Calcium Oxalate

Urolithiasis and calcium oxalate crystal deposition diseases are still significant medical problems. In the course of nephrocalcin cDNA cloning, we have identified FKBP-12 as an inhibitory molecule of calcium oxalate crystal growth. lambdagt 11 cDNA libraries were constructed from renal carcinoma tissues and screened for nephrocalcin cDNA clones using anti-nephrocalcin antibody as a probe. Clones expressing recombinant proteins, which appeared to be antigenically cross-reactive to nephrocalcin, were isolated and their DNA sequences and inhibitory activities on the calcium oxalate crystal growth were determined. One of the clone lambda gt 11 #31-1 had a partial fragment (80 bp) of FKBP-12 cDNA as an insert. Therefore, a full-length FKBP-12 cDNA was PCR-cloned from the lambda gt 11 renal carcinoma cDNA library and was subcloned into an expression vector. The resultant recombinant FKBP-12 exhibited an inhibitory activity on the calcium oxalate crystal growth (Kd=10(-7) M). Physiologica...

Nephrolithiasis is quite common in children. It sometimes has a genetic basis and can lead to serious complications like urinary obstruction, multiple surgical interventions, or even renal insufficiency if left treated. Cystinic stones and cystinuria account for approximately 8% of the cases of nephrolithiasis in children. We studied seven pediatric patients, 1 to 3 years old (mean age: 20.5 months), with cystinic urinary stones receiving D-penicillamine plus other drugs to dissolve the stone. All of them tolerated the treatment very well and did not show any serious complication. All of our cases were managed with Dpenicillamine that was initiated at a low dose and then increased progressively. We used low dose D-penicillamine, maximim15 mg/kg/day, which was beneficial without any specific side effects. D-penicillamine can be used safely in little children. Gradual induction and close observation with CBC, urine analysis, BUN, creatinine, and liver function tests may be required. D-penicillamine can prevent new stone formation and resolve the present cystinic calculi. Low dose D-penicillamine may be sufficient in treating cystinic calculi in children. We suggest more evaluations on the advantage of low dose Dpenicillamine in cystinuria.

Calcium oxalate crystals (COC) are one of the most prevalent and widely distributed biomineralizations in plants. The aim of this work is to analyze and compare the data previously reported about the presence and production of COC in leaves of plant species from forests, wetlands, and agroecosystems of the southeast of the Pampean Plain. Diaphanization, clearing of tissues with 50% sodium hypochlorite, and cross sectioning of the leaves were realized. The material was mounted with gelatin-glycerin, and COC were identified and described with optical, polarization, and scanning electron microscopes. Crystal size and density were calculated. Calcification mainly occurred in leaf mesophyll. In terrestrial species, crystals were closely associated with vascular bundles, while in aquatic species, they were associated with aerenchyma. Druses, prisms, and raphides were observed in the leaves of all species analyzed. Average crystal size was smaller in terrestrial species than aquatic ones (12 and 80 μm, respectively), but average crystal density was higher (246 and 23 crystals/mm 2 , respectively). These different patterns in COC production and distribution may be related to taxonomical characteristics, the types of cells where crystals precipitate, their function, and the differential transpiration rates, among other factors.

Physical and chemical methods available for kidney stone analysis are critically reviewed. Although various methods, such as the FTIR and Raman spectroscopy, scanning electron microscopy, thermogravimetry etc. can be used for qualitative phase analysis of kidney stones, the Rietveld method based on high quality X-ray powder diffraction data provides a precise and reliable technique for identifying the structure as well as the quantitative phase abundance of different crystalline components in human urinary calculi. Quantitative phase analyses of ten (10) kidney stones (KS1-KS10) from eastern India revealed that most of the calculi samples are mixture of phases with calcium oxalate monohydrate (whewellite) as the major constituent and varying amounts of calcium oxalate dihydrate (weddellite), calcium hydroxyapatite, uric acid and ammonium acid urate. The crystal structures of whewellite and weddellite have been redetermined using X-ray powder diffraction methodology.

Purple urine bag syndrome is a rare condition, characterized by purple coloration of the urine inside the bag. It is observed in patients who have urinary catheters together with an infection associated with certain bacterial species, which produce a chemical reaction between the plastic of the urine bag and the urine, resulting in an intense purple color of the urine. We report a patient with PUBS, because it is an unfrequented phenomenon that generates alarm in family members and health care workers and because of the clinical implications of urinary tract infection management.

Taro [Colocasia esculenta (L) Schott] belongs to the family Araceae. It is an important staple food crop grown mainly by small scale farmers in many parts of the world. Taro is also grown in South Africa from the costal parts of the northern Eastern Cape to the KwaZulu-Natal north coast. Although it is an important staple crop in South Africa, very little information exists on the genetic diversity of the crop. Knowledge of the genetic diversity of a crop is important for breeding programmes. The aim of this study is to assess the genetic diversity of taro using morphological and molecular techniques and to determine the calcium oxalate content of 25 South African taro accessions. This study showed that the aerial portions of taro are variable for most quantitative characters. Most of the morphological variation was due to lamina length, petiole length, lamina width and plant girth that explained 54% of the variance in principal component analysis. The number of raphides was able to divide the accessions into two groups, one with relatively low counts and the other with high counts. Ntumeni had the lowest raphide count of only 27 ±12 raphides and Modderfontein had the highest count with 1150 ±104 raphides. Twelve accessions having low raphide counts ranging from 27 ±12 to 147 ±28 raphides per cell have been identified. RAPD data separated the accessions into three main groups that were further divided into five subgroups. The accessions did not group according to geographical locations. The ITS2 sequence generated clustering patterns that were similar to that obtained from RAPDs. The variation in the ITS2 secondary structure of taro included one common motif that was present in all 25 accessions. Some motifs were only present in some accessions. The discovery of these motifs strengthens the potential of the ITS2 region as a taxonomic marker and a powerful barcode for taro. The ITS2 motifs provide the means of identifying each of the 25 accessions of taro. The high genetic diversity, morphological variation and accessions with low vi calcium oxalate content found in this study provide taro breeders a selection of parent crops for the improvement of taro.

