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Nutrients Jan 2024Nephrolithiasis is a common urologic manifestation of Crohn's disease. The purpose of this study was to investigate the clinical characteristics, intestinal oxalate...
Nephrolithiasis is a common urologic manifestation of Crohn's disease. The purpose of this study was to investigate the clinical characteristics, intestinal oxalate absorption, and risk factors for urinary stone formation in these patients. In total, 27 patients with Crohn's disease and 27 healthy subjects were included in the present study. Anthropometric, clinical, and 24 h urinary parameters were determined, and the [C]oxalate absorption test was performed. Among all patients, 18 had undergone ileal resection, 9 of whom had a history of urinary stones. Compared to healthy controls, the urinary excretion values of calcium, magnesium, potassium, sulfate, creatinine, and citrate were significantly lower in patients with Crohn's disease. Intestinal oxalate absorption, the fractional and 24 h urinary oxalate excretion, and the risk of calcium oxalate stone formation were significantly higher in patients with urolithiasis than in patients without urolithiasis or in healthy controls. Regardless of the group, between 83% and 96% of the [C]oxalate was detected in the urine within the first 12 h after ingestion. The length of ileum resection correlated significantly with the intestinal absorption and urinary excretion of oxalate. These findings suggest that enteric hyperoxaluria can be attributed to the hyperabsorption of oxalate following extensive ileal resection. Oral supplementation of calcium and magnesium, as well as alkali citrate therapy, should be considered as treatment options for urolithiasis.
Topics: Humans; Oxalates; Crohn Disease; Calcium; Magnesium; Urinary Calculi; Urolithiasis; Hyperoxaluria; Calcium, Dietary; Citrates; Citric Acid
PubMed: 38257157
DOI: 10.3390/nu16020264 -
Kidney360 Feb 2024Thiazide treatment successfully lowered urine calcium and both calcium oxalate and calcium phosphate supersaturations in both types of stone formers (SFs). Alkali...
KEY POINTS
Thiazide treatment successfully lowered urine calcium and both calcium oxalate and calcium phosphate supersaturations in both types of stone formers (SFs). Alkali therapy may not confer the same benefits on calcium phosphate SFs as it does on calcium oxalate SFs.
BACKGROUND
Randomized controlled trials have shown that both thiazide diuretics and potassium citrate (K-Cit) can prevent calcium stone recurrence, but most participants formed calcium oxalate (CaOx) stones. While thiazides are expected to lower risk of calcium phosphate (CaP) stone formation, the effect of K-Cit on risk of CaP stone formation is unclear.
METHODS
To study the effect of common calcium stone treatments, we analyzed the 24-hour urines of CaOx and CaP stone formers (SFs) by four treatment types: Lifestyle, K-Cit, Thiazide, or Both medications.
RESULTS
Patients treated with thiazides reduced urine calcium in both CaOx (=−74.4, =94.6 mg/d) and CaP (=−102, =99.7 mg/d) SFs while those on K-Cit had no change in urine calcium. Among CaOx SFs, urine citrate rose in patients administered K-Cit with or without thiazide, but citrate did not rise significantly in CaP SFs. Urine pH rose in all CaOx SFs, but among CaP SFs, only rose in patients receiving K-Cit. CaOx supersaturation (SS) decreased in all patients who received Thiazide, and decreased among CaOx SFs treated with K-Cit. CaP SS decreased in both CaOx SFs (=−0.46, =0.86) and CaP SFs (=−0.76, =0.85) treated with Thiazide, except CaOx SFs who received Both. Patients treated with K-Cit alone increased CaP SS in CaOx SFs (=0.25, =0.79).
CONCLUSIONS
Patients treated with Thiazide lowered urine calcium and SS in both stone groups. Patients treated with K-Cit had no significant changes in urine calcium and had a decrease in CaOx SS in CaOx SFs. The study raises questions about the best preventive treatment for patients with CaP stones and suggests that K-Cit may not confer the same benefits on CaP SFs as it does on CaOx SFs.
Topics: Humans; Calcium Oxalate; Phosphates; Calcium Phosphates; Kidney Calculi
PubMed: 38251931
DOI: 10.34067/KID.0000000000000362 -
International Journal of Health Sciences 2024is a small tree under the genus . Previous studies showed medical applications, such as antibacterial and antihypertensive, for .
OBJECTIVE
is a small tree under the genus . Previous studies showed medical applications, such as antibacterial and antihypertensive, for .
METHODS
Sixty naïve mice were classified into six groups: control, sap-treated group, methanol extract-treated group, acetone extract-treated group, heparin-treated group, and aspirin-treated group. Blood samples from each mouse in the six groups were collected in EDTA, sodium citrate, and heparin tubes. The body weight of each mouse was measured at the beginning and end of the experiment. Furthermore, complete blood count, kidney and renal function tests, coagulation profiles, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), D-dimer, and fibrinogen concentrations were estimated for each mouse.
