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Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Polymorphism refers to the existence of a drug substance in multiple crystalline forms, known as polymorphs. Recently, this term has been expanded to include solvates (forms containing a solvent), amorphous forms (non-crystalline forms), and desolvated solvates (forms from which the solvent has been removed).
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Urinary Tract Calculi I: Introduction01:28

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Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
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Estimation of Urinary Nanocrystals in Humans using Calcium Fluorophore Labeling and Nanoparticle Tracking Analysis
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[Sulfamethoxazole crystalluria].

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    Sulfamethoxazole can cause kidney damage by forming crystals, similar to sulfadiazine. Stopping the drug resolved the crystalluria in patients, highlighting a potential cause of drug-induced kidney injury.

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    Area of Science:

    • Nephrology
    • Pharmacology
    • Toxicology

    Background:

    • Drug-induced crystalluria is a significant cause of acute kidney injury.
    • Sulfonamides, particularly sulfadiazine, are known for poor solubility in acidic urine, leading to crystal formation.
    • Sulfamethoxazole is a commonly used sulfonamide, often in combination with trimethoprim.

    Observation:

    • Two patients treated with sulfamethoxazole developed crystalluria resembling that caused by sulfadiazine.
    • The crystalluria observed in these patients was pleomorphic.
    • Previous reports have seldomly documented sulfamethoxazole-induced crystalluria.

    Findings:

    • Sulfamethoxazole may induce nephrotoxicity through the production of crystals in the renal tubules.
    • The crystalluria in the reported cases was morphologically similar to sulfadiazine crystals.
    • Discontinuation of sulfamethoxazole led to the resolution of crystalluria in both patients.

    Implications:

    • These findings suggest that sulfamethoxazole, despite its widespread use, can be a nephrotoxic agent via crystal formation.
    • Clinicians should consider sulfamethoxazole-induced crystalluria in patients presenting with acute kidney injury.
    • Strategies like hydration and urine alkalinization may be beneficial in preventing sulfamethoxazole crystalluria, similar to sulfadiazine.