Effects of Acute Acid Loading on the Risk of Calcium Phosphate and Calcium Oxalate Crystallization in Urine

The aim of this study was to examine the risk of calcium phosphate and calcium oxalate crystallization during acute acid loading under controlled conditions. The effects of acute acid loading on rates of renal excretion of calcium, magnesium, phosphate, citrate, oxalate and urine pH were studied in healthy subjects. The risk of calcium phosphate and calcium oxalate crystallization were evaluated by estimates of the ion activity products of calcium phosphate [AP(CaP)-index] and calcium oxalate [AP(CaOx)-index] according to Tiselius. In addition, the risk of brushite [AP(Bru)-index] crystallization was estimated. An acute acid load administered as ammonium chloride (NH4Cl) produced increased urinary excretion of calcium, phosphate and oxalate, decreased urinary excretion of citrate, and a decrease in urine pH. Consequently, calcium-citrate-ratio in urine increased markedly in response to acid loading. AP(CaP)-index decreased markedly due to a fall in urine pH. AP(Bru)-index decreased slightly and remained low throughout the study. AP(CaOx)-index increased significantly, and acid loading is suggested as a risk factor for calcium oxalate stone formation

Short report. The AIDIT and IMPACT conference 2006: Outcomes and future directions

IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in BRCA1/2 mutation carriers and controls) is an international collaboration investigating the utility of targeted prostate-specific antigen (PSA) screening for men at increased risk of prostate cancer due to inherited predisposition. Although the majority of prostate cancer occurs sporadically, it is recognized that family history plays a role in a significant number of cases: a family history either of prostate cancer alone, or of other cancers including breast and ovarian cancer. Evidence of the link between single genes and prostate cancer risk is strongest for the BRCA1 and BRCA2 genes, with BRCA2 in particular thought to lead to a relative risk of 4.65 (95%CI 3.48-6.22). This relative risk may be as high as 7.33 in men under the age of 65 years

History, epidemiology and regional diversities of urolithiasis

Archeological findings give profound evidence that humans have suffered from kidney and bladder stones for centuries. Bladder stones were more prevalent during older ages, but kidney stones became more prevalent during the past 100 years, at least in the more developed countries. Also, treatment options and conservative measures, as well as ‘surgical’ interventions have also been known for a long time. Our current preventive measures are definitively comparable to those of our predecessors. Stone removal, first lithotomy for bladder stones, followed by transurethral methods, was definitively painful and had severe side effects. Then, as now, the incidence of urolithiasis in a given population was dependent on the geographic area, racial distribution, socio-economic status and dietary habits. Changes in the latter factors during the past decades have affected the incidence and also the site and chemical composition of calculi, with calcium oxalate stones being now the most prevalent. Major differences in frequency of other constituents, particularly uric acid and struvite, reflect eating habits and infection risk factors specific to certain populations. Extensive epidemiological observations have emphasized the importance of nutritional factors in the pathogenesis of urolithiasis, and specific dietary advice is, nowadays, often the most appropriate for prevention and treatment of urolithiasis