Urease Inhibitor Therapy in Infected Renal Stones

Abstract

The strict dependence of struvite and carbonate apatite renal stones on the urease-producing germs confirm the need to combine bacterial urease inhibitor drugs with antibiotic treatment. Of the two antiurease drugs used the better results were obtained with acetohydroxamic acid, both for its minimum side effects and its more powerful urease-inhibitor capacity. Thus stone recurrence was avoided even in patients with urinary infection not responding to specific antibiotic treatment.

Treatment of the Infected Stone

“…24 Hydroxyurea was also investigated as an oral urease inhibitor but was found to be inferior to AHA. 25 AHA works well because it achieves high levels in the urine and can penetrate bacterial cell walls. Randomized and placebo-controlled studies have proved AHA's ability to significantly reduce stone growth; however, it does not decrease existing stone burden.…”

Synthesis of 3,4,5-trihydroxybenzohydrazone and evaluation of their urease inhibition potential

“…Thus, it plays a vital role in the pathogenesis of the gastric as well as peptic ulcers which may cause cancer (Devesa et al, 1998). Additionally, urease causes kidney stones formation but also engages in the growth of urolithiasis, pyelonephritis, and hepatic encephalopathy (Martelli et al, 1981). In agriculture, during urea fertilization, high urease activity results in significant environmental and economic losses by discharge of abnormally huge amounts of ammonia in atmosphere.…”

Low Dosage Treatment with Propiono-Hydroxamic Acid in Paraplegic Patients

“…The efficacy of hydroxamic acids as inhibitors of bac terial urease has been definitely demonstrated [4][5][6]. Propiono-hydroxamic acid (PHA) proved to be the more reliable of these molecules, owing to the lower incidence of toxic, teratogenic and mutagenic effects [7,8].…”