Urolithiasis is a common disorder which is recognised in most parts of the world and occurs in both man and animals. The multifactorial nature of the problem requires an interdisciplinary approach which has always been a feature of this series of International Symposia which started in Leeds in 1968 and has progressed at four-yearly intervals through Madrid, Davos and Williamsburg. The latest Meeting, at Garmisch-Partenkirchen in April 1984, involved 302 participants from all five continents. The major emphasis of the Meeting was to blend the basic and clinical research on urolithiasis. Comprehensive reviews of the major areas of current research were presented by invited speakers, all internationally recognized experts in their fields. From more than 250 submitted abstracts, 18 were selected for oral presentation and the remainder presented at three afternoon poster sessions which provided an opportunity for informal and more lengthy discussions of the work on display. The Meeting also included three ad hoc Evening Discussions on how to approach various unsolved questions in the clinical and laboratory evaluation of stone patients and four Round Table Discussions involving specialists in the field who debated the theoretical aspects of stone formation in the urinary tract, the measurement of inhibitory activity of urine, the treatment of idiopathic stones with drugs, and the nature and treatment of stones arising from urinary tract infection.
Inhaltsverzeichnis
I. General Aspects.- Genetics.- Inborn Errors of Metabolism Complicated by Urolithiasis Examples from Purine Metabolism.- Urolithiasis in a Large Kindred Deficient in Adenine Phosphoribosyltransferase (APRT).- Urolithiasis in Hereditary Renal Hypouricemia.- Familial Xanthinuria in a Large Kindred: Purine Metabolites in Plasma and Urine of Xanthinurics, Siblings and Normal Subjects.- Heredity, Serum Phosphate and Urinary Calcium in Calcium Urolithiasis.- The Significance of the Sexual Dependency of Lithogenic and Inhibitory Substances in Urine.- Epidemiology.- Incidence of Renal Stones in Western Countries.- Urolithiasis Epidemiological Data from the South of Portugal.- Epidemiological Aspects of Urolithiasis in a German County.- Epidemiology of Urolithiasis and Calcium Metabolism in Human Diabetes Mellitus.- Nutrition.- Urinary Calcium Excretion and Net Acid Excretion: Effects of Dietary Protein, Carbohydrate and Calories.- Dietary Factors Important in Calcium Stone-Formation.- Dietary Factors as Causes of the So-Called Renal Leak of Calcium in Idiopathic Stone Formers.- Dietary History and Dietary Records in Renal Stone Patients and Controls.- Urolithiasis in Southern Rajasthan: Contribution of Dietary Oxalate to Urinary Oxalate.- Nutrition and Calcium Oxalate Urolithiasis.- The Effect of an Increased Intake of Various Constituents of a High Animal Protein Diet on the Risk of Calcium Oxalate Stone Formation in Men.- Calculogenic Potential of the Diet A New Concept.- Tea Drinking A Risk Factor for Urolithiasis?.- Environment.- Influence of Water Quality on Urolithiasis.- Drinking Water Quality and Urolithiasis.- II. Gastrointestinal Physiology and Pathophysiology.- Intestinal Absorption of Calcium: Basic Aspects.- Nephrolithiasis Associated with Intestinal Disease.- Intestinal Absorption of Calcium, Magnesium, Phosphate and Oxalate: Deviation from Normal in Idiopathic Urolithiasis.- Kinetic Study of the Intestinal Calcium-Binding Protein in Absorptive Hypercalciuria.- Intestinal Flora and Oxalate Excretion in Patients with Enteric Hyperoxaluria.- Renal Tubular Function in Patients Following Intestinal By-pass Operations.- Mechanism of Sodium Glycolate Absorption in Rat Intestine.- Intestinal Absorption of Oxalate in Gonadectomized Rats.- Effect of Maleic Acid on the Intestinal Uptake of Calcium and Oxalate in Pyridoxine-Deficient Rats.- III. Renal Physiology and Pathophysiology.