Melamine and Nephrolithiasis in Children in Taiwan

Wang, I-Jen; Chen, Pau‐Chung; Hwang, Kung‐Chang

doi:10.1056/nejmc0810070

Cited by 44 publications

(32 citation statements)

References 2 publications

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“…To falsely elevate protein content, melamine was added to baby formula. This is an example of contamination with a substance that causes acute kidney injury (AKI) and nephrolithiasis in neonates (13).…”

Section: Potential Nephrotoxinsmentioning

confidence: 99%

Renal Vulnerability to Drug Toxicity

Perazella¹

2009

Clinical Journal of the American Society of Nephrology

337

267

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Drug-induced kidney disease occurs primarily in patients with underlying risk factors. A number of factors enhance the vulnerability of the kidney to the nephrotoxic effects of drugs and toxins. They are broadly categorized as patient-specific, kidney-related, and drug-related factors. One, two, or all three of the factor categories can act to promote various forms of renal injury. Importantly, all compartments of the kidney can be affected and result in one or more classic clinical renal syndromes. These include acute kidney injury, various tubulopathies, proteinuric renal disease, and chronic kidney disease. Recognizing risk factors that increase renal vulnerability to drug-induced kidney disease is the first step in reducing the renal complications of drugs and toxins.

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Section: Potential Nephrotoxinsmentioning

confidence: 99%

Renal Vulnerability to Drug Toxicity

Perazella¹

2009

Clinical Journal of the American Society of Nephrology

337

267

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“…Calcium oxalate stones are radiopaque, struvite and cystine stones are less so, and uric acid stones are radiolucent. Melamine stones also appear to be radiolucent [49]. Evaluated stones ranged in size from small and sand-like to as large as 9 mm [37,41,50].…”

Section: Stone Formationmentioning

confidence: 99%

“…Evaluated stones ranged in size from small and sand-like to as large as 9 mm [37,41,50]. Ultrasound for detection of stones in China and Taiwan yielded mixed results [37,49,50].…”

Section: Stone Formationmentioning

confidence: 99%

Melamine Toxicity

2010

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Melamine contamination of infant formula in China and its health effects highlight the safety of the global food supply especially as it relates to formula-fed infants. Melamine is a widely used industrial chemical not considered acutely toxic with a high LD 50 in animals. The data available on acute and chronic human exposure to melamine have been limited and extrapolated from animal data. Pet food contamination in 2004 and 2007 showed stone formation and illness in animals when melamine was co-ingested with cyanuric acid. The recent outbreak in infants showed that melamine ingested in large doses may cause stones and illness without significant ingestion of cyanuric acid or other melamine-related chemicals. This may be due to increased uric acid excretion in infants and formation of melamineuric acid stones. Diagnosis and treatment of infants exposed to melamine requires further study. Clinical signs and symptoms in infants are nonspecific. The stones may be radiolucent and are not consistently seen on ultrasound. The use of alkalinization of the urine for treatment has been proposed, but is of unproven benefit. The FDA and other regulatory agencies have recommended acceptable levels of melamine in foods for consumption. Melamine ingestion has been implicated in stone formation when co-ingested with cyanuric acid, but will cause urinary stones in infants when large amounts of melamine alone are ingested.

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“…Hence, multiple dosing is more deleterious than single-dose bolus injection. 8,9 Prevention and precautions To prevent AMG-induced nephrotoxicity in clinical practice, the following points need emphasis: [10][11][12][13][14][15][16][17][18] • AMG nephrotoxicity is directly dependent on the dose and duration of therapy. Thus, nephrotoxicity is more likely to occur if large doses are given over prolonged periods, or usual doses are given to patients with underlying renal disease.…”

Section: Mechanism Of Toxicitymentioning

confidence: 99%