Flashcards in Genitourinary Disorders Deck (18)
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.
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.
calcium oxalate stones
--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
uric acid stones
--low purine diet
--maintain alkaline urine (above pH 6) to increase solubility of uric acid
details of kidney stone prevention research & recommendations
**Grapefruit juice = RISK, and apple and cranberry = bad.
low oxalate diet (to reduce kidney stones)
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
--citrate is natural inhibitor of stone formation
Recurrent Urinary Tract Infection
--vitmin A (200,000)
--chinese herbal medicine & UTI in postmenopausal women (acute sinusitis, acute bronchitis as well)
--nasturtium & horseradish
--parts of plant used
ripe fruit (berry)
--juice (typically diluted & sweetened)
--powdered whole berry or berry extract
--flavonoids (anthocyanidins & proanthocyanidins)
--other = organic acids, Vit C, natural sugars w/ anti-microbial activity
--only 5% of flavonoids from oral doses show up in urine
--likely mech of action
--proanthocyanidins/ anthocyanidins, inhibit adhesion of some urinary pathogens to epithelial cells.
--unlikely mech of action
--acids, vit C, and microbe-inhibiting sugars probably never reach high enough urinary concentrations
--adult women (50X more likely)
--elderly men & women
--neurogenic bladder patients
--frequency of Dx UTIs by laboratory testing only (ex: bacteriuria)
--frequency of Dx laboratory testing & clinical S&S