Cats with idiopathic cystitis (bladder inflammation of unknown cause) may have struvite crystalluria
(struvite crystals in the urine).
, urolithiasis, hematuria, hemoglobinuria, pyuria, bacteriuria and neoplasia (Table 1).
Methotrexate can precipitate in the acidic urine causing crystalluria
, hence alkalinizing the urine with oral or parenteral sodium bicarbonate can help prevent this and improve methotrexate excretion .
and glistening urine can occur with primidone overdose (1-5), the likely cause in this renally compromised patient.
Table 1: Etiologies of Acute Kidney Injury in Lymphoma Pre-renal Intravascular volume depletion Nausea, emesis, diarrhea Hemorrhage Reduced kidney perfusion Vasoconstriction Sepsis Liver disease Medications (diuretics, nonsteroidal anti-inflammatory drugs) Renal Acute tubular necrosis Kidney ischemia Tumour lysis syndrome Medications (acetaminophen, nonsteroidal anti-inflammatory drugs, aminoglycosides) Tubulointerstitial disorders Secondary kidney infiltration Primary kidney lymphoma Glomerular disorders Amyloidosis IgA nephropathy Renovascular disorders Renal vein thrombosis Thrombotic microangiopathy Post-Renal Obstruction Exterior compression (lymphadenopathy, obstructing tumour) Internal obstruction (nephrolithiasis, crystalluria
) (*)Adapted from Luciano & Brewster (2014).
Our study for the first time confirms that in hyperoxaluric animals, rottlerin treatment leads to reduced renal cellular injury, diminished crystalluria
, reduced NADPH oxidase activity as well as a decline in translocation of PKC<5 from cytoplasmic fraction to the membrane and mitochondrial fraction, suggesting an inhibition of PKC[delta] activity.
In addition, they reported that crystalluria
was more important in lithiasis subjects compared with healthy non-fasting patients.9 In the study that was conducted by Miladipour et al.10 on effect of Ramadan fasting on urinary factors, 24-hour urine samples of 37 patients with recurrent calcium calculus formers and 20 volunteers with no history of kidney disease or calculus formation were analyzed before the beginning of Ramadan and during Ramadan.
The precipitation of salts and other solutes in the kidney results in either kidney stones (calculi) or crystalluria
. The final urinary content is composed of the solutes the body no longer needs diluted in the volume of water the body does not need at the time the urine is formed.
Apart from symptomatic improvement, one can monitor therapy with regular urinalysis to rule out calcium crystalluria
, which may be suggestive of hypercalcaemia Patients who cannot be monitored regularly in an ideal manner should be prescribed lower, but more frequent doses of oral vitamin D3.
This effect can be used in case of lithokinetic therapy, crystalluria
, after removal of drainage systems (stents, nephrostomy), and chronic urinary stones excretion.
In each case, complete hemogram, routine urine examination (especially for proteinuria, hematuria, glycosuria, urine pH, and crystalluria
), blood urea, serum creatinine, serum sodium, serum potassium, serum calcium, serum phosphorus, serum uric acid, serum protein, serum albumin, X-rays, and ultrasound of abdomen were carried out.
Pathophysiology of drug-induced nephropathy Level of the nephron Action Drugs Preglomerular Afferent arteriolar Cyclosporine (afferent arteriole) constriction Glomerulus Decreased GFR NSAIDs (prostaglandins) Gold, NSAIDs Glomerulonephritis Penicillamine, cisplatin Proximal tubules Acute tubular necrosis Aminoglycosides, radiocontrast dyes Distal tubules Renal tubular ACE inhibitors, acidosis type 4 cyclosporine Tubules and ducts Crystalluria
Acyclovir, sulphonamide Interstitium Interstitial nephritis Penicillin, allopurinol Renal papilla Papillary necrosis NSAIDs, analgesics Table 2.