- The Renal Handling of Magnesium.- Influence of Bicarbonate on the Renal Handling of Magnesium.- Urinary Excretion of Citrate Influence of Metabolism and Acid-Base Conditions.- The Renal Handling of Citrate.- Effects of Metabolic Acidosis and Alkalosis on the Renal Brush Border Membrane Transport of Citrate.- Renal Handling of Oxalate.- Relation of Severity of Renal Impairment to Tissue Calcium Concentration in the Human Kidney.- Calcification Sites in Human Kidneys A REM Study.- The Influence of Glucose and Insulin on Calcium Excretion in the Urine.- The Effect of Indomethacin and Flurbiprofen on Calcium Excretion and Glomerular Filtration Rate in the Anaesthetized Rat.- IV. Metabolism.- Studies on the Endogenous Production of Oxalate in Man.- Red Blood Cell Transmembrane Oxalate Flux in Idiopathic Calcium Oxalate Nephrolithiasis.- The Effect of Ingestion of Megadoses of Ascorbic Acid on Urinary Oxalate Excretion in Normal Subjects and Stone Formers.- Interactions of Steroid Hormones and Pyridoxine in the Regulation of Oxalate Metabolism in Rats.- Glyoxylate Oxidation and Enzymes of Oxalate Biosynthesis in Thiamine-Deficient Rats.- Effect of Pyruvate on Oxalate-Synthesizing Enzymes in Liver and Kidney of Glycolate-fed Rats.- Is Magnesium Metabolism Related to Calcium Urolithiasis?.- Low Urinary Magnesium/Calcium Ratio Due to Increased Urinary Calcium Excretion in Essential Hypertension.- A Study of Factors Affecting Urinary Citrate Levels.- Relation Between Hypercalciuria and Vitamin D3-Status in Renal Stone Formers.- V. Clinical Urolithiasis.- Institution and Management of a Stone Clinic.- Temporal Changes in Urinary Risk Factors Following Renal Colic.- Anatomical Localization of Urinary Risk Factors of Calcium Oxalate S tone Formation.- An Ambulatory Metabolic Study of Calcium Urolithiasis in Venezuela.- Hyperuricosuric Calcium Stoneformers: Effect on Fasting and Calcium Hyperabsorption.- Calcium Oxalate (CaOx) Urine Supersaturation in Calcium Stone Formers (CSF): Hypercalciuria Versus Hyperoxaluria.- The Origin of Metabolic Abnormalities in Primary Calcium Stone Disease Natural or Unnatural Selection?.- Studies on Urine Composition in Patients with Calcium Oxalate Stone Disease.- Alterations in Kidney Location with Changes in Patient Position: Implications for Percutaneous Renal Procedures.- In Vitro Determination of Optimal Conditions for Coagulum Pyelolithotomy.- A One Day Cellulose Phosphate (CP) Test Discriminates Non-Absorptive From Absorptive Hypercalciuria.- Serum Parathormone and Urinary and Nephrogenous Cyclic AMP in Idiopathic Hypercalciuria and in Primary Hyperparathyroidism.- Hypercalciuria in Patients with Normocalcemic Hyperparathyroidism and Stone Disease.- Vitamin D Metabolism in Hypercalciuric Patients.- Proximal Tubule Sodium Handling in Calcium S tone Formers.- Evidence for Magnesium Depletion in Idiopathic Hypercalciuria.- Magnesium Excretion in Recurrent Calcium Urolithiasis.- The Diagnostic Value of Renal Tubular Reabsorption of Magnesium Calculations in Calcium-Containing Kidney Stone Formers.- Some Stone Promoting and Inhibiting Factors in Fasting and Postprandial Urines of Stone Patients and Controls Preliminary Results.- Urinary and Serum Sulfate in Idiopathic Recurrent Calcium Urolithiasis (RCU).- Urine and Serum Potassium in Patients with Recurrent Calcium Urolithiasis (RCU) Results of a Pilot Study.- Activity of Adenine Phosphoribosyltransferase (APRT) in Patients with Renal Failure and Urolithiasis.- The Significance of Hyperuricemia and Hyperuricosuria in Calcium Oxalate Stone Formers.- Urinary Excretion Pattern of Main Glycosaminoglycans in Stone Formers and Controls.- The Connection Between Amino Acids, Urinary Enzymes and S tone Formation.- Urinary Isocitrate Excretion in Normal Individuals and in Stone Patients.- Urinary Citrate Excretion in Normals and Patients with Idiopathic Calcium Urolithiasis.