RESULTS
The sodium, potassium, chloride, blood urea nitrogen, creatinine, alanine transaminase, and aspartate transaminase levels did not show statistical differences between all groups. Moreover, PT, aPTT, and INR were prolonged in the sap, methanol, and acetone extracts-treated mice compared with those in the heparin and aspirin-treated groups ( < 0.01). D-dimer and fibrinogen concentrations did not show significant statistical differences between all groups.
CONCLUSION
The current study concludes that the sap, methanol, and acetone extracts prolonged PT, aPTT, and bleeding time in naïve mice more than heparin and aspirin. This means that the extracts may have antithrombotic activity and may be used in the future to resolve intravascular thrombosis in patients having prosthetic valves.
PubMed: 38188900
DOI: No ID Found -
Applied Microbiology and Biotechnology Dec 2024The high recurrence rate of renal uric acid stone (UAS) poses a significant challenge for urologists, and potassium sodium hydrogen citrate (PSHC) has been proven to be...
The high recurrence rate of renal uric acid stone (UAS) poses a significant challenge for urologists, and potassium sodium hydrogen citrate (PSHC) has been proven to be an effective oral dissolution drug. However, no studies have investigated the impact of PSHC on gut microbiota and its metabolites during stone dissolution therapy. We prospectively recruited 37 UAS patients and 40 healthy subjects, of which 12 patients completed a 3-month pharmacological intervention. Fasting vein blood was extracted and mid-stream urine was retained for biochemical testing. Fecal samples were collected for 16S ribosomal RNA (rRNA) gene sequencing and short chain fatty acids (SCFAs) content determination. UAS patients exhibited comorbidities such as obesity, hypertension, gout, and dyslipidemia. The richness and diversity of the gut microbiota were significantly decreased in UAS patients, Bacteroides and Fusobacterium were dominant genera while Subdoligranulum and Bifidobacterium were poorly enriched. After PSHC intervention, there was a significant reduction in stone size accompanied by decreased serum uric acid and increased urinary pH levels. The abundance of pathogenic bacterium Fusobacterium was significantly downregulated following the intervention, whereas there was an upregulation observed in SCFA-producing bacteria Lachnoclostridium and Parasutterella, leading to a significant elevation in butyric acid content. Functions related to fatty acid synthesis and amino acid metabolism within the microbiota showed upregulation following PSHC intervention. The correlation analysis revealed a positive association between stone pathogenic bacteria abundance and clinical factors for stone formation, while a negative correlation with SCFAs contents. Our preliminary study revealed that alterations in gut microbiota and metabolites were the crucial physiological adaptation to PSHC intervention. Targeted regulation of microbiota and SCFA holds promise for enhancing drug therapy efficacy and preventing stone recurrence. KEY POINTS: • Bacteroides and Fusobacterium were identified as dominant genera for UAS patients • After PSHC intervention, Fusobacterium decreased and butyric acid content increased • The microbiota increased capacity for fatty acid synthesis after PSHC intervention.
Topics: Humans; Citric Acid; Potassium Citrate; Sodium Citrate; Potassium; Uric Acid; Gastrointestinal Microbiome; Sodium; Citrates; Bacteroides; Butyric Acid
PubMed: 38183479
DOI: 10.1007/s00253-023-12953-y -
Canadian Journal of Kidney Health and... 2023Imatinib is used in the treatment of Philadelphia chromosome positive (Ph+) leukemias and has been reported to have a direct effect on bone physiology.
RATIONALE
Imatinib is used in the treatment of Philadelphia chromosome positive (Ph+) leukemias and has been reported to have a direct effect on bone physiology.
PRESENTATION
To report on a child with Ph+ acute lymphoblastic leukemia who presented with bilateral flank pain and gross hematuria.
DIAGNOSIS
She was diagnosed with obstructive kidney stones 101 days after commencing daily oral imatinib. Stone analysis revealed the presence of calcium phosphate.
INTERVENTIONS AND OUTCOME
The patient passed the stones spontaneously with medical therapy that included the use of thiazide, allopurinol, and potassium citrate, but she required temporary insertion of a double-J stent to relieve an obstruction.
NOVEL FINDINGS
Imatinib inhibits receptor tyrosine kinases and stimulates the flux of calcium from the extracellular fluid into bone, resulting in hypocalcemia with a compensatory rise in parathyroid hormone that may result in phosphaturia and the formation of calcium phosphate stones. Given that kidney stones are rare events in children, we believe that monitoring for kidney stone formation needs to be performed in children receiving imatinib.
PubMed: 38107158
DOI: 10.1177/20543581231215849 -
Molecules (Basel, Switzerland) Nov 2023We previously enabled a direct insight into the quality of citrate anticoagulant tubes before their intended use for specimen collection by introducing an...