Objective: This study aimed to evaluate whether clinical, laboratory, and radiological data could effectively identify struvite stones without the need for crystallographic analysis. Methods: Stone fragments obtained using endourological procedures were subjected to crystallographic analysis. A prospective evaluation and comparison were conducted between patients with and without struvite stones. Sex, age, comorbidities, Hounsfield Unit Coefficient, stone size, urine culture, and urinary pH were analyzed. Results: Among the 221 stones enrolled, 18% were struvite. Among patients with struvite stones, 95% were women, whereas in the group without struvite stones, 51% were women. The average age was 40.6 years among patients with struvite stones, and 51.5 years in the other group (p<0.001). The stone size in the struvite group (24.9 mm) was significantly larger than that in the non-struvite group (15.6 mm)
(p<0.001). The urinary pH was significantly higher in the struvite group than in the non-struvite group (p<0.001). Patients with a positive urine culture had a 3.78 times greater chance of having a struvite stone than those with a negative urine culture (p<0.01). Multivariate analysis considering pH, age, and stone size yielded an AUC value of 0.83, sensitivity of 0.39, specificity of 0.95, and accuracy of 0.85. There was no significant difference between the groups in terms of the Hounsfield Unit Coefficient and comorbidities. Conclusion: Our analysis further supports the conclusion that characteristics such as pH, age, stone size, and urine culture have notable specificity but low sensitivity for identifying struvite stones.

We evaluated the effects of the leaves, “pine ” or “head ” (plants without leaves) age of Agave atrovirens on the epidermal, parenchyma and fibrillar microstructure as possible maturity indicators, since plant age is a determinant factor of the concentration of inulin. Samples were taken from three, six and nine year-old plants, and observations were made with scanning electronic microscopy (SEM) and light microscopy (LM). The results showed that the isolated cuticular membrane (ICM) microstructure in the Agave plant changes considerably with the age, becoming harder and allowing the mature plant to avoid excessive water loss, on the other hand, the increased size of the suprastomal cavity makes the respiration process more efficient in older plants. The Agaves present the three main types of calcium oxalate crystals reported for monocotyledons (druses, raphides and styloids). The plant age is an important factor in the identification of calcium oxalate crystals because it is only i...

Nephrolithiasis is a terrible pathological condition marked by the presence and formation of kidney stones. It affects around 3-20% of the community in the world. Several environmental, physiological, and nutritional conditions influence this disease. Not only the food sources but also the body's own metabolism add up oxalate content in the human body. The increased intake of oxalate leads to hyperoxaluria, which often results in the formation of calcium oxalate stones, commonly known as kidney stones. The incidences of kidney stone are very common, and the current therapeutic measure of its cure is not much effective. Therefore, new therapeutic approaches are needed. In the last few years, the use of gut microbiome with oxalate-degrading activity has emerged as an excellent therapeutic approach to treat kidney stones. As the genes responsible for oxalatedegrading enzymes are not found in humans use of bacterial enzymes with the ability to degrade oxalate in intestinal digestion has a significant therapeutic impact. This chapter summarizes the roles of microbial enzymes produced by gut microflora involved in the solubilization of the dietary oxalates, and their potential applications in kidney stone diseases.

The hill fort of Raigad is a massive historical structure constructed with basaltic stone blocks and cemented together with lime mortar. The lime mortar samples from the fort were examined using a petrological microscope, grain size distribution, X-ray fluorescence (XRF), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and scanning electron microscope coupled with energy dispersive x-ray analysis (SEM-EDX). The mineralogical and compositional characteristic of the mortar was analyzed to provide a compatible repair mix for large scale restoration. Aggregates derived from weathering of basaltic rocks of Sahyadri hills were sourced from the vicinity of the fort. Non-hydraulic aerial lime of moderate porosity was specifically used in India's highly rain-fed Western Ghats for rapid evaporation of water and to prevent the build-up of salts. Thin section analysis and FTIR results indicate the use of organic proteinaceous material during the preparation of lime. FTIR analysis also showed the disorder in the man-made calcite crystals while XRD and SEM-EDX analysis elucidated the mixing of quartz and plagioclase feldspar derived from basaltic aggregates in the calcite matrix. The present study gives a holistic approach to prepare a compatible mortar for restoration.

The use of nanotechnology for nanobacteria (or calcifying nanoparticles) treatment is a new creative approach. Use of selenium nanoparticles (SeNPs) as anti-nanobacterial agents might be considered as a bright promising approach due to their critical role in the inhibition of crystal growth and aggregation of calcium oxalate. Hence, in this study, we investigated the probable outcome of SeNPs inhibitory effects on growth of nanobacteria. Fragments of thirty urinary tract stones were chemically analyzed by X-ray diffraction (XRD) and urinary stones Kits for calcifying nanoparticles presence. Then powder of stone fragments were resuspended in Dulbecco's modified Eagle's medium (DMEM), sterilized by filtration and cultured in presence of 1, 5, 30, 60, and 90 μmol/L SeNPs concentrations. Besides, calcifying nanoparticles growth in the culture without SeNPs was measured spectrophotometrically. Also, scanning electron microscopy (SEM) and transmission electron microscopy (TEM) analyses were used, where calcifying nanoparticles formation occurred. Results showed that in the culture without SeNPs, the positive calcifying nanoparticles detection was 60% while after adding SeNPs at 90 μmol/L, not any calcifying nanoparticles were observed. Further confirmation came out when Energy-dispersive X-ray (EDX) analysis showed calcium and phosphate peaks in the culture medium without any SeNPs while in the culture containing 90 μm/L SeNPs a decrease in calcium and other minerals was obvious. Therefore, SeNPs clearly restricted the growth of nanobacteria due to their inhibitory effects on calcium oxalate deposition.

Bölgemizdeki üriner sistem taþlarýnýn taþ içeriði Amaç: Bölgemizde tedavi edilen üriner sistem taþ hastalarýnýn taþ kompozisyonunun spektrumunu deðerlendirmek. Metod: Ekstrakorporeal þok dalga litotripsi, endoskopik veya çeþitli açýk cerrahi yöntemleriyle elde edilenler ile hastalarýn kendi düþürdükleri toplam 710 üriner taþ, laboratuarda esas olarak mineralleri saptamak için kullanýlan kimyasal ve fizikokimyasal yöntemler kullanýlarak incelendi. Bulgular: Taþlarýn 454ü (%64.9) kalsiyum okzalat, 104ü kalsiyum fosfat (%14.6), 99u struvite (%13.9), 24ü ürik asit (%3.3), 21i karýþýk (%2.9), 5i (%0.7) sistin, 3ü ksantin (%0.4) idi. Sonuç: Bizim bölgemizde kalsiyum taþlarý, özellikle kalsiyum okzalat diðer taþ tipleri arasýnda daha fazla görülmektedir. Enfeksiyon taþlarý da kalsiyum fosfat taþlarýna yakýn seviyede belirgin bir insidansa sahiptir. Bu veriler taþ analizi deðerlendirmesi yapýlmamýþ hastalarda beslenme önerileri ve tedavi planlarý için yararlý olabilir.

