Nephrolithiasis as a Complication of Ulcerative Colitis and Regional Enteritis
Authors: JULIUS J. DEREN
Journal: Annals of Internal Medicine (1962)

Article1 June 1962Nephrolithiasis as a Complication of Ulcerative Colitis and Regional EnteritisJULIUS J. DEREN, M.D., JEROME G. PORUSH, M.D., MARVIN F. LEVITT, M.D., F.A.C.P., MANSHO T. KHILNANI, M.D.JULIUS J. DEREN, M.D.Search for more papers by this author, JEROME G. PORUSH, M.D.Search for more papers by this author, MARVIN F. LEVITT, M.D., F.A.C.P.Search for more papers by this author, MANSHO T. KHILNANI, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-6-843 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe coexistence of gastrointestinal disease and renal calculi has been noted in few clinical entities. Calcium urolithiasis and upper gastrointestinal symptoms with occasional frank peptic ulceration often present as associated manifestations of primary hyperparathyroidism (1). The development of nephrocalcinosis after prolonged treatment of chronic peptic ulcer with absorbable alkali and a milk diet is also well documented (2). Apart from these syndromes, a well defined association between renal lithiasis and disorders of the digestive tract has been reported infrequently.Among the complications developing during the course of ulcerative colitis and regional enteritis, urolithiasis has received little attention. Jankelson, McClure, and...References1. ST. GOAR WT: Gastrointestinal symptoms as a clue to the diagnosis of primary hyperparathyroidism: a review of 45 cases. Ann. Intern Med. 46: 102, 1957. LinkGoogle Scholar2. BURNETTCOMMONSALBRIGHTHOWARD CHRRFJE: Hypercalcemia without hypercalcuria or hypophosphatemia, calcinosis and renal insufficiency. New Engl. J. Med. 240: 787, 1949. CrossrefMedlineGoogle Scholar3. JANKELSONMCCLURESWEETSIR IRCWFN: Chronic ulcerative colitis. II. Complications outside the digestive tract. Rev. Gastroenterology 9: 99, 1942. Google Scholar4. LINDENBERG J: Ulcerative colitis. Acta Chir. Scand. Supp. 236, 1958. Google Scholar5. BANKSKORELITZZETZELL BMBIL: The course of non-specific ulcerative colitis: review of 20 years' experience and late results. Gastroenterology 32: 983, 1953. CrossrefGoogle Scholar6. BROWNKASICKWEINGARTEN MLAMB: Complications of chronic ulcerative colitis. Amer. J. Digest. Dis. 18: 52, 1951. CrossrefMedlineGoogle Scholar7. HIGHTOWERBRODERSHAINESMCKENNEYSOMMER NCACRDJFAW: Chronic ulcerative colitis. II. Complications. Amer. J. Digest. Dis. 3: 861, 1958. CrossrefMedlineGoogle Scholar8. WILLARDPESSELHUNDLEYBOCKUS JHJFJWHL: Prognosis of ulcerative colitis, J. A. M. A. 111: 2078, 1938. CrossrefGoogle Scholar9. HURST AF: Ulcerative colitis. Guy. Hosp. Rep. 85: 317, 1935. Google Scholar10. RICKETTSPALMER WEWL: Complications of chronic nonspecific ulcerative colitis. Gastroenterology 7: 55, 1946. MedlineGoogle Scholar11. RICE-OXLEYTRUELOVE J.S: Complications of ulcerative colitis. Lancet 1: 607, 1950. CrossrefGoogle Scholar12. BARGENJACKMANKERR JARJJG: Studies on the life histories of parents with chronic ulcerative colitis (thromboulcerative colitis) with some