scholarly journals Comparison of Two Dietary Supplements for Treatment of Uric Acid Renal Lithiasis: Citrate vs. Citrate + Theobromine

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2012
Author(s):  
Yumaira Hernandez ◽  
Antonia Costa-Bauza ◽  
Paula Calvó ◽  
Joan Benejam ◽  
Pilar Sanchis ◽  
...  

Background. Uric acid (UA) renal lithiasis has a high rate of recurrence and a prevalence ranging from 10% and 15%, depending on the population. The most important etiological factor is persistence of urinary pH below 5.5 and one of the most common treatments is alkalization with citrate. Recent studies demonstrated that theobromine, which is abundant in chocolate and cocoa, is a potent inhibitor of UA crystallization. Aim. The aim was to compare the efficacy of citrate versus citrate + theobromine as treatment for UA lithiasis. Methods. This randomized cross-over trial investigated the efficacy of two treatments in 47 patients with UA renal lithiasis. Urine volume, pH, UA excretion, theobromine excretion, and risk of UA crystallization (RUAC) at baseline and at the end of each intervention period were measured. Results. Each treatment significantly reduced the risk of UA crystallization compared to basal values. The RUAC after citrate + theobromine was lower than the RUAC after citrate, although this difference was not statistically significant. Conclusion. The combined consumption of citrate and theobromine may be a promising strategy for the prevention of UA kidney stones.

1960 ◽  
Vol 199 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Willoughby Lathem ◽  
Bernard B. Davis ◽  
Gerald P. Rodnan

Renal tubular secretion of uric acid was demonstrated in mongrel dogs receiving sodium urate intravenously when an osmotic diuresis was induced by the administration of mannitol. Under these conditions the excretion of urate was greatly augmented and in the majority of experiments the renal clearance of urate exceeded the clearance of creatinine. The high rate of excretion was attributed to a combination of tubular secretion and reduced urate reabsorption, the latter resulting from osmotic diuresis. The administration of probenecid at the height of diuresis tended to reduce the clearance of urate, suggesting that this drug may inhibit tubular secretion of urate. A study of the effect of urinary pH on uric acid excretion indicated that this acid is not excreted by nonionic diffusion.


2019 ◽  
Vol 12 ◽  
pp. 117956111985355
Author(s):  
Juan Antonio Galan-Llopis ◽  
Carlos Torrecilla-Ortiz ◽  
Maria Pilar Luque-Gálvez ◽  
Prevent-Lit Group ◽  
Xavier Peris-Nieto ◽  
...  

Introduction: We assessed the effectiveness of the joint use of a pH meter in combination with dietary supplements in restoring the urinary pH balance of patients with medical history of uric acid or calcium phosphate/calcium oxalate stones in real-world practice. Methods: An interventional, prospective, and open-label study was performed. At baseline visit, patients were assigned to a group according to the type of previous calculus and urinary pH: the alkalinizer group (uric acid stones and/or pH < 5.5) and acidifier group (calcium oxalate stones and/or pH > 6.2) received dietary supplement to increase or decrease, respectively, urinary pH. Patients were examined at baseline and after treatment for 30, 60, and 90 days. Urinary pH, type of therapy, compliance, and self-reported renal colic events were recorded at each visit. Results: The study included 143 patients, 45.5% in the alkalinizer group and 54.5% in the acidifier group, and the mean age was 53.60 years. Both nutraceuticals were significantly effective in normalizing urinary pH ( P < 0.00001) at all follow-up visits compared with baseline, with a maximum percentage of patients who achieved nonlithogenic pH (54.9%) at day 60 ( P < 0.00001). Analysis of the effect of treatment compliance at 60 days indicated that 71.8% of compliant and 45.9% of noncompliant patients achieved nonlithogenic pH (odds ratio [OR]: 3.03, 95% confidence interval [CI]: 1.29-6.66). A Cox-regression model indicated that nonlithogenic pH at 90 days (hazard ratio [HR]: 0.428, 95% CI: 0.193-0.947) and compliance at 60 days (HR: 0.428, 95% CI: 0.189-0.972) were independently associated with colic complaints-free survival. Conclusions: In patients with medical history of renal lithiasis, monitoring of pH in combination with dietary supplements may be useful in maintaining nonlithogenic pH values, yielding very high ratios of success, especially in compliant patients. Besides this main outcome, a reduction in self-reported colic complaints associated with pH balance was also observed.


Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3346
Author(s):  
Sahbanathul Missiriya Jalal ◽  
Abdulrahman Abdulhadi Alsultan ◽  
Hala Hazam Alotaibi ◽  
Ester Mary ◽  
Abeer Abbas Ibrahim Alabdullatif

The study purpose was to investigate the effect of Phaseolus Vulgaris (PV) on urinary biochemical parameters among patients with kidney stones. We conducted a randomized controlled study among 60 patients with kidney stones (size < 10 mm) in the nephrology unit of both government and private hospitals, Al-Ahsa. Urinary volume, calcium, magnesium, potassium, oxalate, uric acid, and power of hydrogen (pH) were assessed before and after the intervention of giving 250 g of PV consumption as an extract thrice weekly (2.2 L to 2.5 L per week) for 6 weeks, which was compared with control. A ‘t’ test was used with the significance at 5%. Mean score of age was 44.5 ± 10.16 in PV group and 43.73 ± 9.79 in control. Four (13.3%) and two (6.7%) had family history of kidney stones. Body mass Index (BMI) mean was 26.44 ± 2.7 and 26.36 ± 2.65 in pre and post-test, respectively, which were significant (p = 0.01017). There were significant changes (p = 0.000) in urine volume from 1962 ± 152.8 to 2005 ± 148.8, calcium 205.4 ± 11.99 to 198.4 ± 12.52, potassium 44.07 ± 3.66 to 52.15 ± 4.37, oxalate 37.12 ± 5.38 to 33.02 ± 5.71, and uric acid 6.88 ± 0.7 to 6.31 ± 0.58. In conclusion, PV is effective management for the patients with kidney stones as it increases the urinary volume and enhances the elimination of small kidney stones.


1992 ◽  
Vol 68 (02) ◽  
pp. 214-220 ◽  
Author(s):  
C Weber ◽  
J R Beetens ◽  
F Tegtmeier ◽  
P Van Rooy ◽  
E Vercammen ◽  
...  

SummaryThe effects of ridogrel, a dual thromboxane A2 (TXA2) synthase inhibitor and TXA2/prostaglandin (PG) endoperoxide receptor antagonist, on systemic and renal production of prostaglandins and on platelet TXA2/PG endoperoxide receptors was evaluated upon chronic administration (300 mg b. i. d. orally, for 8 and 29 days) to man. Such a medication with ridogrel inhibits the systemic as well as the renal production of TXA2 as measured by the urinary excretion of 2,3-dinor-TXB2 and TXB2 respectively without inducing significant changes in systemic or renal PGI2 production. Simultaneously with the latter effects, the production of TXB2 by spontaneously coagulated whole blood ex vivo is inhibited (>99%) while that of PGE2 and PGF2α is largely increased. Administration of ridogrel causes a three- to five-fold shift to the right of concentration-response curves for U46619 in eliciting platelet aggregation; no tachyphylaxis is observed after 29 days of treatment in this respect. Apart from a reduction of serum uric acid levels with a concomitant increase in urinary uric acid excretion during the first days of treatment, no clinically significant changes in hematological, biochemical, hemodynamic and coagulation parameters occur during the 8 days or 29 days study. The study demonstrates that ridogrel is a potent inhibitor of the systemic as well as renal TXA2 synthase and an antagonist of platelet TXA2/PG endoperoxide receptor in man, covering full activity during 24 h at steady-state plasma level conditions without tachyphylaxis during 29 days of medication. The compound is well tolerated, at least during 1 month of administration.


2018 ◽  
Vol 69 (10) ◽  
pp. 2728-2730
Author(s):  
Raluca Costina Barbilian ◽  
Victor Cauni ◽  
Bogdan Mihai ◽  
Ioana Buraga ◽  
Mihai Dragutescu ◽  
...  

The aim of this study is to assess the efficiency and safety of the tranexamic acid in reducing hemmorrhagic complications and transfusion requirements in patients with renal lithiasis treated by percutaneous approach. Percutaneous nephrolithotomy (PCNL) is a minimally invasive technique used for large kidney stones (]20mm). Urinary sepsis and intra or postoperative bleeding are the very serious complications associated with this type of procedure. Tranexamic acid is used in the treatment of many haemorrhagic conditions. The experience with tranexamic acid in preventing bloodloss during percutaneous nephrolithotomy is very limited. The use tranexamic acid in percutaneous nephrolithotomy is safe and is associated with reduced blood loss and a lower transfusion rate.


2019 ◽  
Vol 25 (6) ◽  
pp. 700-709 ◽  
Author(s):  
Shuangshuang Zhang ◽  
Yong Wang ◽  
Jinsong Cheng ◽  
Ning Huangfu ◽  
Ruochi Zhao ◽  
...  

Purine metabolism in the circulatory system yields uric acid as its final oxidation product, which is believed to be linked to the development of gout and kidney stones. Hyperuricemia is closely correlated with cardiovascular disease, metabolic syndrome, and chronic kidney disease, as attested by the epidemiological and empirical research. In this review, we summarize the recent knowledge about hyperuricemia, with a special focus on its physiology, epidemiology, and correlation with cardiovascular disease. This review also discusses the possible positive effects of treatment to reduce urate levels in patients with cardiovascular disease and hyperuricemia, which may lead to an improved clinical treatment plan.


