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      Struvite Stones

      Nephron

      S. Karger AG

      Kidney stones, Urease, Struvite

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          Abstract

          Struvite stones constitute only about 2–3% of the stones reaching the laboratory for analysis, but the clinical problems they create including sepsis and even renal demise are greater than with any other stone type. This article reviews the evidence that bacterial urease, usually from a Proteus species, is responsible for the chemical changes in urine which result in struvite formation. Available urease inhibitors and other forms of medical management of patients with these stones are discussed. A patient with struvite stones should be assumed to have a progressive disease which cannot be ignored. Even after seemingly successful elimination of stones with lithotripsy and/or percutaneous nephrolithotomy, careful medical follow-up is critical. The medical profession is probably underutilizing postprocedure hemiacidrin irrigation because of shortsighted financial considerations. Primary-care physicians need to be educated in the importance of aggressive management of Proteus and other urea-splitting infections.

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          Most cited references 1

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          Surgical, bacteriological, and biochemical management of "infection stones"

           N Nemoy (1971)
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            Author and article information

            Journal
            NEF
            Nephron
            10.1159/issn.1660-8151
            Nephron
            S. Karger AG
            978-3-8055-6818-0
            978-3-318-00390-1
            1660-8151
            2235-3186
            1999
            December 1998
            24 December 1998
            : 81
            : Suppl 1
            : 50-59
            Affiliations
            Division of Clinical Pharmacology, Department of Medicine, Cornell University School of Medicine, and Division of Nephrology, Department of Medicine, Lenox Hill Hospital, New York, N.Y., USA
            Article
            46299 Nephron 1999;81(suppl 1):50–59
            10.1159/000046299
            9873215
            © 1998 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Figures: 1, Tables: 1, References: 54, Pages: 10
            Product
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/46299
            Categories
            Paper

            Cardiovascular Medicine, Nephrology

            Urease, Kidney stones, Struvite

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