparathyroidism. We have previously demonstrated no differences in the prevalence of clinically active urolithiasis between NPHPT and hypercalcemic asymptomatic PHPT, and that it is significantly higher in postmenopausal osteoporotic women with NPHPT in comparison to women with normal serum PTH and calcium concentrations. Few studies have addressed the occurrence of silent or occult kidney stones in asymptomatic hypercalcemic PHPT, but no data are available for NPHPT. Objective: To determine the presence of occult urolithiasis in NPHPT patients using routine abdominal ultrasonography. Methods and Results: We studied 35 patients with NPHPT (mean age 63.2 ± 10.7 years, 96% women; serum PTH 116.5 ± 39.2 pg/mL, 25OHD 38.5 ± 6.82 ng/mL, total calcium 9.1 ± 0.56 mg/dL; albumin 4.02 ± 0.37 g/dL; BUN 34.35 ±10.23 mg/dL; p = 3.51 ± 0.60 mg/dL; estimated glomerular filtration rate 88.44 ± 32.45 mL/min/1.73 m2, and 24-h urinary calcium excretion 140.6 ± 94.3 mg/24 h). The criteria for the diagnosis of NPHPT were as follows: serum PTH above the reference range (11–65 pg/mL), normal albumin-corrected serum calcium concentrations, normal 24-h urinary calcium excretion, serum 25OHD above 30 ng/mL, estimated GFR (MDRD) above 60 mL/min/1.73 m2 (with the exclusion of medications such as thiazide diuretics, lithium, bisphosphonates, and denosumab), a history of clinical symptoms of urolithiasis, and a family history of kidney stones. Thirty-five patients were evaluated and 25 of them met the inclusion criteria. Five patients presented nephrolithiasis corresponding to 20% of the study population. There were no statistically significant differences in any of the clinical or laboratory variables studied between patients with or without urolithiasis, although mean serum PTH levels were higher in patients with stones (180.06 ± 126.48 vs. 100.72 ± 25.28 pg/mL, p = 0.1). The size of the stones ranged from 0.6 to 0.9 cm and all of the stones were located in the renal pelvis. Conclusion: We found a high prevalence of occult kidney stones in NPHPT patients, similar to what is observed in clinically manifested urolithiasis, in hypercalcemic PHPT.

The Mediastinal Tumor Diagnosed in 15-Year-Old Patient with Renal Colic Syndromes - A Case Report

Background: Urolithiasis in the pediatric population is about 10 times less common than among adults. Adolescents present with similar symptoms to adult patients, among them renal colic (acute, severe flank pain, which radiates to the groin). This case report shows an atypical course of retromediastinal tumor, which mimicked symptoms of renal colic. Case presentation: A 15-year-old boy was admitted to Pediatric, Nephrology and Allergology Department, Military Institute of Medicine due to suspicion of urolithiasis. Patient presented left flank pain treated as renal colic. Before admission the boy was hospitalized in three centers during March 2016, July 2016 and September 2016. During those hospitalizations X-ray examination revealed a small calcification in the left kidney, however no renal calculi were detected in urography and repeated ultrasound examinations. Discussion: Patient was treated twice with antibiotics (cefuroxime, amikacin) due to increased inflammatory parameters. Analgesics and antispasmodic drugs were administered almost continuously, without any significant effect on reported symptoms. At admission no stones were visible in ultrasound examination, therefore abdominal computed tomography (CT) was performed. No signs of urolithiasis were observed in the scan, however abnormal mass on the left-side of the chest wall was found. The study was extended to thoracic CT scan, which revealed a mediastinal tumor. Patient was referred to an oncology department where Ewing sarcoma/ primitive neuroectodermal tumor (PNET) was diagnosed in pathologic analysis. Conclusion: Symptoms which mimic renal colic may not always be caused by urolithiasis. Even though posterior mediastinal tumors among children are significantly less common than renal stones, doctors should always consider all potential causes of symptoms that are reported by our patients. Ultrasonography remains the study of first choice, however CT should be recommended in patients with persistent symptoms of urolithiasis or nondiagnostic ultrasound examination.