Our own studies and those of others have shown that the incidence of calcium oxalate stones and plaques is markedly increased by nephrotoxins. The possible role of oxalate as a nephrotoxin has not been fully appreciated. However, recent studies in experimental animals and in cultured cells support this possibility . The results of these studies led us to hypothesize that hyperoxaluria promotes stone formation in several ways: by providing a substrate for the formation of the most common form of renal stones, calcium oxalate stones, and by inducing damage to renal epithelial cells. Damaged cells in tum would produce an environment favorable for crystal retention and provide membranous debris that promotes crystal nucleation, aggregation and adherence. The present report summarizes evidence for oxalate nephrotoxicity and discusses the potential importance of oxalate toxicity in the pathogenesis of stone disease.

Oxalate toxicity in LLC-PK1 cells: Role of free radicals. Oxalate, the most common constituent of kidney stones, is an end product of metabolism that is excreted by the kidney. During excretion, oxalate is transported by a variety of transport systems and accumulates in renal tubular cells. This process has been considered benign; however, recent studies on LLC-PK1 cells suggested that high concentrations of oxalate are toxic, inducing morphological alterations, increases in membrane permeability to vital dyes and loss of cells from the monolayer cultures. The present studies examined the basis for oxalate toxicity, focusing on the possibility that oxalate exposure might increase the production/availability of free radicals in LLC-PK1 cells. Free radical production was monitored in two ways, by monitoring the reduction of nitroblue tetrazolium to a blue reaction product and by following the conversion of dihydrorhodamine 123 (DHR) to its fluorescent derivative, rhodamine 123. Such studies demonstrated that oxalate induces a concentration-dependent increase in dye conversion by a process that is sensitive to free radical scavengers. Specifically, addition of catalase or superoxide dismutase blocked the oxalate-induced changes in dye fluorescence/absorbance. Addition of thsc free radical scavengers also prevented the oxalate-induced loss of membrane integrity in LLC-PK1 cells. Thus it seems likely that free radicals are responsible for oxalate toxicity. The levels of oxalate that induced toxicity in LLC-PK1 cells (350 .rM) was only slightly higher than would be expected to occur in the renal cortex. These considerations suggest that hyperoxaluria may contribute to the progression of renal injury in several forms of renal disease. Oxalate, the most common constituent of kidney stones, is a simple dicarboxylic acid that is produced as a byproduct of a number of metabolic pathways . This byproduct cannot be processed further in man and is excreted by the kidney. Studies of renal oxalate handling have shown that oxalate is freely filtered at the glomerulus and undergoes both reabsorption and secretion in the proximal tubules , with secretion predominating under normal physiological conditions . Removal of oxalate in the kidney is facilitated by a variety of transport systems at the apical and basolateral surfaces of both proximal [5-7] and distal tubular cells; in the course of vectorial transport, oxalate accumulates intracellularly . This accumulation has been considered benign, despite the fact that oxalate can alter the activity of a number of enzymes (lactate dehydrogenase, malate dehydrogenase, pyruvate kinase, etc., see ). Indeed, the only pathologies that have been attributed to oxalate (oxalosis, hyperoxaluria,

Objective: We investigated and compared the effects of taraxasterol, aqueous extract of T. officinale (AET) aerial part, and potassium citrate (PC) on calcium oxalate (CaOx) crystallization in vitro. Materials and methods: CaOx crystallization was induced by adding sodium oxalate to synthetic urine. Taraxasterol (2.5, 5, 7.5 and 12.5 lg/mL), extract (1, 2, 4 and 8 mg/mL), and PC (100, 150, 200 and 350 mg/mL) were subjected to anti-crystallization activities. The absorbance and %inhibition of nucleation of CaOx crystals were evaluated by spectrophotometer at 2, 4, 6, 8, 10, 20, 30, 40, 50 and 60 min and the number and morphology of crystals were studied by light microscopy after 60 min. Results: Presence of taraxasterol, extract and PC decreased absorbance in experimental samples compared to control, significantly. The nucleation of crystals is inhibited by taraxasterol, extract, and PC (26-64, 55-63 and 60-70%, respectively). The number of CaOx crystals were decreased in presence of taraxasterol (p < .01), extract (p < .001), and PC (p < .001) in a dose-dependent manner. Presence of taraxasterol, extract, and PC decreased the number of CaC 2 O 4 monohydrate, while increased CaC 2 O 4 dihydrate crystals, significantly. Also, the diameter of CaC 2 O 4 dihydrate crystals was decreased in presence of taraxasterol, extract and PC, significantly. Conclusions: This research indicated that taraxasterol and extract have anti-crystallization activities and effectiveness of the extract is more potent than taraxasterol. It could be because of another constituent in the extract with the synergistic effect.

Introduction: Kidney stone is one of the most important diseases of the urinary tract and the most important cause of death due to urinary tract disease. The prevalence of urinary tract disease is increasing and therefore more effective and low-risk therapies are needed for treatment. Melon seeds have been suggested for the treatment of kidney diseases such as kidney stones. The aim of the present study was to investigate the effect of hydroethanolic extract of melon seed on renal expression of tamm-horsfall coding gene in male rats with kidney stones. Materials & Methods: Induction of calcium oxalate kidney stone was performed by oral treatment of ammonium chloride (3 days) and ethylene glycol (38 days) in male rats. Potassium citrate (2.5 g/Kg) and hydro-ethanolic extract of melon seed (150, 300 and 600 mg/kg body weight) were treated orally with ethylene glycol for 38 days. After 41 days, the animals were anesthetized and right kidney was removed for evaluation of renal expression of tamm-horsfall coding gene by real-time PCR. Result: Results showed that daily oral administration of potassium citrate and extract (150, 300 and 600 mg/kg body weight) significantly increased the expression of tamm horsfall coding gene (UMOD) in experimental rats compared to control rats (p<0.001). In conclusion, melon seed extract can improve kidney stone disease by enhancing the expression of tamm-horsfall encoding genes and is effective for treating the kidney stone disease.

