Modern Aspects of Chemical Dissolution of Human Renal Calculi by Irrigation

Timmermann, Albert; Kallistratos, G.

doi:10.1016/s0022-5347(17)63480-3

Cited by 48 publications

(11 citation statements)

References 6 publications

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“…Because of its numerous side effects on the bladder wall in humans, rabbits and mice, in vivo stone dissolution with tEDTA was abandoned, and other stone removal techniques were developed, such as extracorporeal shockwave lithotripsy. 5 , 6 , 16 , 17 …”

Section: Discussionmentioning

confidence: 99%

“…In the human literature, studies have shown that tetrasodium EDTA (tEDTA) has the ability to chelate calcium within CaOx stones and therefore result in their dissolution in vitro. 4 – 6 EDTA is a metalloprotease inhibitor that acts as a chelating agent. It has the ability to form stable complexes in solution with multiple ions such as magnesium, calcium, strontium and barium, and therefore is able to dissolve CaOx crystals.…”

Section: Introductionmentioning

confidence: 99%

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Use of tetrasodium EDTA acid for the treatment of intraluminal obstruction of subcutaneous ureteral bypass devices

Duval

Dunn

Vachon

2022

Journal of Feline Medicine and Surgery

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Objectives The aim of this study was to evaluate the efficacy and tolerability of a 4% tetrasodium EDTA (tEDTA) infusion protocol in the subcutaneous ureteral bypass (SUB) devices of cats with intraluminal obstruction at a veterinary teaching hospital between July 2017 and April 2020. Methods This was a retrospective controlled study. Cats with an obstructed SUB device underwent a 4% tEDTA infusion protocol. Obstruction of the device was diagnosed based on renal pelvic dilation, dilatation of the ureter, mineralized material within the device (cystostomy or nephrostomy catheters) seen on ultrasound, the absence of visible bubbles within the renal pelvis and/or urinary bladder following ultrasound-guided flushing of the device with saline. Results A total of 16 tEDTA infusion protocols were performed in 14 cats. The infusion protocol was considered successful in 11/16 SUB devices (68.8%). Six devices (n = 6/11; 54.5%) had recurrence of obstruction with a median time of 87 days. One or more episodes of self-limiting pollakiuria and/or hematuria following infusion was seen in eight patients (n = 8/14; 57.1%). Conclusions and relevance Infusions of 4% tEDTA successfully relieved intraluminal obstruction in patients with occluded SUB devices; however, the recurrence of obstruction was common. Additional studies evaluating case selection and optimal protocols are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of tetrasodium EDTA acid for the treatment of intraluminal obstruction of subcutaneous ureteral bypass devices

Duval

Dunn

Vachon

2022

Journal of Feline Medicine and Surgery

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“…Deep venous thrombosis prophylaxis was considered mandatory because of patient immobility during therapy. 28,31,42 In 1979, Dretler and colleagues 28 (Table 4) chronicled these concerns by reporting frequent irrigation cessations for elevated intrapelvic pressures, repeated fluoroscopy trips to radiology, and psychologically taxing lengths of immobility and hospitalization in patients on Renacidin irrigation.…”

Section: Declining Popularitymentioning

confidence: 99%

The History of Kidney Stone Dissolution Therapy: 50 Years of Optimism and Frustration With Renacidin

González

Whiting²,

Canales³

2012

Journal of Endourology

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Background and Purpose: Over the last 50 years, chemolysis as a primary or adjuvant treatment for urinary stones has fallen in and out of favor. We review the literature for a historical perspective on the origins and chronology of Renacidin therapy, focusing on landmark studies and impracticalities that have seemingly condemned it to history. Materials and Methods: A MEDLINE search was performed on the topic of chemolysis of urinary calculi. Historical literature was reviewed with regard to stone composition, treatment modalities, outcomes, and complications. Results: A total of 61 articles were reviewed, 40 of which were case series, representing a total of 817 patients studied. Mulvaney first introduced Renacidin in 1959 as a modification of Suby and Albright's 1943 solution.Because of an overabundance of nonstandardized irrigation protocols, six deaths were reported in the early 1960s resulting in a Food and Drug Administration ban on the practice of upper urinary tract stone dissolution. Over time, Renacidin returned to the urologist's arsenal, appearing first as an adjunct to dissolve catheter and bladder calculi and later (1990) as an approved agent for renal pelvis and ureter use. This feat was almost singlehandedly the result of a successful hemiacidrin case series published in 1971 by Nemoy and Stamey. By using daily urine cultures, prophylactic antibiotics, and meticulous intrarenal pressure monitoring, Nemoy and Stamey virtually eliminated all major irrigation complications, paving the way for a flurry of studies. More importantly, they established the link between residual struvite stones, persistent infection, and recurrent staghorn stone formation. Conclusions: Dissolution of urinary calculi by chemolysis has been shown to be safe and effective if performed with sterile urine cultures, prophylactic antibiotics, and low intrapelvic pressures. The pioneers of this therapy are remembered for their attempts to develop an alternative to open surgery, and, in the process, solidified the ''stone-free'' concept for infection-based stones.

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“…Recent reports have described the nonsurgical chemical dissolu tion of urinary tract calculi by sodium bicarbonate [6,8], THAM [5], solution G [9,10], EDTA [4,7,12], and so on [1,3], Renal calculus dissolution by irrigation is occasionally a useful treatment…”

Section: Commentmentioning

confidence: 99%

Combined Treatment of Medullary Sponge Kidney by EDTA Potassium Citrate and Extracorporeal Shock Wave Lithotripsy

Nakatsuka¹,

Kinoshita²,

Ueda³

et al. 1988

Eur Urol

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Modern Aspects of Chemical Dissolution of Human Renal Calculi by Irrigation

Cited by 48 publications

References 6 publications

Use of tetrasodium EDTA acid for the treatment of intraluminal obstruction of subcutaneous ureteral bypass devices

Use of tetrasodium EDTA acid for the treatment of intraluminal obstruction of subcutaneous ureteral bypass devices

The History of Kidney Stone Dissolution Therapy: 50 Years of Optimism and Frustration With Renacidin

Combined Treatment of Medullary Sponge Kidney by EDTA Potassium Citrate and Extracorporeal Shock Wave Lithotripsy

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