Dietary Effects on Urinary Physicochemistry in Navy Bottlenose Dolphins (Tursiops truncatus) for the Prevention of Ammonium Urate Kidney Stones

Bottlenose dolphins are susceptible to developing ammonium urate (NH4U) kidney stones. The current study was designed to test the hypothesis that diet influences the urinary physicochemistry risk factors associated with nephrolithiasis in dolphins. A comprehensive nutrient analysis was performed revealing that the baseline diet (BD) commonly fed to dolphins under professional care had a greater purine content and a more negative dietary cation-anion difference (DCAD) when compared with a model diet consumed by free-ranging dolphins. A modified diet (MD) was formulated to include free-ranging diet fish species and achieve a more positive DCAD. The BD had a more negative DCAD (-52 mEq/Mcal metabolizable energy) when compared to the MD (+ 51 mEq/Mcal ME) which more closely approximated the DCAD of the free-ranging model diet (+ 152 mEq/Mcal ME). Six dolphins (with stones) were fed the BD followed by the MD for a minimum of 4 weeks. At the end of each feeding trial, a 6-hour continuous urine collection was performed to compare urine parameters of dolphins fed the BD versus MD. Dolphins consuming the MD demonstrated a significant decrease in urinary ammonium, net acid excretion, saturation index of ammonium urate, and phosphorous, and a significant increase in urinary citrate and net GI alkali absorption, as compared with urine parameters assessed when fed the BD. Increasing the proportion of free-ranging diet fish species and optimizing the DCAD, positively influenced some of the risk factors believed to be associated with NH4U kidney stone development in bottlenose dolphins under professional care.

Il calcolo urinario. Proposta di un nuovo metodo di determinazione: dati preliminari

Introduzione: La visualizzazione soggettiva delle reazioni utilizzate per l’identificazione e la quantificazione delle sostanze presenti nel calcolo urinario presentano notevoli problemi. Metodi: Viene descritta una nuova procedura per la determinazione del calcolo urinario. La rilevazione dei carbonati e le concentrazioni di calcio, fosforo, magnesio, ammonio, acido urico (dosaggi quantitativi su analizzatore COBAS 6000 ditta Roche) ed ossalato e cistina (determinazioni adattate su Viva E ditta Siemens) si inseriscono in un foglio Excel per ottenere i possibili principali calcoli urinari (calcio ossalato, acido urico, urato di ammonio, cistina, struvite, brushite, apatite, carbonato apatite) e più in generale “calcio fosfato”. Le determinazioni di chimica clinica sono simili a quelle utilizzate effettuate per lo studio metabolico sulle urine delle 24h in cui il dosaggio fotometrico della cistina all’acido fosfotungstico, non essendo commercializzato, è stato costruito ed adattato su analizzatore Viva E. Particolarmente utile risulta l’uso del rapido metodo quantitativo al ferro-solfosalicilico, non commercializzato e costruito nel nostro laboratorio, per la determinazione dell’ossalato nel calcolo. Risultati: Il software proposto converte le concentrazioni degli analiti in mmoli/dL e, partendo dalla struvite, definisce successivamente l’eventuale presenza di calcio ossalato, urato di ammonio ed i diversi calcio fosfato, determinati a seconda del rapporto Ca/P. La conversione finale in concentrazione delle diverse componenti presenti nel calcolo, assieme ad un eventuale residuo inorganico, da la presentazione dei dati in percentuale. Conclusioni: I dati ottenuti, specie se riferiti a concrezioni formate da più componenti, evidenziano buoni risultati se confrontati con la tecnica di riferimento FTIR suggerendo una metodica di laboratorio pratica, rapida ed affidabile. A new laboratory procedure is described for the determination of urinary calculus. The detection of carbonates (production of carbon dioxide with the use of concentrated sulfuric acid) and the concentrations of calcium, phosphorus, magnesium, ammonium, uric acid (quantitative dosages carried out on COBAS 6000 analyzer of the Roche company) and oxalate and cystine (determinations adapted by us on the Siemens Viva E instrument) they are inserted in an Excel sheet created by us in order to obtain the main possible urinary calculations (calcium oxalate, uric acid, ammonium urate, cystine, struvite, brushite, apatite, carbonate apatite and more generally "calcium phosphate." The clinical chemistry determinations are similar to those used for the metabolic study carried out on the urine of 24 hours in which the photometric dosage of cystine with phosphotungstic acid, not being marketed, was built by us and adapted on Viva E analyzer. The use of the rapid quantitative method, with non-commercial sulfosalicylic acid, is particularly useful zato and then built in our laboratory, for the determination of oxalate in the calculation. The software proposed by us converts all the concentrations of the above mentioned analytes to mmoles / dL and, starting from struvite (molecular ratios: 1P - 1Mg - 1NH4), the possible presence of calcium oxalate is subsequently defined (molecular ratios: 1Ca - 1Ox ), that of ammonium urate and the different calcium phosphate (brushite, apatite / carbonate apatite and "calcium phosphate"), the latter determined according to the Ca / P ratio (brushite: <1.155; 1.155≥ "calcium phosphate" <1 , 45; apatite ≥1.45). The final conversion into concentration of the various components present in the calculation, together with any inorganic residue, determines the presentation of the data as a percentage. The data obtained, especially if referring to concretions formed by several components, show good results when compared with the FTIR reference technique.