BACKGROUND: Urinary oxalate and citrate are the keyfactors in caox urolithiasis of cats and Gamma GlutamylTransferase is a good test for assessment of kidney damage.Favorable effects of Cynodon dactylon on calcium oxalate stoneformation have recently been proved in rats. OBJECTIVES: Thepresent study was designed to investigate the alteration ofurinary oxalate, citrate, and GGT after administration of thehydroalcoholic extract of Cynodon dactylon to experimentalhyperoxaluric cats. No scientific study has been done so far todemonstrate the beneficial effect of this plant in cats. METHODS:13 mature male cats were randomly divided into 3 groups: groupAreceived standard diet and drinking water while, group B andC also received ethylene glycol at sub-toxic dose (130 mg/kg)daily for 30 days. Group C received hydroalcoholic extract ofC.dactylon (400 mg/kg) from day 0 to 30, as well. Urine sampleswere collected on days 0, 15, and 30 and were analyzed foroxalate, citrate, and GGT levels. RESU...

Powder mixtures with a given molar ratio of Ca/P = 1.67 were prepared under mechanical activation conditions from hydroxyapatite powder Ca10(PO4)6(OH)2 and a 1M aqueous solution of oxalic acid H2C2O4 at a molar ratio of Ca10(PO4)6(OH)2/H2C2O4 = 1:4. The phase composition of obtained powder mixture included brushite (calcium hydrophosphate dihydrate) CaHPO4·2H2O, calcium oxalate monohydrate CaC2O4·H2O in form of whewellite and weddellite, and some quantity of quasi-amorphous phase. This powder mixture was used to produce microporous monophase ceramics based on hydroxyapatite Ca10(PO4)6(OH)2 with apparent density of 1.25 g/cm3 after firing at 1200 °C. Microporosity of sintered ceramics was formed due to the presence of particles with plate-like morphology, restraining shrinkage during sintering. Microporous ceramics based on hydroxyapatite Ca10(PO4)6(OH)2 with the roughness of the surface as a consequence of the created microporosity can be recommended as a biocompatible material for ...

A Universidade Federal do Rio Grande do Norte por fornecer as condições necessárias para realização desse trabalho; Ao Programa de Pós-Graduação em Ciências da Saúde do Centro de Ciências da Saúde da Universidade Federal do Rio Grande do Norte pela oportunidade de cursar uma pós. Ao professor e meu orientador Dr. Hugo Alexandre, pela confiança, credibilidade e paciência para a conclusão desse trabalho e, principalmente, por sua amizade durante esses anos. Aos professores e funcionários do Departamento de Bioquímica e do Programa de Pós-Graduação em Ciências da Saúde, pelo ótimo convívio e pelos conhecimentos passados. A Alana, Kaliene e todas as secretarias do PPGCSA, pelo carinho e atenção ao longo desse período. A Professora Naisandra (Sandrinha), minha comadre, amiga, irmã e tudo que for necessário. Que com o seu exemplo de perseverança e empenho, demostra que tudo é possível, desde que façamos sempre o melhor. Aos meus colegas da Pós: Antenor, Nednaldo, Ivan e tantos outros pelo convívio tão agradável. Ao amigo Leandro que muito contribuiu para o desenvolvimento deste trabalho.

A 7-year-old female spayed domestic shorthair cat was referred to the urology service for nonsurgical urocystolith removal. A urolith was attached to the urothelium by ectopic bone. Interventional removal without surgery was successful. Follow-up evaluation 3 years after urolith removal revealed recurrent uroliths, bladder wall mineralization, and marked renal mineralization. This case illustrates the metaplastic potential of the urothelium and that ectopic bone should be included among the pathological factors that promote lithogenesis.

Silica urolithiasis is infrequent in dogs, but in Mexico represents 12.9%. Our hypothesis is the consumption of high amounts of silicates in the diet, especially that dissolved in tap water. e objective of this study was to determine the concentrations of silica in the tap water in different geographical areas and their relationship with cases of silicate urolithiasis in dogs. From 179 cases of silicate urolithiasis, 98.9% were from dogs within a geographic area called the Trans-Mexican Volcanic Belt, which represents a cross shaft to the center of the country. Silica concentrations in tap water ranged between 3 and 76 mg/L, with a range of 27 to 76 mg/L, a mean of 49.9 ± 12 mg/L within the Trans-Mexican Volcanic Belt, and a concentration from 3 to 30 mg/L, with a mean of 16.4 ± 7 mg/L outside this area; these were significantly different (p < 0.001). ese findings demonstrate that there is a geographic risk factor for silicate urolithiasis in urolith-forming dogs, related to the consumption of tap water with a high concentration of silica. Further studies are necessary to identify this same pathophysiological association in other species.

Leaf chemistry alterations due to increasing atmospheric CO2 will reflect plant physiological changes and impact ecosystem function. Longleaf pine was grown for 20 months at two levels of atmospheric CO2 (720 and 365 µmol mol -1 ), two levels of soil N (4 g m -2 year -1 and 40 g m -2 year -1 ), and two soil moisture levels (-0.5 and -1.5 MPa) in open top chambers. After 20 months of exposure, needles were collected and ergastic substances including starch grains and polyphenols were assessed using light microscopy, and calcium oxalate crystals were assessed using light microscopy, scanning electron micros copy, and transmission electron microscopy. Polyphenol content was also determined using the Folin-Denis assay and condensed tannins were estimated by precipitation with protein. Evaluation of phenolic content histochemically was compared to results obtained using the Folin-Denis assay. Total leaf polyphenol and condensed tannin content were increased by main effects of elevated CO2, low soil N and well-watered conditions. Elevated CO2 and low soil N decreased crystal deposition within needle phloem. Ele vated CO2 had no effect on the percentage of cells within the mesophyll, endodermis, or transfusion tissue which contained visible starch inclusions. With respect to starch accumulation in response to N stress, mesophyll > en dodermis > transfusion tissue. The opposite was true in the case of starch accumulation in response to main effects of water stress: mesophyll < endodermis < transfusion tissue. These results indicate that N and water conditions significantly affect deposition of leaf ergastic substances in

