The Clinical Use of Renacidin in Urinary Calcifications

Mulvaney, William P.

doi:10.1016/s0022-5347(17)65519-8

Cited by 71 publications

(16 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Clinical applica tion of this so-called 'solution G' (table 1) was first described by Suby and Albright [5] in 1943 and was suc cessfully used via nephrostomy tubes and ureteric cathe ters in the years after [6,7], In 1959, Mulvaney [8] introduced hemiacidrin (renacidin) for chemolysis, a solution very similar to Suby G solution (table 1). Clinical success [9,10], however, went along with a series of major complications [11][12][13][14][15]. Some cases of death obviously associated with the use of renacidin [16][17][18][19], caused the US Food and Drug Adminis tration (FDA) to withdraw hemiacidrin from use in the upper urinary tract in the USA.…”

mentioning

confidence: 99%

When Is the Indication of Percutaneous Chemolysis Justified?

Heimbach¹,

Winter²,

Hesse³

1995

Urol Int

View full text Add to dashboard Cite

Persistent residual stone fragments after extracorporeal Shockwave lithotripsy (ESWL), percutaneous nephrolitholapaxy (PNL) as well as pyelo- and nephrolithotomy represent a great problem in the treatment of stones. The choice of therapy for patients with insufficient renal drainage, poor renal function, and a high anesthetic risk also remains quite difficult. Between 1991 and 1993, 5 patients underwent percutaneous antegrading chemolysis with ‘Suby G’ solution. Two patients, presenting struvite and apatite stones, were free of stones afterwards. In 1 patient, where stone analysis revealed a predominant brushite component, a large decrease in stone size could be observed. In 2 other cases, with stones mainly consisting of whewellite and weddelite, chemolysis proved ineffective. Evaluating our own clinical experience and relevant medical literature, the present study goes on to prove that the indication of percutaneous chemolysis in risk patients as described above is dependent on stone analysis, and must be regarded as an effective adjuvant treatment.

show abstract

mentioning

confidence: 99%

When Is the Indication of Percutaneous Chemolysis Justified?

Heimbach¹,

Winter²,

Hesse³

1995

Urol Int

View full text Add to dashboard Cite

show abstract

“…Numerous investigators report the effectiveness of Renacidin irrigations through nephrostomy tubes in order to dissolve residual postoperative stone fragments, or through ureteral catheters to primarily dissolve renal calculi (Mulvaney, 1960;Mulvaney & Henning, 1962;Ries & Malament, 1962;Fam, Rossier, Yalla & Berg, 1976). Several deaths occurring during renal Renacidin irrigation resulted in the United States Food and Drug Admin istration withdrawing approval for its use in the renal pelvis.…”

Section: Discussionmentioning

confidence: 99%

“…Recent reports demonstrate both its safety and efficacy, including its use in spinal cord injury patients (Fam, Rossier, Yalla& Berg, 1976) when sterility of the urine is maintained and the technique insures immediate cessation of irrigation when evidence of obstruction, back pain or fever occur (Blaivas, Pais & Spellman, 1975;Jacobs & Gittes, 1976). Mulvaney (1960) is credited with the initial use of Renacidin in the treatment of bladder calculi. Several paraplegic patients used the solution and completely dissolved their stones.…”

Section: Discussionmentioning

confidence: 99%

Dissolution of vesical calculi with renacidin in a paraplegic man

Woodside

Crawford

1980

Spinal Cord

View full text Add to dashboard Cite

Abstract. Vesical calculi are common in spinal cord injury patients. The majority are composed of magnesium ammonium phosphate, a compound readily soluble in the solvent Renacidin. We describe a paraplegic man with recurrent bladder stones in whom cystolitholopaxy was unsuccessful. His calculi were completely dissolved by continuous Renacidin bladder irrigation. We recommend Renacidin for the initial treatment of vesical calculi in selected spinal cord injury patients. Many such stones will completely dissolve and others may be made softer or smaller, facilitating cystolitholopaxy. A significant number of patients will be spared the inconvenience, cost and morbidity of hospitalisation for a surgical procedure.

show abstract

“…9,10 Based on Dr. Mulvaney's initial reports, several large case series with modest results were published using Renacidin irrigations to treat catheter encrustation and a variety of renal and bladder stones compositions, not just struvite (Table 1). 8,13,[15][16][17][18][19][20] This increase in clinical use also unveiled some limitations. First, because Renacidin solution contained high levels of magnesium and phosphate, its use was contraindicated in patients with advanced renal disease (creatinine clearance < 10 mL/min).…”

Section: Development and Introduction Of Hemiacidrin (Renacidin)mentioning

confidence: 99%

“…[21][22][23][24][25][26][27] Second, as if foreshadowing future catastrophies, Mulvaney reported in 1960 that debris and sand tended to obstruct single ureteral catheters, resulting in patient discomfort and obstruction. 15 Years later, the development of percutaneous nephrostomy puncture techniques would lead to improved irrigation and drainage ( Fig. 1).…”

Section: Development and Introduction Of Hemiacidrin (Renacidin)mentioning

confidence: 99%

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

González

Whiting²,

Canales³

2012

Journal of Endourology

View full text Add to dashboard Cite

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.

show abstract

The Clinical Use of Renacidin in Urinary Calcifications

Cited by 71 publications

References 6 publications

When Is the Indication of Percutaneous Chemolysis Justified?

When Is the Indication of Percutaneous Chemolysis Justified?

Dissolution of vesical calculi with renacidin in a paraplegic man

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

Contact Info

Product

Resources

About