NEFROLITIASIS PADA ANAK USIA TIGA TAHUN DI RSUD DR. HI. ABDUL MOELOEK, LAMPUNG: SEBUAH LAPORAN KASUS

ABSTRACT Background: The incidence of nephrolithiasis in children increases over time. It has been reported an increase of 6 to 10% per year for the last twenty-five years. Research in developing country showed that urinary tract infection and metabolic disorders were the caused of nephrolithiasis. Illustration Case: Three years 10 months old boy had a complaint of pain in plank region followed by tea-like urine since two months ago. Physical examination showed that he appeared to be moderately ill and compos mentis. His physical examinations were normal except positive ballotement and positive costoverebral angle (CVA) pain in the right flank region. Laboratory finding showed positive eritrocyte in urinalysis. Ultrasonography and abdominal CT-scan consistent with nephrolithiasis. Management: Pyelolitotomy was performed under general anesthesia. Postoperatively, patient treated in a pediatric surgery room and observation was carried out. He was given D5NS 500 ml administered 20 drops per minute microdrip IV, paracetamol 3 x 225 mg IV, and cefotaxime injection 2 x 500 mg IV after a skin test first. Result and Follow Up: An irregular stone 1,5 cm x 1 cm in size consist of 45% ammonium urate, 31% sodium urate monohydrate, and 24% amorphous calcium phosphate carbonate was found. Discussion: Nephrolithiasis in children occurs due to several related conditions such as genetics, ethnicity, climate, and nutrition. Complications can be prevented by managing and controlling appropriate risk factors.

Нефролітіаз у корів: діагностика забійних тварин

Мета статті – висвітлити дані стосовно захворювання великої рогатої худоби на нефролітіаз у Полтавській області з урахуванням уже наявних літературних даних щодо поширення вказаної патології. Методика дослідження. У процесі виконання роботи проводили ветеринарно-санітарну експертизу внутрішніх органів (нирок) великої рогатої худоби при забої, виявляли органолептично нефроліти та визначали їх параметри. Результати дослідження. У роботі наведено результати досліджень щодо ураження нирок корів нефролітами. Нефролітіаз був встановлений у п’яти (2,1 %) із 243 голів. Виявлено локалізацію ниркових каменів, величину, масу та колір. Елементи наукової новизни. Невеликі камені (пісок) у корів виявлені в ниркових чашечках. Практична значущість. З’ясування ролі екологічних та аліментарних факторів у розвитку ниркових каменів у корів заслуговують на увагу. The purpose of the article is to highlight data on bovine nephrolithiasis disease in Poltava region, taking into account the available information on spreading of this pathology. Research methods. In the process of work we conducted veterinary-sanitary expert examination of the internal organs (kidneys) of cattle at slaughtering, organoleptically detected nephroliths and determined their parameters. Research results. The results of the conducted veterinary-sanitary expert examination revealed stones in the kidneys in five animals, which was about 2.1 % of the total number of slaughtered animals. Uroliths were localized, mainly in the ureter, and less frequently in the calix renalis. Kidney stones were of different sizes from 1 to 14 mm, in some cases, very small stones in the form of sand grains, the so-called renal sand. At the same time, uroliths differed in shape. The some stones were large and solid, others were small and sandy. Externally, they had a smooth or rough (thorny) surface. The color varied from light gray to yellow-gray. The weight of uroliths varied from 2.1 mg (the smallest stones) to 0.98 g (the largest stones). Not rarely, during examining the kidneys, isolated cysts of different sizes were detected, which were filled with light-serous fluid. The analysis of calculus showed its mixed composition (calcium oxalate, magnesium phosphate, calcium phosphate and ammonium urate), which is similar to the results of other researchers and it is coordinated with the hypothesis of the diversity of uroliths’ composition in cattle. The elements of scientific novelty. Small stones (sand) are found in the calix renalis of cows. Practical significance. Clarifying the role of ecological and alimentary factors in the development of kidney stones in cows deserves attention.