Excessive consumption of fructose (FR) leads to obesity, metabolic syndrome (MS) and insulin resistance, which are known risk factors for kidney stones. The epidemiological study has suggested the association between fructose consumption and urolithiasis, but the precise mechanism is still not well understood. Male Wistar rats were assigned for 8 weeks to three groups with different FR content in diet: RD (n = 5)-regular diet with a FR < 3%; F10 (n = 6)-regular diet with an addition of 10% Fr in drinking water; F60 (n = 5)-60% FR as a solid food. Serum concentration of FR, creatinine (Cr), insulin (Ins), triglycerides (Tg), homocysteine (HCS), uric acid (UA), calcium (Ca), phosphate (Pi), magnesium (Mg) and sodium (Na) were measured. Based on 24 h urine collection the following tests were performed: urine pH, proteinuria (PCR), excretion of N-Acetyl-(D)-Glucosaminidase (NAG), monocyte chemoattractant protein (MCP-1), uric acid (uUAEx), phosphate (uPiEx), calcium (uCaEx), magnesium (uMgEx) and sodium (uNaEx). The creatinine clearance (CrCl) was calculated. Calcium deposits in kidney sections were examined using hematoxylin and eosin (HE) and von Kossa stains. The rats on F10 and F60, as compared to the RD diet, showed a tendency for lower CrCl, higher HCS level and some features of MS as higher Ins and TG levels. Interestingly, F10 (fluid) versus F60 (solid) diet led to higher serum Ins levels. F10 and F60 versus RD demonstrated higher urinary excretion of MCP-1 and NAG which were suggestive for inflammatory injury of the proximal tubule. F10 and F60 as compared to RD showed significantly lower uUAEx, although there were no differences in clearance and fractional excretion of UA. F60 versus RD induced severe phosphaturia (>30×) and natriuria (4×) and mild calciuria. F10 versus RD induced calciuria (3×), phosphaturia (2×) and mild natriuria. Calcium phosphate stones within the tubules and interstitium were found only in rats on FR diet, respectively, in two rats from the F10 group and another two in the F60 group. The rats which developed stones were characterized by significantly higher serum insulin concentration and urinary excretion of calcium and magnesium. A fructose-rich diet may promote development of calcium stones due to proximal tubule injury and metabolic syndrome.

This was a retrospective analytical study conducted from May 01 2018 to May 30, 2020 for a period of two years in a 750-bedded tertiary care hospital, Shree Birendra Hospital (SBH), Kathmandu, Nepal. All patients who underwent Fourier transform infrared spectroscopy (FT-IR) analysis of the retrieved calculi were included in the study. The type of surgery performed was decided by the operating surgeon based on the treatment options available at the center and the recent evidences on management of the stone. The study was conducted after an approval from institutional Review Board (IRB) of NAIHS. Results: A total 400 patients underwent Infrared spectroscopic analysis (FT-IR) for the retrieved stone. Among them, majority of urolithiasis was seen among male population 277 (69.2%) with an age group between 31 -45 years {204 (51%)}. Calcium -oxalate was detected in majority of cases 257 (64.25%) followed by struvite 90 (22.5%) and mixed stones 53 (13.2 %). conclusions: Majority of the patients in our study had kidney stone followed by ureteric stone. The predominance of calcium oxalate stones was seen in kidney stones followed by Struvite and mixed stones.

Urolithiasis is a general term referring to the causes and effects of stones anywhere in the urinary tract. Urolithiasis should not be viewed conceptually as a single disease with a single cause but rather as a sequela of multiple interacting underlying abnormalities. Thus, the syndrome of urolithiasis may be defined as the occurrence of familial, congenital, or acquired pathophysiological factors that, in combination, progressively increase the risk of precipitation of excretory metabolites in urine to form stones. Naturally occurring urolithiasis is affected by many risk factors, some of which are known and some of which are unknown. Some risk factors that are known to affect canine uroliths include (1) breed, (2) gender, (3) age, (4) anatomical and functional abnormalities of the urinary tract, (5) abnormalities of metabolism, (6) urinary tract infections, (7) diet, and (8) urine pH. Each of these factors may have different effects on different types of uroliths. For example, an alkaline urine pH is a risk factor for struvite uroliths but is a protective factor in relation to cystine uroliths. Each contributing (or protective) factor may play either a limited or significant role in the development or prevention of different types of uroliths. Recognition of highly significant nondietary risk factors for urolithiasis may aid in earlier recognition of dogs affected with this disease. Recognition and control of environmental factors and modification of diet may minimize From the

Objective—To evaluate the effect of dietary supplementation with sodium chloride (NaCl) on urinary calcium excretion, urine calcium concentration, and urinary relative supersaturation (RSS) with calcium oxalate (CaOx). Animals—6 adult female healthy Beagles. Procedure—By use of a crossover study design, a canned diet designed to decrease CaOx urolith recurrence with and without supplemental NaCl (ie, 1.2% and 0.24% sodium on a dry-matter basis, respectively) was fed to dogs for 6 weeks. Every 14 days, 24- hour urine samples were collected. Concentrations of lithogenic substances and urine pH were used to calculate values of urinary RSS with CaOx. Results—When dogs consumed a diet supplemented with NaCl, 24-hour urine volume and 24-hour urine calcium excretion increased. Dietary supplementation with NaCl was not associated with a change in urine calcium concentration. However, urine oxalate acid concentrations and values of urinary RSS with CaOx were significantly lower after feeding...

Many developing countries employ medicinal plants for the treatment of kidney stone dissolution. Patients consume aqueous extracts without precise knowledge of the plant's composition. This study aimed to expand the phytochemical knowledge of traditional herbal remedies and evaluate their constituents for the dissolution and inhibition of kidney stones. The herbal plants selected were Ammi visnaga, Nigella sativa, Berberis vulgaris, Haloxylon scoparium, Atriplex halimus and Arthrophytum schmittianum. An extract of each plant was prepared by the infusion method in physiological serum; the extract was filtered and put in the presence of calculi for eight weeks under magnetic agitation. The calculi were weighed biweekly after undergoing a drying process at 40°C for 18 hours, and the pH of the solution was consistently determined. Ammi visnaga, Nigella sativa and Haloxylon scoparium caused significant mass loss and thus had a considerable influence on the dissolution and in vitro inhibition of calcium calculi. In conclusion, this study shows that plants containing coumarins, alkaloids, triterpenes and tannins affect the dissolution and inhibition of kidney stone calcium oxalate. Rezumat Plantele medicinale se utilizează pentru tratamentul calculilor renali, însă pacienții consumă fitopreparatele fără a cunoaște cu exactitate compoziția acestora. Studiul a evaluat constituenții fitopreparatelor pentru dizolvarea și inhibarea calculilor renali. Plantele medicinale selectate au fost Ammi visnaga, Nigella sativa, Berberis vulgaris, Haloxylon scoparium, Atriplex halimus și Arthrophytum schmittianum. A fost preparat un extract din fiecare plantă prin metoda infuziei în ser fiziologic; extractul a fost filtrat și evaluat în prezența calculilor timp de opt săptămâni sub agitație magnetică. Calculii au fost cântăriți de două ori pe săptămână, după ce au fost supuși unui proces de uscare la 40°C timp de 18 ore, iar pH-ul soluției a fost determinat în mod constant. Ammi visnaga, Nigella sativa și Haloxylon scoparium au provocat pierderi semnificative de masă și, prin urmare, au avut o influență considerabilă asupra dizolvării și inhibării in vitro a calculilor de calciu. În concluzie, acest studiu arată că produsele vegetale care conțin cumarine, alcaloizi, triterpene și taninuri influențează dizolvarea și inhibarea calculilor renali de oxalat de calciu.