- Drug Nephrolithiasis:An Unrecognized and Underestimated Pathology.- Triamterene Solubility and Metabolism are not Causative Factors of Triamterene Nephrolithiasis.- The Effect of a High Intake of Tartaric Acid on Urinary and Plasma Oxalate.- Role of Fluoride in Formation of Calcium Oxalate Stones.- Transient Hypercalciuria During Acute Pyelonephritis and Active S tone Formation.- Ureaplasma Urealyticum and Renal Stones.- Infection Concrements Induced by Ureaplasma Urealyticum.- Stone Analysis and Urinary Tract Infection in Renal Stone Patients.- Vesical Calculi in Patients with Neurogenic Urinary Bladder Dysfunction B. Suryaprakash.- Biochemical Studies in Paraplegic Renal S tone Patients.- The Effectiveness of Hemodialysis and Continuous Ambulatory Peritoneal Dialysis (CAPD) in Controlling Plasma Oxalate Concentrations.- Round Table Discussion on Secondary Lithiasis.- VI. Treatment.- Dietary Therapy.- The Effect of High Fibre Biscuits on Urinary Risk Factors for Stone Formation.- Is Salt Restriction Necessary to Reduce the Risk of Stone Formation?.- Restricted Calcium Diet and Calcium Oxalate Urolithiasis.- Pyrophosphate Excretion in Various Groups of Calcium Stone-Formers: Effect of a Calcium-Restricted Diet.- The Use of Wheat Bran to Decrease Calcium Excretion and to Treat Calcium Oxalate Stone Disease.- Critical Role of Oxalate Restriction in Association with Calcium Restriction to Decrease the Probability of Being a Stone Former: Insufficient Effect in Idiopathic Hypercalciuria.- Dietary Treatment of Hyperoxaluria Following Jejunoileal Bypass.- The Stone Clinic Effect in Patients with Idiopathic Calcium Urolithiasis.- Do Stone Formers Accept Dietary Advice?.- Drug Treatment.- The Prevention of Calcium Stones with Thiazides.- Experience with Long-Term Thiazide Treatment in Calcium Oxalate Stone Disease.- Thiazide Prophylaxis of Urolithiasis: A Double Blind Study in General Practice.- Appraisal of Methodology in Studies of Either Thiazide or Orthophosphate Therapy for Recurrent Calcium Urolithiasis.- The Effects of Orthophosphates and Ion Binders.- Effect of Orthophosphate Treatment on Urine Composition in Idiopathic Calcium Urolithiasis.- Phosphate Treatment of Calcium Urolithiasis B. Wikström.- The Role of Urate and Allopurinol in Stone Disease: A Review.- Allopurinol Treatment in Urolithiasis.- Further Reduction of Oxalate Excretion by Allopurinol in Stone Formers on Low Purine Diet.- The Effect of Long-Term Treatment with Allopurinol on Stone Recurrence in Calcium Urolithiasis.- A Placebo Controlled Double-Blind Study of Allopurinol in Severe Recurrent Idiopathic Renal Lithiasis. Preliminary Results.- Drugs Against Kidney Stones: Effects of Magnesium and Alkali.- Urine Composition in Calcium Oxalate Stone Formers During Treatment with Alkali.- The Effect of Alkalinizing Agents and Chelating Agents on the Dissolution of Calcium Oxalate Kidney Stones.- The Effect of Alkalinizing Agents on Calcium Oxalate Stone Formation in a Rat Model.- A Multicentre Trial to Evaluate Three Treatments for Recurrent Idiopathic Calcium Stone Disease A Preliminary Report.- Prophylaxis of Calcium Oxalate S tones: Clinical Trials of Allopurinol, Magnesium Hydroxide and Chlorthalidone.- The Effectiveness of Long-Term Treatment for Recurrent Kidney Stones Using the DI Method.- Calcium Oxalate Stone Formers Five Years Later.- The Relationship Between Clinical Outcome and Urine Biochemistry During Various Forms of Therapy for Idiopathic Calcium Stone Disease.- Biochemical Alterations in Urinary Stone Patients on Chemoprophy laxis.- Five-Year Treatment in Hyperoxaluric Stone Formers.- The Influence of Flurbiprofen on Calcium Excretion and Vitamin D3 in Recurrent Calcium Lithiasis A Double Blind Study.- The Inhibition of Experimental Nephrocalcinosis with a Prostaglandin Synthetase Inhibitor.