Comparison of potential dietary and urinary risk factors for ammonium urate nephrolithiasis in two bottlenose dolphin (Tursiops truncatus) populations

Dietary and urinary risk factors have been implicated in conditions favoring ammonium urate nephrolithiasis in managed dolphins compared with free-ranging dolphins. In this study, urine samples were collected from 16 dolphins (8 cases, 8 controls) from the U.S. Navy Marine Mammal Program for the purposes of assessing changes in urinary biomarkers after a large meal. Urinary biomarkers and nephrolithiasis presence were assessed opportunistically in 15 long-term resident free-ranging dolphins living in Sarasota Bay, Florida. Additionally, the total purine contents of fish commonly consumed by each dolphin population were measured to evaluate potential dietary risk factors. Populations were compared for total dietary purine composition, recently fed status, nephrolithiasis presence, and differences in urinary biochemical, acid-base, and physicochemical parameters via Wilcoxon rank sum analysis and least square means. Managed dolphins had higher urinary pH and ammonium ([Formula: see text]) in both pre- and postprandial conditions and higher urinary uric acid and saturation indices of NH4U in the postprandial condition compared with free-ranging dolphins ( P < 0.05). The purine content was greater ( P < 0.0001) in the diet consumed by managed dolphins [7 mmol/Mcal metabolizable energy (ME)] than in the free-ranging dolphin diet (4 mmol/Mcal ME). Free-ranging dolphins did not show evidence of nephrolithiasis. Observed differences in urinary biomarkers and dietary purine content in these two dolphin populations suggest a pathophysiologic basis for the role of fish types on the risk of NH4U stone formation. Future research should investigate fish type and feeding frequency, inhibitors and promoters, and alkalinizing therapy for reducing NH4U nephrolithiasis in dolphins.

Urinary stone composition: Gender and age variations, and evolution in the last 7 years.

Objectives: To evaluate urinary stone composition in our institution, its gender and age, including variations and the evolution in the last 7 years. Material and Methods: The authors reviewed all urinary stone analysis performed since January 2009 to September 2015 in our hospital – Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal. Patients were stratified by gender, age and stone composition analyzing the evolution of stone composition in different years. The stone analysis method was infrared spectroscopy. Results: From 302 valid stone analysis reports, 55,3% were female and 44,7% were male patients. Mean patient age was 51±14 years old. A total of 7 different mineral components were identified. 51,6% (n=156) of all the stones had Calcium Oxalate, 41% (n=124) had Calcium Phosphate (33% of Apatite form), 37,7% (n=114) had Uric Acid, 22,1% (n=67) had Ammonium Urate, 9,6% (n=29) had Magnesium Ammonium Phosphate, 6,3% (n=19) had Sodium Urate, and 1,3% (n=4) had Cystine in its composition. Only 30,4% of stones had a single chemical compound. Of these 56% were pure stones of Calcium Oxalate, and 31% were pure stone of Uric Acid. The most frequent mixed stone was Calcium Oxalate + Calcium Phosphate (Apatite) followed by Uric Acid + Ammonium Urate comprehending 45% and 27% of all mixed stones respectively. Related to the ethology we divided stones into 3 groups, pure non-infection, pure infection, and mixed with component of infection, and the prevalence was 37,7%, 4,3% and 57,9% respectively. The distribution between genders was similar and the highest difference was in the Ammonium Urate compound with 28% prevalence in male and 17% in women. (p=0,379) Patients after 50 years old had more prevalence of Uric Acid component accounting for 49% of their stones.(p<0,001) . Along the 7 years of study we identified a significant reduction in the prevalence of mixed stones with component of infection, gradually decreasing from 89,6% in 2009 to 27% in 2015. Conclusions: Calcium Oxalate calculus were the most prevalent, but this difference was not as important as in other studies worldwide. This study highlights the importance of the development of National and European database to report all regional stone composition variations.