Recent evidence indicates that the reninangiotensin system (RAS) seems to play a considerable role in the development of tubulointerstitial (TI) lesions caused by hyperoxaluria (Hox). The purpose of the present study was to evaluate the specific mechanism by which Hox involving RAS induces chemokine and cytokine expression and, therefore, renal TI damage in the ethylene-glycol (ETG) induced hyperoxaluric rat model. Sprague-Dawley rats, separated into five groups, received: G1 regular water, and G2, G3, G4 and G5 1% ETG (a precursor for oxalates) in their drinking water for 4 weeks. An angiotensin converting enzyme inhibitor, benazepril (BZ) 10 mg/kg/day, angiotensin II receptor antagonists, subtype 1 (AT1) losartan (LOS) 40 mg/kg/day and subtype 2 (AT2) PD 123,319 (PD) 10 mg/kg/day, were administered daily to G3, G4 and G5, respectively. At the end of the study, the inflammatory response to Hox was evaluated using anti-NF-jB (p50), anti-IL-6, anti-MCP-1; anti-RANTES and anti-ED1 (monocytes/macrophages) in each group. In spite of the same urine oxalate levels, rats belonging to the hyperoxaluric groups treated with either BZ or LOS showed significantly (P<0.01) less TI lesions together with a lower immunoexpression of inflammatory mediators when compared with untreated hyperoxaluric animals. NF-jB (p50) was increased in tubular cells in the ETG group (43.6±8.7 positive cells/mm 2 ) and was significantly (P<0.01) reduced by LOS (11.2±4 positive cells/mm 2 ) and even more by BZ (6.1±2.4 positive cells/ mm 2 ). There was a significant (P<0.01) correlation between NF-jB (p50) positive cells and ED1 cells in the ETG group (r=0.88) and in the ETG+LOS group (r=0.92). LOS showed better control on IL-6 and MCP-1 with respect to untreated rats, while BZ showed the best control on RANTES and ED1 cells in comparison with untreated animals. Renal function was significantly (P<0.01) better preserved in BZ and LOS treated groups compared to both untreated animals and rats with PD, as indicated by creatinine clearance values. These results suggest that Hox stimulates the NF-jB cascade and, therefore, induces the overexpression of inflammatory mediators like IL-6, MCP-1, and RAN-TES. This pathway seems to be mediated not only by AT1 but also by AT2 receptors of angiotensin II.

The urinary system is one of the excretory systems of the body. Nephron is the structural and functional unit of kidney. Kidney stones are one of the most painful of the urologic disorders and are one of the most common disorders of the urinary tract. The 5% of the population will have a clinical stone event at some time during their lives. A Kidney stone is a hard mass developed from crystals that separate from the urine and buildup on the inner surfaces of the kidney. In the present study, organic and mineral analysis was carried out in serum. Urine also analyzed for the quantification of oxalate, citrate, calcium and citrate. Sodium and phosphorous found to be decreased in Nephrolithiasis patients when compared to normal subjects. Calcium, potassium and citrate found to be elevated. Uric acid is not significantly changed in serum when compared with normal. In urine, oxalate and calcium excretion increased whereas citrate excretion decreased. In the case of uric acid no significant change occurs in excretion amount. From the results, it was concluded that the patients were affected by calcium and oxalate stones.

Introduction: Urolithiasis (UL) is a common disease whose incidence increased in the last quarter of the twentieth century. Metabolic evaluation is necessary for diagnosis, which requires the establishment of reference values (RV) for the population in question. Objective: To determine the RV for calcium, oxalate, citrate, uric acid, phosphate, magnesium, sulphate and sodium in 24-hour urine belonging to students from the School of Biochemistry and Biological Sciences at Universidad Nacional del Litoral, province of Santa Fe, Argentina. Once RV were established, a frequency of alterations was determined and then compared with literature data. Methods: The NCCLSC28-A3 guideline (2008) was used. The study group included 69 students. The enzymatic colorimetric method, a Metrolab 1600 plus spectrophotometer and a DIESTRO ionselective electrode were also employed. Results: The RV found (95 % CI) were the following: oxalate, 1.96-45.08; calcium, 20.65-250.74; citrate, 112.78-666.01; uric ...

Urolithiasis is a pathology that has increased its incidence and prevalence in the last quarter of the 20th century. It is among the three most frequent urinary tract illnesses together with urinary infection and prostate benign disease [1], its recurrence rate being high as well . Patients suffering urolithiasis need repeated hospital surgery and admission. Also, people who endure this disease are subject to repeated convalescence periods, being isolated from their routine activities and, in some cases, they even get to lose their kidneys unless they undergo the appropriate treatment. Its idiopathic origin is assumed in 50% of the cases [3]. However, multiple factors such as age, sex, race, diet, geography location, occupation, body mass index, among others, are associated with this disease .

Erythrina velutina Willd., Fabaceae, known as "mulungu", is a tree of tropical regions, as northeastern Brazil. Its bark is used in folk medicine as tranquilizer, sedative and insomnia. This study aimed to characterize the stem and leaf anatomy and to provide subsidies to quality control of the plant drug due to its wide use in folk medicine as well as its differentiation from other species with the same popular name. Samples were collected at Cuité, in Paraíba State, Brazil, fi xed in FAA50, semipermanent slides were made, following usual procedures in plant anatomy. The stem shows a cylindrical contour, covered by a uniseriate epidermis covered by a thickened cuticle. It shows claviform glandular and branched trichomes with uniseriate stalk. Secretory cavities are into the phloem. The leaf epidermis has branched and glandular trichomes and anisocytic and paracytic stomata, on both sides, with predominance of branched trichomes and stomata on abaxial surface. Secretory cavities in stem and leaf, types of trichomes and stomata, its location and distribution constitute diagnostic characters for this specie. The structural characterization of the stem and leaf allows its distinction from other ones of this genus, ensuring safety for commercial pharmacological uses, allowing certifi cation of the authenticity of raw material.