- Clinical Manipulation of Urinary GAGS A new method of Stone Prevention(?).- Treatment of Hyperoxaluria in Patients with Jejunoileal Bypass: Effects of Calcium, Aluminum, Magnesium, and Cholestyramine.- Relative Merit of Various Nonsurgical Treatments of Infection Stones in Dogs.- Efficacy and Safety of Non-steroidal Anti-Inflammatory Drugs in Ureteral Colic: A Double-Blind Controlled Trial.- Methods and Results of Conservative Expulsion of Urinary Calculi.- Surgical Treatment.- Modern Strategies in Stone Surgery, with Special Emphasis on Prevention of Stone Recurrence.- Operative Ureterorenoscopy for Endoscopic Removal of Ureteric Calculi.- Renal Autotransplantation with Direct Pyelocystostomy in Patients with Recurrent Renal Calculi.- Three-Dimensional Inter-operative Renal Radiography by Means of a Combination of Polaroid Films and Intensifier Screens.- Dissolution of Phosphate Stones by Percutaneous Nephrostomy and Local Irrigation.- A Direct Comparison of the Litholytic Capacity of Renacidin and Some New Calcium Oxalate and/or Phosphate Dissolving Irrigation Systems.- Postoperative Recurrence of Idiopathic Calcium Urolithiasis.- VII. Analytical Methods.- Urine and Plasma Analysis.- Advances in Analysis of Urinary Oxalate: The Ascorbate Problem Solved.- A Comparison of Three Methods for Measuring Urinary Oxalate With a Note on Ascorbic Acid Interference.- The Effect of Ascorbic Acid on Urine Oxalate Measurement.- Spontaneous In Vitro Generation of Oxalate from L-Ascorbate in Some Assays for Urinary Oxalate and its Prevention.- Enzymatic Assay of Oxalate Using Oxalate Oxidase from Sorghum Leaves.- Determination of Urinary Oxalate by Reversed-Phase Ion-Pair High-Performance Liquid Chromatography.- Human Plasma Oxalate Concentration Re-Examined.- The Measurement of Oxalate and Glycolate with Immobilized Enzyme Systems.- The Value of Oxalate Determination by High-Performance Liquid Chromatography in Clinical Practice.- Enzymatic Determination of Oxalate in Urine.- A New Rapid Spectrophotometric Method for Detection of Xanthinuria.- Combined Enzymatic Degradation with Chondroitinases and Alcian Blue Precipitation in Determination of Urinary Chondroitin Sulphates.- On the Preservation of Urines for the Determination of Citrate.- Stone Analysis.- A New Method for Quantitative Wet-Chemical Analysis of Urinary Calculi and the Principles for Calculation of Results and Mass Recovery by an Algorithm.- Analysis of Urinary Calculi by Inductively Coupled Plasma Atomic Emission Spectroscopy: New Insight into Stone Structure.- Hardness Testing of Urinary Calculi.- Scanning Electron Microscopy Studies on Infection-Induced Urinary Concrements.- Matrix-Mineral Configuration in Whewellite Kidney Stones: Ultrastructural Analysis.- Clinical-Chemical Study of Urinary Stones in Saudi Arabia I. Uric Acid Stones.- Struvite Stones Analysis by Infrared Spectrophotometry in Adults and Children.- Composition and Structure of Infected Stones.- Urinary Calculi in Children Epidemiological and Mineralogical Aspects.- A Scanning Electron Microscopy (SEM) Study of the Bladder Mucosa in Paediatric Patients with Idiopathic Calculus Disease.- Childhood Urolithiasis in Iran: A Study of Urinary Calculi Using X-Ray Diffraction, Polarizing Microscopy and Chemical Analysis.- Stone Analysis in the Doctor s Office or in a Specialized Laboratory?.- Computed Tomographic Analysis of the Composition of Renal Calculi.- VIII. Physical Chemistry.- Crystal Formation.- Urine Supersaturation: The Nucleation, Growth and Dissolution of S tones.- Dissolution Kinetics of Calcium Oxalate Calculi.- A Whole Urine System for Studying Nucleation, Growth and Aggregation of Calcium Oxalate Crystals.- Crystallization Characteristics of Synthetic Urine in a Fast Evaporator.- A Comparison of the Tiselius Risk Index (RI) and Relative Saturation (RS) of Calcium Oxalate (CaOx) in Stone Formers.