Diagnostic and therapeutic workup of patients with hematuria: Analysis of 1048 consective patients in a German outpatient service.

399 Background: The diagnostic workup of patients with hematuria especially microhematuria is discussed controversially. For this reason the diagnostic and therapeutic procedures of 1049 patients with hematuria referred to our urological outpatient service in the years 2011-2012 were analysed. Methods: A number of 1049 consecutive patients with hematuria referred to the outpatient service Praxisklinik Urologie Rhein-Ruhr in the years 2011-2012 were retrospectively included into the analysis. The following parameters were measured: demographic data, concomittant diseases, clinical symptoms regarding the urinary tract, history of cancer or radiation of the pelvis, diagnostic and therapeutic procedures. Results: The median age was 58 years and the study group comprised 479 men and 570 women. A number of 160 patients had a urinary tract infection within 4 weeks of presentation and 89 individuals presented with macrohematuria. Symptoms of urolithiasis occured in 148 patients. All patients had ultrasound of the genitourinary tract and 731 were examined by excretion urogram, 111 patients via CT-scan of the abdomen and 888 individuals via urethrocystoscopy. Further workup revealed 77 stones via radiological examination and a total of 11 renal cell cancers, 57 papillary urothelial tumors of the bladder, 1 tumor of the ureter and 6 muscle-invasive bladder tumors were detected. Conclusions: Our data presented here reassures invasive diagnostic workup of patients with hematuria due to the fact that cancer of the genitourinary tract is detected in more than 5 percent of patients.

A Survey on knowledge, attitude and practice on urinary tract stones among patients presenting to the Out Patient Department (OPD), Teaching Hospital Peradeniya

Background Urinary tract stones are one of the major problems in present urology practice. As it mostly affects working age group, it is a major socioeconomic burden for the society. In this study our objective was to determine knowledge, attitude and practice on urolithiasis among patients who presented to the OPD of the Teaching Hospital Peradeniya and to compare the difference in between patients who had stones previously and not had stones. Methods This was a descriptive cross sectional study. We distributed a self administered questionnaires to 290 consented patients presented to the OPD over a period of one week. Patients’ demographic data, knowledge on risk factors and symptoms, positive attitudes and practice pattern of prevention were assessed. Results Out of 290 patients 194 were female and 96 were males. Their mean age was 36.9 years (age range 20-60 years). Of them 26 (9%) had a history of stone disease. The mean knowledge score was 9.03 out of 22 (41.06%, SD=2.14). However, most of them (85.9%) believed hard water can cause urinary tract stones. Few participants (35.4%) identified foods which associated with stone formation. 36.81% were aware on symptoms of urolithiasis. Regarding consultation for stone disease, 44.5% go to Nephrologist and 36.9% go to Urologist. Participants who had a history of stone disease have shown better knowledge which was statistically significant (P value Conclusions As participants’ knowledge, attitudes and practice on urolithiasis were poor, there is a need for the implementation of awareness programme for general population.

HIV Therapies and the Kidney: Some Good, Some Not So Good?

Several observational studies have identified tenofovir as an independent risk factor for kidney impairment. Conversely, randomized trials have only demonstrated minor tenofovir-related changes in kidney function, but these studies included patients with normal kidney function and with low underling risk for progression of their renal function, had limited size, and limited follow-up. Several potential mechanisms of tenofovir nephrotoxicity are known. Atazanavir can, equally to indinavir, cause urolithiasis, but both drugs have also been associated with chronic kidney disease (CKD) and fast declining eGFR in persons without clinical symptoms of urolithiasis, especially when the plasma drug concentration is boosted by concomitant ritonavir use. In 2012, only a minority of HIV-positive individuals are affected by drug-induced nephrotoxicity. However, in the future, the clinical impact and hence the requirement for more research in this area will likely increase due to ageing and continued cART exposure of the HIV-positive population.