Kebiasaan minum teh pada masyarakat tegal sudah menjadi tradisi turun temurun dan dilakukan hampir setiap hari. Didalam teh ini terdapat kandungan oksalat dan kalsium. Jika asupan makanan yang mengandung oksalat melebih batas kebutuhan tubuh, maka oksalat bebas dan kalsium dapat mengendap di urine dan membentuk kristal kalsium oksalat. Hal ini lambat laun dapat menyebabkan kejadian batu di ginjal. Tujuan penelitian ini adalah mencoba melihat apakah ada hubungan kebiasaan minum teh terhadap kandungan kalsium oksalat urine pada responden yang diteliti. Metode yang digunakan dengan memberikan kuesioner untuk mengetahui kebiasaan minum teh pada responden kemudian dilakukan pengambilan sampel urine untuk memeriksa kandungan kalsium oksalat pada urine responden tersebut. Sampel diperiksa dengan metode mikroskopis di laboratorium Dinkes Kota Tegal. Jumlah responden sebanyak 30 orang yang merupakan pegawai kantor di instansi Pemerintah Kota Tegal. Desain penelitian menggunakan metode deskri...

BackgroundIn Ethiopian folk medicine, there is a claim that medicinal plants can treat urolithiasis although there is insufficient scientific evidence. The objective of this study was to evaluate the curative efficacy ofGomphocarpus fruticosusextracts in experimentally induced nephrolithiatic rats.MethodsUrolithiasis was induced in male Wistar rats by feeding ethylene glycol in drinking water for 28 days. The curative effects were evaluated after oral administrations of 200 mg/kg of the extracts from 15 to 28 days. Urine samples were collected 1 day before sacrificing the rats. Blood, liver and kidney samples were gathered under anaesthetic condition at day 28. Crystals in the urine were also analyzed by light microscopy.ResultsG. fruticosusEtOAc extract reduced significantly the level of sodium (P &lt; 0.001), whereas it was significantly elevated the levels of magnesium and citrate (P &lt; 0.01) compared to lithiatic control.G. fruticosusBuOH extract lowered the levels of potassiu...

Kidney stone disease is a crystal concretion formed usually within the kidneys. It is an increasing urological disorder of human health, affecting about 12% of the world population. It has been associated with an increased risk of end-stage renal failure. The etiology of kidney stone is multifactorial. The most common type of kidney stone is calcium oxalate formed at Randall&#39;s plaque on the renal papillary surfaces. The mechanism of stone formation is a complex process which results from several physicochemical events including supersaturation, nucleation, growth, aggregation, and retention of urinary stone constituents within tubular cells. These steps are modulated by an imbalance between factors that promote or inhibit urinary crystallization. It is also noted that cellular injury promotes retention of particles on renal papillary surfaces. The exposure of renal epithelial cells to oxalate causes a signaling cascade which leads to apoptosis by p38 mitogen-activated protein ki...

A wide range of biological properties and a potent therapeutic and prophylactic effect on chronic diseases are all present in Argania spinosa L. press cake. The aim of this research is to valorize the anticrystallization properties against calcium oxalate crystals of Argania spinosa L. press cake fractions and identify its bioactive components. Chemical species identification was performed using GC–MS analysis. The turbidimetric model was used to investigate crystallization inhibition in vitro. Infrared spectroscopy technique was used to characterize the synthesized crystals. Furthermore, both DPPH and FRAP methods were used to assess antioxidant activity. The results show that the fractions are equally important in crystallization inhibition percentages of calcium oxalate crystals. For saponin and polyphenol fractions, the inhibition percentages are in the orders of 83.49% and 82.83%, respectively. The results of the antioxidant activity by DPPH method show that the two fractions a...

The facade of the church of the Pavia Charterhouse, built at the end of the 15th century, shows outstanding decorative features made of different stone materials, such as marbles, breccias and sandstones. Magnificent ornamental elements are made of thin lead sheets, and some marble slabs are inlaid with them. Metal elements are shaped in complex geometric and phytomorphic design, to form a Greek fret in black contrasting with the white Carrara marble. Lead pins were fixed to the back of the thin lead sheets with the aim of attaching the metal elements to the marble; in so doing the pins and the lead sheets constitute a single piece of metal. In some areas, lead elements have been lost, and they have been substituted with a black plaster, matching the colour of the metal. To the authors&#39; knowledge, this kind of decorative technique is rare, and confirms the refinement of Renaissance Lombard architecture. This work reports on the results of an extensive survey of the white, orange...

Meconium constitutes infants' first bowel movements postnatally. The consistency and microbial load of meconium are different from infant and adult stool. While recent evidence suggests that meconium is sterile in utero, rapid colonization occurs after birth. The meconium microbiome has been associated with negative health outcomes, but its composition is not well described, especially in preterm infants. Here, we characterized the meconium microbiomes from 330 very preterm infants (gestational ages 28 to 32 weeks) from 15 hospitals in Germany and in fecal samples from a subset of their mothers (N = 217). Microbiome profiles were compiled using 16S rRNA gene sequencing with negative and positive controls. The meconium microbiome was dominated by Bifidobacterium, Staphylococcus, and Enterococcus spp. and was associated with gestational age at birth and age at sample collection. Bifidobacterial abundance was negatively correlated with potentially pathogenic genera. The amount of bacterial DNA in meconium samples varied greatly across samples and was associated with the time since birth but not with gestational age or hospital site. In samples with low bacterial load, human mitochondrial sequences were highly amplified using commonly used, bacterial-targeted 16S rRNA primers. Only half of the meconium samples contained sufficient bacterial material to study the microbiome using a standard approach. To facilitate future meconium studies, we present a fivelevel scoring system ("MecBac") that predicts the success of 16S rRNA bacterial sequencing for meconium samples. These findings provide a foundational characterization of an understudied portion of the human microbiome and will aid the design of future meconium microbiome studies. IMPORTANCE Meconium is present in the intestines of infants before and after birth and constitutes their first bowel movements postnatally. The consistency, composition and microbial load of meconium is largely different from infant and adult stool. While recent evidence suggests that meconium is sterile in utero, rapid colonization occurs Editor

In this paper we present the phase and morphological characteristics of urinary stones from Serbian patients. The study included for the first time the determination of the phase composition and a statistical analysis of the presence of different types of urinary stones in both men and women in Serbia. The main goal of study was representation of collected data for the first time. For past three years, more than 600 samples were collected from Serbian patients. The phase composition of all samples of urinary stones was investigated using XRD analysis. Morphology and chemical composition of phases in some characteristic samples was determinate by the SEM-EDS analysis. Results indicate that there are several different types of urinary stones that vary in mineral composition, chemistry and morphology. It was found that 312 (52%) of the 600 stones were composed of calcium oxalate minerals (CaOx): 17.3% of which were pure calcium oxalate monohydrate COM, 4% were pure calcium oxalate dihydrate COD; 200 (33.3%) were a mixture of CaOx and Hydroxyapatite HA, 19 (3.1%) were uric acid (uricite) UA and uric acid dihydrate UAD, 17 (2.8%) were a combination of UA and CaOx minerals, 41 (6.8%) were combination of CaP minerals and CaOx, 11 (1.9%) were cystine (Cy) stones. The obtained data shows the diversity of types of urinary stones. Morphological, chemical and XRPD analysis give us statistical data which shows that the most common urinary stones from Serbian patients are from CaOx group and in most of cases are associated with CaP.

