Drug-induced nephrolithiasis and crystalluria: the particular case of the sulfasalazine derivatives (original) (raw)
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Sulfadiazine-induced nephrolithiasis in children
Pediatric Nephrology, 2004
Sulfadiazine-associated urinary calculi have been described in HIV-positive adult patients but rarely in children. We report two pediatric cases of sulfadiazine-induced nephrolithiasis and review 45 adult cases from the literature. One had a hyper-IgM syndrome and was treated with sulfadiazine for cerebral toxoplasmosis, the other had toxoplasmic retinitis. Both developed multiple bilateral lithiasis with acute renal failure. Normalization of renal function and reduction of calculi size was rapidly achieved after discontinuation of sulfadiazine, hyperhydration, and alkalinization. Bilateral ureteral stents were required in one patient because of anuria.
Interstitial nephritis from mesalazine: case report and literature review
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We report a new case of biopsy-confirmed mesalazine-induced interstitial nephritis in an 18-year-old male with ulcerative colitis. His renal function improved with drug discontinuation and corticosteroid treatment. An English literature review revealed an additional 22 cases of this complication that, taken together, showed (1) a male predominance, (2) an absence of specific symptoms or findings on urinalysis, (3) a 61% frequency of residual chronic renal insufficiency with 13% of patients developing end-stage renal disease, and (4) an apparent favorable response to steroid therapy. We conclude that patients receiving 5-aminosalicylates should be routinely monitored with serum creatinine measurements to prevent this uncommon but potentially serious adverse drug reaction.
Use of drugs for nephrolithiasis
Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, 2008
Renal stone disease often begins by renal colic. In order to manage this event adequately, several goals should be pursued: first, attenuate pain; second, favour progression and spontaneous expulsion of stones; third, prevent from obstructive and infectious complications. All of the aforementioned points pertain to medical management of this disease. Concerning prevention, it is widely agreed that pathogenesis of kidney stones is a consequence of abnormalities in urine environment, leading to a disequilibrium between promoters and inhibitors of crystallization. Therefore, the rationale for therapy is to make urine less conductive to stone formation, by both decreasing state of saturation and increasing inhibitory potential. In only some types of stone-forming salts it is possible to obtain undersaturation with the solid phase. Indeed, uric acid stones can be chemically dissolved by using alkali and allopurinol. To a lesser extent, this also applies to cystine stones, with the use of...
Drug-Induced Urolithiasis in Pediatric Patients
Pediatric Drugs
Drug-induced nephrolithiasis is a rare condition in children. The involved drugs may be divided into two different categories according to the mechanism involved in calculi formation. The first one includes poorly soluble drugs that favor the crystallization and calculi formation. The second category includes drugs that enhance calculi formation through their metabolic effects. The diagnosis of these specific calculi depends on a detailed medical history, associated comorbidities and the patient's history of drug consumption. There are several risk factors associated with drug-induced stones, such as high dose of consumed drugs and long duration of treatment. Moreover, there are some specific risk factors, including urinary pH and the amount of fluid consumed by children. There are limited data regarding pediatric lithogenic drugs, and hence, our aim was to perform a comprehensive review of the literature to summarize these drugs and identify the possible mechanisms involved in calculi formation and discuss the management and preventive measures for these calculi.
Acute interstitial nephritis due to mesalazine. Case Report
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A case of mesalazine-induced acute interstitial nephritis (AIN) in a 41-year-old patient with ulcerative colitis (UC) is reported here. Clinical symptoms such as fever and arthralgia, and laboratory findings such as eosinophilia and renal failure suggested AIN, which was confirmed by biopsy. With withdrawal of mesalazine and intravenous methylprednisolone the patient's renal function was recovered. It is observed that early discontinuation of mesalazine is associated with amelioration of interstitial nephritis in most patients, so the recommendation is that patients receiving mesalazine should undergo routine monitoring of renal function. Delayed diagnosis may lead to permanent renal function impairment.
Metabolic causes such as hypercalciuria, urinary tract infection, and obstruction are the most common aetiologies of urolithiasis, and drugs, although important in this regard, are rarely the cause of urolithiasis. Administration of one of these drugs, ceftriaxone (CTX), has been associated with biliary pseudolithiasis in adult and paediatric patients, and rarely may cause urolithiasis. Several factors, including drug concentration and incubation time, are very important for determining the degree of CTX/calcium (Ca) crystallisation in the urine. According to this data, CTX crystallisation was a dose and time-dependent reaction. It is particularly important to monitor patients on high-dose long-term CTX treatment with the urinary Ca to creatinine ratios, ultrasound sonography, and renal function testing, as these individuals may be at greater risk of large stones and renal damage. This type of screening may help prevent permanent complications in the future. This underlying review will help to educate readers on the pathophysiology and interaction between CTX and urolithiasis.
The complex pathophysiology of urolithiasis (kidney stones) and the effect of combinational drugs
Journal of Drug Delivery and Therapeutics, 2022
Body organs are very crucial when it comes to homeostatically maintaining them. If any changes occur in their function, it may lead to the development of diseases in the body. The kidney is one of the functionalised organs that is connected with the ureter and urinary bladder, which is basically the lower part of the body. The kidney priorly controls the volume of various body fluids, fluid osmolality, acid-base balance, various electrolyte concentrations, and the removal of toxins. Any disbalance in the function of the kidney can generate a disease like renal calculi (kidney stone), chronic kidney disease (CKD), polycystic kidney disease (PKD), urinary tract infections (UTI), etc. Kidney stones (KS) are prevalent worldwide, affecting 15% of individuals. A stone arranged into various sizes may be micro, macro, and nano or found as mono or polycrystalline forms. The names of the two most common kidney stones, calcium and non-calcium stones (Uric acid stones, struvite stones, cysteine stones, and drug-induced KS), are determined primarily by their composition. Calcium stones are commonly found in individuals, approximately 80% of KS. This review provided recent details on kidney stone symptoms, etiology, psychophysiology, and management perspective.
Thiazide and thiazide-like diuretics in nephrolithiasis
2020
Thiazide and thiazide-like diuretics are widely used for the management of hypercalciuria among stone-forming patients. Although the effects of different thiazides should be relatively similar in terms of prevention of stone recurrence, their potency and side effects may differ. However, there is scarce data concerning the metabolic and bone effects of these agents among recurrent nephrolithiasis patients with hypercalciuria. The aim of this update article was to compare our experience in the use of thiazide and thiazide- like diuretics with that of the current literature, concerning their anticalciuric properties and consequent reduction of recurrent stone formation. Their impact on bone mass and potential side effects were also discussed.