Lithiasis in cystic kidney disease and malformations of the urinary tract

Abstract

The prevalence of renal stones in renal cystic and malformative conditions exceeds the prevalence of renal stones in the general population, suggesting that the above-mentioned cystic and malformative disorders favor stone formation. Urinary stasis is generally assumed to play a major part in the pathogenesis of the nephrolithiasis associated with distorted renal anatomy due to a delayed washout of crystals and risk of urinary infections. However metabolic factors are also important in the pathogenesis of stones in these conditions. Indeed, metabolic abnormalities have been observed in the majority of stone-forming patients with conditions such as horseshoe kidney and ureteropelvic junction obstruction. Five different models of stone formation can be identified, depending on stone composition, risk of infection stones, and pathogenesis of renal cystic and malformative conditions. A proper metabolic evaluation should be conducted to diagnose specific, treatable metabolic disorders, thereby reducing the frequency of recurrent stone disease in these conditions as well.

The<i> I</i>550<i>V</i> polymorphism in the renal human sodium/dicarboxylate cotransporter 1 (<i>hNaDC</i>-1) gene is associated with the risk for urolithiasis in adults from Southeastern, Mexico

“…This observation is consistent with results of previous studies which evaluated the same association in other populations [4][5][6][7] and; with the results obtained in a previous study conducted in the Yucatan population, in which hypocitraturia was found in 63.6% of patients with UL [3]. Given that we did not find any association between I550V-hNaDC-1 genotype and hypocitraturia itself, the genetic contribution of this SNP towards hypocitraturia was not demonstrated in this Mexican population; so the possible genetic basis should be in relation to different implicated genes or different SNPs.…”

“…Hypocitraturia, which is considered as a urine citrate excretion below 320 mg in 24 hours [2], represents the most common metabolic abnormality in adults with UL [3]. Hypocitraturia is known to be a major risk factor for the development of lithiasis [4][5][6][7], because of citrate acts as a calcium chelating agent, which reduces the formation of oxalate and calcium phosphate, thus inhibiting the generation of urinary calculus [8].…”

Alterações anatômicas em pacientes com nefrolitíase

“…5,6 Major anatomical the metabolic disorders, reducing the recurrence of urinary stones, even in individuals with anatomical alterations. 13 The limitations of the present study comprise its retrospective character and performing only two imaging exams in the patients. However, most anatomical alterations reported in the literature may be assessed by use of both methods.…”

A Case of Medullary Sponge Kidney Diagnosed at an Older Age

“…Cystic dilation of medullary collecting tubules causes urinary stasis which contributes to nephrolithiasis (8). MSK is found in 20% of patients with kidney stones and more than 70% of patients with MSK develop stones (7,9). Nephrolithiasis in MSK facilitates urinary tract infection (3).Dilatation of collecting tubules in MSK also plays role in recurrent pyelonephritis (10).…”