- Equations Defining Urinary Crystallization Conditions with Respect to Stone-Forming Calcium Salts.- Calculation of Complex Chemical Equilibria in Urine: Estimation of the Risk of Stone-formation and Derivation of Prophylactic Measures.- Epitaxial Growth of Calcium Oxalate on Uric Acid.- The Conditions for Precipitation of Uric Acid and Sodium Acid Urate.- The Oxalate-Tolerance-Value: A Diagnostic Tool for the Recognition of Stone Forming Patients.- The Crystallization of Magnesium Ammonium Phosphate (Struvite) in Acidic Sterile Urine.- In Vitro Investigations of Stone Growth Inhibition and Dissolution.- Inhibitors and Promoters.- Inhibitors of the Precipitation of Stone-Forming Urinary-Constituents: Are the Established Inhibitors Effective in Preventing Stone Formation and Growth or is a Moss-Covered Stone Inevitable?.- The Relative Importance of Calcium Phosphate Urinary Inhibitors.- Natural Inhibitors of Formation and Dissolution of S tone Minerals.- Urinary Inhibitors of Hydroxyapatite Crystal Growth: A Constant Composition Approach.- Gel Filtration of Concentrated Urine: The Relation Between Calcium Oxalate Crystal Growth Inhibition and Glycosaminoglycan Chromatograms.- Effect of Additives and Whole Urine on Calcium Oxalate Dihydrate Formation.- Crystal Inhibition: Binding of Heparin and Chondroitin Sulphate to Calcium Oxalate, Sodium Urate and Uric Acid Crystals.- Studies on the Mode of Action of Polyanionic Inhibitors of Calcium Oxalate Crystallization in Urine.- The Relative Inhibitory Potential of Urinary Macromolecular Fractions on CaOx Precipitation.- Adsorption of RNA onto Aged Calcium Oxalate Monohydrate (COM).- The Additive Effects of Magnesium and Tartrate Upon Inhibition of Calcium Oxalate Crystal Formation in Whole Urine.- Calcium Oxalate Crystal Growth: Investigations on Inhibitory Activity of Model Compounds and Urine Samples.- The Effect of Uric Acid on the Inhibitory Activity of Glycosaminoglycans and Urine.- Hyperuricosuria and Calcium Oxalate Stone Formation.- Further Studies on the Possible Lithogenetic Role of Uric Acid in Calcium Oxalate Stone Disease.- Does the Bladder Mucosa Contribute to Urinary Inhibitory Activity?.- The Contribution of the Bladder to Calcium Oxalate Crystal Growth Inhibition in Voided Urine X. Martin.- Effects of Human Urine on Aggregation of Calcium Oxalate Crystals: Normal Persons Versus S tone-Formers.- Determination of Stone Forming Risk by Measuring Crystallization Inhibitor Activity in Urine with a Gel Model.- Macromolecules in Whole Urine that Promote Calcium Oxalate and Phosphate Crystal Formation.- The Inhibition of Calcium Oxalate Crystal Growth by Chondroitin Sulphates, Heparin, Pentosan Polysulphate and Tamm-Horsfall Glycoprotein.- N-Sulpho-2-Amino Tricarballylate, a New Analog of Phosphocitrate: Metabolism and Inhibitory Effects on Renal Calcification.- The Effect of Sodium Sulfopentosan on the Crystallization of Calcium Oxalate.- Magnesium and Citric Acid in the Dissolution of Struvite and Hydroxyapatite.- Round Table Discussion on the Comparison of Models for the Study of Inhibitory Activity in Urine.- Matrix.- Urinary Stone Matrix and Urinary Macromolecules.- Alternating Crystallization A Proposed Mechanism for Lamellar Structure Formation in Renal Stones.- A Microscopic Study of the Matrix of Some Calcium Oxalate Renal S tones.- Chemical Models.- Comment on the Round Table Discussion on Theoretical Models Related to Urolithiasis.- IX. Animal Models.- Microstructure of Calcium Oxalate Foreign Body Stones Produced in Rat Bladder.- Urine and Serum Biochemistry Relative to the Risk of Lithogenesis in Rats on an Atherogenic Diet.- Histopathological Changes in the Kidney of the Rat on an Atherogenic Diet.- 14C-Calcium Oxalate (CaOx) Adherence in the Rat Bladder.- Dissolution of Crystalline Calcium Oxalate.- Induction and Inhibition of Struvite Bladder S tones in Rats.- List of Participants.