2020 ◽  
Vol 22 (1) ◽  
pp. 22-30
Author(s):  
Esteban Emiliani ◽  
Adrian Jara ◽  
Andres Koey Kanashiro

Background: Kidney stones are one of the oldest known and common diseases in the urinary tract with a prevalence that varies from 1% to 20%. Many phytotherapic and herbal medicines for kidney stones have been described for their treatment and prevention. Objective: The objective of this study is to perform a comprehensive review of several phytotherapic and herbal medicines published including clinical and animal studies. Results: Phytotherapy may influence the risk of recurrence in calcium oxalate and uric acid stones. The most solid evidence suggest that Phyllanthus niruri is one of the most studied components that appear to interfere with the calcium oxalate crystallization, reduced hyperoxaluria and hiperuricosuria and increased shock wave lithotripsy efficacy due to reduced crystallization without significant adverse effects, also Theobromine have shown to reduce the crystallization of uric acid in patients and appears to be a promising supplement to treat such stones. Conclusion: Many phytoterapic and herbal agents have been studies to treat and present urolithiasis, most of them only with studies of small number of patients or in animal models. Further randomized clinical trials are needed to evaluate the effect of these agents in kidney stones.


2020 ◽  
Vol 20 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Mahnaz Arian ◽  
Mina AkbariRad ◽  
Ahmad Bagheri Moghaddam ◽  
Abdollah Firoozi ◽  
Mohammad Jami

: Allopurinol is an FDA -Approved xanthine oxidase inhibitor, which is effective in the treatment of gout, hyperuricemia and uremic kidney stones in patients with an increased level of uric acid excretion. Xanthine oxidase acts by converting hypoxanthine and xanthine into uric acid, and therefore its inhibition results in decreased production of uric acid. The most common side effects of this medication are as follows: maculopapular rashes, hives, itching, headache, dizziness, abnormal hair loss, fever and hypersensitivity reaction. Case Presentation: This report represents a case of drug-induced meningitis of a senile man who ended up in the ICU due to the remarkably reduced state of consciousness.


2021 ◽  
Vol 14 (3) ◽  
pp. 217
Author(s):  
Jiri Patocka ◽  
Kamil Kuca ◽  
Patrik Oleksak ◽  
Eugenie Nepovimova ◽  
Martin Valis ◽  
...  

Since December 2019, SARS-CoV-2 (COVID-19) has been a worldwide pandemic with enormous consequences for human health and the world economy. Remdesivir is the only drug in the world that has been approved for the treating of COVID-19. This drug, as well as vaccination, still has uncertain effectiveness. Drug repurposing could be a promising strategy how to find an appropriate molecule: rapamycin could be one of them. The authors performed a systematic literature review of available studies on the research describing rapamycin in association with COVID-19 infection. Only peer-reviewed English-written articles from the world’s acknowledged databases Web of Science, PubMed, Springer and Scopus were involved. Five articles were eventually included in the final analysis. The findings indicate that rapamycin seems to be a suitable candidate for drug repurposing. In addition, it may represent a better candidate for COVID-19 therapy than commonly tested antivirals. It is also likely that its efficiency will not be reduced by the high rate of viral RNA mutation.


Diseases ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 39
Author(s):  
Prakrati Acharya ◽  
Chirag Acharya ◽  
Charat Thongprayoon ◽  
Panupong Hansrivijit ◽  
Swetha R. Kanduri ◽  
...  

Very-low-carbohydrate diets or ketogenic diets are frequently used for weight loss in adults and as a therapy for epilepsy in children. The incidence and characteristics of kidney stones in patients on ketogenic diets are not well studied. Methods: A systematic literature search was performed, using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from the databases’ inception through April 2020. Observational studies or clinical trials that provide data on the incidence and/or types of kidney stones in patients on ketogenic diets were included. We applied a random-effects model to estimate the incidence of kidney stones. Results: A total of 36 studies with 2795 patients on ketogenic diets were enrolled. The estimated pooled incidence of kidney stones was 5.9% (95% CI, 4.6–7.6%, I2 = 47%) in patients on ketogenic diets at a mean follow-up time of 3.7 +/− 2.9 years. Subgroup analyses demonstrated the estimated pooled incidence of kidney stones of 5.8% (95% CI, 4.4–7.5%, I2 = 49%) in children and 7.9% (95% CI, 2.8–20.1%, I2 = 29%) in adults, respectively. Within reported studies, 48.7% (95% CI, 33.2–64.6%) of kidney stones were uric stones, 36.5% (95% CI, 10.6–73.6%) were calcium-based (CaOx/CaP) stones, and 27.8% (95% CI, 12.1–51.9%) were mixed uric acid and calcium-based stones, respectively. Conclusions: The estimated incidence of kidney stones in patients on ketogenic diets is 5.9%. Its incidence is approximately 5.8% in children and 7.9% in adults. Uric acid stones are the most prevalent kidney stones in patients on ketogenic diets followed by calcium-based stones. These findings may impact the prevention and clinical management of kidney stones in patients on ketogenic diets.


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