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Flashcards in Genitourinary Disorders Deck (18)
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1

Kidney Stone Prevention

1) long-term observational studies that try to correlate certain dietary habits w increased or decreased risk of symptoms
2) short-term lab studies that eval urinary changes in response to diff dietary changes.

2

laboratory eval for kidney stones

--24h urinary calcium
--24h urinary oxalate
= 2 most common precursors of kidney stones.
maybe: serum Mg, urinary uric acid or serum acid.

3

calcium oxalate stones
--principles

--increase fluid in general = improve solubility of urine
--reduce urinary calcium w/o putting bone health at risk.
--reduce urinary oxalate.
--increase natural inhibitors of crystal formations

4

uric acid stones

--low purine diet
--maintain alkaline urine (above pH 6) to increase solubility of uric acid

5

details of kidney stone prevention research & recommendations
INCREASE:

--coffee!!!
--black tea
--milk
--beer (20-40%)
--wine (40-60%)
**Grapefruit juice = RISK, and apple and cranberry = bad.

6

low oxalate diet (to reduce kidney stones)

--spinach
--rhubarb
--beet greens
--nuts
--chocolate
--tea
--bran
--strawberries

7

supplements for kidney stones

--do NOT avoid calcium unless patient has been shown to have absorptive hypercalciuria
--EVERYONE else calcium increases risk of kidney stones
--Mg2+ 200-400mg/d
--citrate is natural inhibitor of stone formation
--B6 50-150mg/d
--Vit C

8

Recurrent Urinary Tract Infection

--cranberry
--vitmin A (200,000)
--chinese herbal medicine & UTI in postmenopausal women (acute sinusitis, acute bronchitis as well)
--nasturtium & horseradish

9

cranberry
--scientific name

vaccinium macrocarpon

10

cranberry
--parts of plant used

ripe fruit (berry)

11

cranberry
--preparations

--juice (typically diluted & sweetened)
--powdered whole berry or berry extract

12

cranberry
(vaccinium macrocarpon)
--active constituents

--flavonoids (anthocyanidins & proanthocyanidins)
--other = organic acids, Vit C, natural sugars w/ anti-microbial activity

13

cranberry
(vaccinium macrocarpon)
--pharmacology

--only 5% of flavonoids from oral doses show up in urine

14

cranberry
(vaccinium macrocarpon)
--likely mech of action

--proanthocyanidins/ anthocyanidins, inhibit adhesion of some urinary pathogens to epithelial cells.

15

cranberry
(vaccinium macrocarpon)
--unlikely mech of action

--acids, vit C, and microbe-inhibiting sugars probably never reach high enough urinary concentrations

16

Eval UTI
--patients

--adult women (50X more likely)
--elderly men & women
--catheterized pt
--neurogenic bladder patients

17

Eval UTI
--outcomes

--frequency of Dx UTIs by laboratory testing only (ex: bacteriuria)
--frequency of Dx laboratory testing & clinical S&S

18

medical Tx for recurrent UTI

--low-dose prophylactic antibiotics
--lifestyle modification (high fluid intake, frequent urination, cotton underwear, etc)