We previously enabled a direct insight into the quality of citrate anticoagulant tubes before their intended use for specimen collection by introducing an easy-to-perform UV spectrometric method for citrate determination on a purified water model. The results revealed differences between the tubes of three producers, Greiner BIO-ONE (A), LT Burnik (B), and BD (C). It became apparent that tubes C contain an additive, which absorbs light in the ultraviolet range and prevents reliable evaluation of citrate anticoagulant concentration with the suggested method. In this research, we re-evaluate the quality of citrate-evacuated blood collection tubes by complementing UV spectrometry with ion chromatography. (1) Comparable results were obtained for tubes B at 220 nm. (2) Citrate concentrations determined with ion chromatography were lower for tubes A and C. Chromatograms reveal additional peaks for both. (3) Influences of heparin on absorption spectra and chromatograms of citrate were studied. Some similarities with the shape of the anticoagulant spectra of tubes A and C were observed, and the lithium heparin peak in chromatograms is close to them, but a confident judgment was not possible. (4) Contamination of anticoagulant solution with potassium, magnesium, and calcium was confirmed for all the brands, and contamination with lithium for B and C.
Topics: Citric Acid; Lithium; Anticoagulants; Heparin; Citrates; Spectrophotometry, Ultraviolet
PubMed: 38067465
DOI: 10.3390/molecules28237735 -
RSC Advances Oct 2023Metal organic frameworks (MOFs), with structural tunability, high metal content and large surface area have recently attracted the attention of researchers in the field...
Metal organic frameworks (MOFs), with structural tunability, high metal content and large surface area have recently attracted the attention of researchers in the field of electrochemistry. In this work, an unprecedented use of multi-walled carbon nanotubes (MWCNTs)/copper-based metal-organic framework (Cu-BTC MOF) composite as an ion-to-electron transducer in a potentiometric sensor is proposed for the determination of orphenadrine citrate. A comparative study was conducted between three proposed glassy carbon electrodes, Cu-MOF, (MWCNTs) and MWCNTs/Cu-MOF composite based sensors, where Cu-MOF, MWCNTs and their composite were utilized as the ion-to-electron transducers. The sensors were developed for accurate and precise determination of orphenadrine citrate in pharmaceutical dosage form, spiked real human plasma and artificial cerebrospinal fluid (ACSF). The sensors employed β-cyclodextrin as a recognition element with the aid of potassium tetrakis(4-chlorophenyl)borate (KTpCIPB) as a lipophilic ion exchanger. The sensors that were assessed based on the guidelines recommended by IUPAC and demonstrated a linear response within the concentration range of 10 M to 10 M, 10 M to 10 M and 10 M to 10 M for Cu-MOF, MWCNTs and MWCNTs/Cu-MOF composite based sensors, respectively. MWCNTs/Cu-MOF composite based sensor showed superior performance over other sensors regarding lower limit of detection (LOD), wider linearity range and faster response. The sensors demonstrated their potential as effective options for the analysis of orphenadrine citrate in quality control laboratories and in different healthcare activities.
PubMed: 37876650
DOI: 10.1039/d3ra06710f -
Alternative Therapies in Health and... Nov 2023To investigate the clinical impact of dietary intervention in combination with bismuth potassium citrate in the management of chronic atrophic gastritis (CAG) caused by... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To investigate the clinical impact of dietary intervention in combination with bismuth potassium citrate in the management of chronic atrophic gastritis (CAG) caused by Helicobacter pylori.
METHODS
From April 2019 to October 2022, 160 patients with newly identified Helicobacter pylori-related CAG were treated at our facility. They were split into two groups at random: the bismuth potassium citrate medication group (n = 80) and the diet intervention + bismuth potassium citrate experimental groups (n = 80). The bismuth potassium citrate treatment group was given bismuth potassium citrate capsule treatment only, and the diet intervention + bismuth potassium citrate treatment group was given diet intervention based on bismuth potassium citrate capsule. The diet intervention score, symptom score, and pathological score of the two groups were observed at baseline and after treatment, and the relationship between dietary intervention and symptoms and pathology of Helicobacter pylori-related CAG was analyzed.
RESULTS
During the baseline period, there was no discernible difference in the diet intervention score, symptom score, or pathology score between the two groups (P > .05); after the diet intervention combination treatment, the diet intervention score, diet intervention + bismuth potassium citrate experimental groups symptom score, and pathology score were considerably lower than those in the bismuth potassium citrate treated group (P < .05).
CONCLUSIONS
Dietary intervention combined with bismuth potassium citrate exhibited more effective treatment than bismuth potassium citrate-only treatment in Helicobacter pylori-related CAG, which hinted us proper diet has a positive impact on improving the therapeutic efficacy of bismuth potassium citrate.