Physico-chemical investigation of urolithiasis today is mostly focused on applying physico-chemical description of precipitation processes to the stone formation with the aim to distinguish between stone formers and nonstone formers. This is done by calculating supersaturation for different solid phases which can be formed in urine using data obtained by urine analysis and existing solubility product, dissociation and complexation constants. In order for this approach to succeed it is of utmost importance that system is described as detailed as possible, i.e., that all species that can be formed are taken into account. Magnesium hydrogenurate octahydrate, Mg(C5H3N4O3)28H2O (Mg(HU)2.8H2O), is among species which can precipitate in the urine and for which solubility data doesn&#39;t exist. In order to fill this void crystals of Mg(C5H3N4O)2.8H2O phase I and phase II have been prepared and characterized. Solubility product constant of Mg(C5H3N4O3)2.8H2O phase I in water at 37 degrees C...

The 24-hour urine is golden standard for metabolic assessment of stone formers. However, due to the difficulties in collecting almost 1/3 of the samples can not be used for the analysis. Therefore, we analyzed first morning urine and calculated different risk indexes in order to asses possibility of using it in determining urolithiasis risk. Subjects were divided into 4 groups: male patients (n = 31, age 18-64), female patients (n = 31, age 25-63), male controls (n = 16, age 25-64) and female controls (n = 19, age 21-65). First morning urine pH, concentrations of calcium, magnesium, phosphate, sodium, potassium, chloride, citrate, urate, oxalate, creatinine and glycosaminoglycans were determined. Based on them, ionic concentrations and activity products of calcium oxalate and phosphate were calculated by EQUIL 2. In addition, different risk indices were calculated. The results showed that both patients and control groups had metabolic disorders, but the frequencies of occurrence wer...

BACKGROUND: Urinary oxalate and citrate are the keyfactors in caox urolithiasis of cats and Gamma GlutamylTransferase is a good test for assessment of kidney damage.Favorable effects of Cynodon dactylon on calcium oxalate stoneformation have recently been proved in rats. OBJECTIVES: Thepresent study was designed to investigate the alteration ofurinary oxalate, citrate, and GGT after administration of thehydroalcoholic extract of Cynodon dactylon to experimentalhyperoxaluric cats. No scientific study has been done so far todemonstrate the beneficial effect of this plant in cats. METHODS:13 mature male cats were randomly divided into 3 groups: groupAreceived standard diet and drinking water while, group B andC also received ethylene glycol at sub-toxic dose (130 mg/kg)daily for 30 days. Group C received hydroalcoholic extract ofC.dactylon (400 mg/kg) from day 0 to 30, as well. Urine sampleswere collected on days 0, 15, and 30 and were analyzed foroxalate, citrate, and GGT levels. RESU...

The localization of calcium in cell organelles at the electron microscope level is often achieved through cytochemical techniques, and verified by X-ray microanalysis. Various methods have been used to cytochemically detect calcium or calcium-binding sites: calcium loading, calcium substitution by strontium, barium, or even lead, and calcium precipitation by oxalate, phosphate, fluoride, or pyroantimonate. Their results may have heuristic value, particularly in preliminary studies of poorly known cell types. A complementary and more physiological approach is offered by quantitative measurement of the total calcium content of organelles after cryofixation. Resin embedding is less demanding than cryomicrotomy and gives better images: it can be used after cryosubstitution in the presence of oxalic acid. This technique was tested, and applied to several cell types.

We report here on a patient who attempted suicide four times by ingesting a lethal dose of antifreeze. Reversibility of renal damage due to ethylene glycol (EG) ingestion is not complete in all patients, and its predictor factors are not well understood. A 30-year-old man suffering from a depressive disorder repeatedly attempted suicide between 2002 and 2005. In December 2002 the patient was admitted in a coma. EG intoxication was confirmed (serum EG level 1.025 g/l) and intensive therapy was started (sodium bicarbonate, ethanol, haemodialysis). After treatment he recovered. In February 2003 this patient again drank EG (serum EG level 0.257 g/l). On admission he had no symptoms of intoxication and received only ethanol i.v. Only mild metabolic acidosis (pH = 7.365) developed. In May 2003 the patient arrived at the hospital six hours after ingestion of 500 ml of EG (serum EG level 0.282 g/l). Metabolic acidosis (pH = 7.176) and signs of nephrotoxicity (serum creatinine 168 micromol/l) had developed, for which he received intensive therapy. In May 2005 the patient was found comatose on the street. Laboratory monitoring on admission showed severe metabolic acidosis (pH = 6.899) and a serum EG level of 2.877 g/l. Intensive therapy was performed again. This case report describes for the first time the repeated ingestion of a large amount of EG by a single patient and documents the improvement of renal functions. These findings support the opinion of full recovery in patients with intensive treatment and no history of kidney damage.

We report here on a patient who attempted suicide four times by ingesting a lethal dose of antifreeze. Reversibility of renal damage due to ethylene glycol (EG) ingestion is not complete in all patients, and its predictor factors are not well understood. A 30-year-old man suffering from a depressive disorder repeatedly attempted suicide between 2002 and 2005. In December 2002 the patient was admitted in a coma. EG intoxication was confirmed (serum EG level 1.025 g/l) and intensive therapy was started (sodium bicarbonate, ethanol, haemodialysis). After treatment he recovered. In February 2003 this patient again drank EG (serum EG level 0.257 g/l). On admission he had no symptoms of intoxication and received only ethanol i.v. Only mild metabolic acidosis (pH = 7.365) developed. In May 2003 the patient arrived at the hospital six hours after ingestion of 500 ml of EG (serum EG level 0.282 g/l). Metabolic acidosis (pH = 7.176) and signs of nephrotoxicity (serum creatinine 168 micromol/l...