Metabolic evaluation in patients with infected nephrolithiasis: Is it necessary?

Fifty-four patients with infected renal lithiasis underwent complete metabolic evaluation searching for underlying factors contributing to stone formation including urine analysis and culture. Metabolic abnormalities were significantly more present in patients with mixed infected stones (struvite+/-apatite and calcium oxalate) than in patients with pure infected stones (struvite+/-carbonate apatite): hypercalciuria in 40%, hyperoxaluria in 34% and hyperuricosuria in 28% (p < 0.05).

Urolithiasis in renal transplantation: diagnosis and management.

Objectives: To report our experience of diagnosis and multimodal management of urolithiasis in renal transplantation.

Patients And Methods: From January 1995 to December 2012, 953 patients underwent renal transplantation in the Kidney Transplant Unit of Treviso General Hospital. Ten (10%) of them developed urinary calculi and were referred at our institution.

Management of Clinically Insignificant Residual Fragments following Shock Wave Lithotripsy.

Clinically insignificant residual fragments (CIRFs) are small fragments (less than 5 mm) that are present in upper urinary tract at the time of regular post-SWL followup. The term is controversial because they may remain silent and asymptomatic or become a risk factor for stone growth and recurrence, leading to symptomatic events, and need further urologic treatment. Although a stone-free state is the desired outcome of surgical treatment of urolithiasis, the authors believe that the presence of noninfected, nonobstructive, asymptomatic residual fragments can be managed metabolically in order to prevent stone growth and recurrence.

Stenting after ureteroscopy for ureteral lithiasis: results of a retrospective study.

Objectives: Routine ureteral stenting after ureteroscopy for stone removal is common. However ureteral stent negatively impact quality of life and can cause significant morbidity. This study was carried out to report our experience.

Nephrolithiasis in medullary sponge kidney.

Seventy-one patients with documented Medullary Sponge Kidney (MSK) and nephrolithiasis underwent complete metabolic evaluation. These patients constituted 7.3% of our calcium stone-forming population Metabolic anomalies (hypercalciuria, hyperoxaluria, hypocitraturia and hyperuricosuria) were observed in 82% of patients.

Urinary alkalization for the treatment of uric acid nephrolithiasis.

Three major conditions control the potential for uric acid stones: the quantitative excretion of uric acid, the volume of urine as it affects the urinary concentration of uric acid and the urinary pH. However, the most important factor for uric acid stone formation is acid urinary pH that is a prerequisite for uric acidic stone formation. Indeed the goal standard of urinary alkalization is to achieve a pH of 6-6.

Management of residual fragments after SWL.

Residual fragments after shock wave lithotripsy (SWL) represent a common and still controversial problem. These fragments can be important risk factors for stone growth and recurrence, may lead to symptomatic events and need further urologic treatment. The term "Clinically Insignificant Residual Fragments" (CIRF) is therefore a misnomer and should be abandoned.