Topics: Humans; Amoxicillin; Anti-Bacterial Agents; Bismuth; Drug Therapy, Combination; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Potassium; Potassium Citrate; Treatment Outcome
PubMed: 37856797
DOI: No ID Found -
Veterinary Medicine and Science Nov 2023Urinary pH manipulation by therapeutic foods or supplements is part of the treatment for urolithiasis. The effectiveness of these diets and supplements should be studied...
BACKGROUND
Urinary pH manipulation by therapeutic foods or supplements is part of the treatment for urolithiasis. The effectiveness of these diets and supplements should be studied to determine which of these strategies is most effective.
HYPOTHESIS/OBJECTIVES
To assess the effect of the oral supplementation of potassium citrate, an ammonium chloride solution (Urical) and two dry therapeutic foods-Hill's® Prescription Diet® u/d® Canine (u/d diet) and Royal Canin® Urinary S/O dog (S/O diet)-on a dog's urinary pH at different time points over 8 h.
ANIMALS
Seven healthy adult male research beagle dogs.
METHODS
A prospective interventional study lasting 31 days. The dogs either received a supplement (potassium citrate or rical) with a dry adult maintenance diet (control diet) or the therapeutic diet (u/d diet or S/O diet). Each treatment had a duration of 2-5 days, with 2- to 4-day washout periods in between. Urinary pH measurements were performed every 2 h between 07h00 and 15h00, with the food being given at 07h00 and 15h00, right after urine collection. The pH measurements obtained in each of the four treatments were compared to control (same dogs fed the control diet exclusively).
RESULTS
When compared to the control diet at the same time points, biologically relevant changes in urinary pH (defined as ≥0.5) were: increase with potassium citrate at 7h00 and 13h00; increase with u/d diet at 9h00, 13h00, and 15h00; decrease with S/O diet at 9h00 and 11h00; Urical did not have a detectable effect on urinary pH.
CONCLUSIONS AND CLINICAL IMPORTANCE
The present study confirms that therapeutic foods S/O and u/d, and potassium citrate supplement affected acid-base balance in healthy adult male beagle dogs, with the tested diets being more effective than the administered doses of the tested supplements at influencing urinary pH.
Topics: Dogs; Animals; Male; Potassium Citrate; Prospective Studies; Hydrogen-Ion Concentration; Diet; Dietary Supplements
PubMed: 37853984
DOI: 10.1002/vms3.1285 -
Medicine Oct 2023Helicobacter pylori (H pylori) can cause gastritis, peptic ulcers, gastric cancer, and many other gastrointestinal diseases. The 14-day neo-dual therapy for H pylori is... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Helicobacter pylori (H pylori) can cause gastritis, peptic ulcers, gastric cancer, and many other gastrointestinal diseases. The 14-day neo-dual therapy for H pylori is considered by most countries to have good eradication rates, while the 7- and 10-day studies have been more widely explored, however, we find that their results are different. The applicability of the shorter and less expensive 10-day neo-dual therapy to our country has not yet been confirmed.
METHODS
The patients were divided into 3 groups of 200 each by randomization method. Group A: patients received vonoprazan 20 mg, bid + amoxicillin(1 g), tid, for 14 days. Group B: vonoprazan (20 mg) bid + amoxicillin (1 g) tid, duration of treatment is 10 days, group C: rabeprazole (20 mg) bid + bismuth potassium citrate tablets/tinidazole tablets/clarithromycin tablets, combined package (4.2 g), bid, duration of treatment 14 days. The main comparisons were H pylori eradication rate, adverse drug reaction profile and cost-effect ratio in each group.
RESULTS
The eradication rates of groups A, B, and C were 92.5%, 91.6%, and 80.1%, respectively. There was no significant difference in the eradication rates of groups A and B (P > .05), groups A and B had statistically significantly better eradication rates than group C (P < .05). The incidence of adverse reactions in groups A, B, and C was 9.5%, 8.5%, and 17.0%, respectively. There was no difference in the incidence of adverse reactions between A and B: (P > .05), The incidence of adverse reactions was statistically significantly lower in groups A and B than in group C (P < .05). Logistic regression analysis showed nonsmokers had a higher eradication rate (OR 2.587, 95% CI: 1.377-4.859, P = .003), and taller patients were more likely to have successful eradication (OR 1.052, 95% CI: 1.008-1.097, P = .020). Group B had the lowest cost-benefit analysis results.
CONCLUSION
Group B had an acceptable eradication rate, the lowest incidence of adverse effects, and the lowest cost analysis. Eradication is more likely to be successful in patients who do not smoke and in those who are taller.
Topics: Humans; Amoxicillin; Anti-Bacterial Agents; Clarithromycin; Drug Therapy, Combination; Helicobacter Infections; Helicobacter pylori; Sulfonamides; Treatment Outcome
PubMed: 37832048
DOI: 10.1097/MD.0000000000035610