suggestions for treatment. Ann. Intern. Med. 12: 339, 1938. LinkGoogle Scholar13. CROHNYARNIS BBH: Regional Enteritis, Grune & Stratton, New York, 1958. Google Scholar14. ARMITAGEWILSON GM: Crohn's disease: survey of literature and report of thirty-four cases. Brit. J. Surg. 38: 182, 1959. CrossrefGoogle Scholar15. VAN PATTERBARGENDOCKERTYFELDMANMAYOWAUGH WJAMBHCWJM: Regional enteritis. Gastroenterology 26: 347, 1954. CrossrefMedlineGoogle Scholar16. DAFFNERBROWN JECH: Regional enteritis. I. Clinical aspects and diagnosis in 100 patients. Ann. Intern. Med. 49: 580, 1958. LinkGoogle Scholar17. ROSSMILLERMESSENGER HRHM: Regional enteritis; diagnosis and treatment. A study of 55 cases over a 9 year period. Med. Clin. N. Amer. 32: 419, 1948. CrossrefMedlineGoogle Scholar18. MELICKHENNEMAN RAPH: Clinical and laboratory studies of 207 consecutive patients in a kidney stone clinic. New Engl. J. Med. 259: 307, 1958. CrossrefMedlineGoogle Scholar19. BADENOCH AW: Uric acid stone formation, Brit. J. Urol. 32: 374, 1960. CrossrefMedlineGoogle Scholar20. BOYCEKING WHJS: Crystal-matrix interrelations in calculi. J. Urol. 81: 351, 1959. CrossrefMedlineGoogle Scholar21. REDISH MH: Ureteral complications and alterations of ureteral tonus in regional ileitis. New Engl. J. Med. 246: 993, 1952. CrossrefMedlineGoogle Scholar22. HARLAN HC: Urologic complication in regional enteritis. New York J. Med. 54: 65 1954. MedlineGoogle Scholar23. HYMANWEINBERGALLEY JASRJL: Chronic ileitis with concomitant ureteritis Amer. J. Surg. 61: 117, 1943. CrossrefGoogle Scholar24. KITTREDGEDOWNS WER: The role of gout in the formation of urinary calculi. J. Urol 67: 841, 1952. CrossrefMedlineGoogle Scholar25. HENNEMANBENEDICTFORBESDUDLEY PHPHAPHR: Idiopathic hypercalciuria. New Engl. J. Med. 259: 802, 1958 CrossrefMedlineGoogle Scholar26. GOODWINFOWLERDEMPSEYHENNEMAN JTMFEFPH: Primary hyperoxaluria and oxalosis. New Engl. J. Med. 259: 1099 1958. CrossrefMedlineGoogle Scholar27. SMITHKALBHARPER DRFOHA The management of cystinuria and cystine stone disease. J. Urol. 81: 61, 1959. CrossrefMedlineGoogle Scholar28. BARTTERFOURMANALBRIGHTFORBESMCKEFFRIESGRISWOLDDEMPSEYBRYANTCARROLL FCPFAPWGEDE The effect of adrenocorticotropic hormone in panhypopituitarism. J. Clin. Invest. 29 950, 1950. CrossrefMedlineGoogle Scholar29. DIETRICKWHEDONSHORR JEGDE, Effects of immobilization upon various metabolic and physiologic functions of nor mal men. Amer. J. Med. 4: 3, 1948. CrossrefMedlineGoogle Scholar30. FARQUAHSONSATTERTIBETTAUB RFWTDMJC: Studies of calcium and phosphorus metabolism. XII. The effect of ingestion of acid producing substances. Clin. Invest. 10: 221, 1931. CrossrefGoogle Scholar31. KNAPP EL: Factors influencing the urinary excretion of calcium. I. In normal persons J. Clin. Invest. 35: 1229, 1956. MedlineGoogle Scholar32. SHORRCARTER EAC: Aluminum gels in the management of renal phosphate calculi. J. A. M. A. 144: 1549, 1950. CrossrefMedlineGoogle Scholar33. VERMEULENGOETZRAGINSGROVE CWRHDWJ: Experimental urolithiasis. IV. Prevention of magnesium ammonium phosphate calculi by reducing the magnesium intake or by feeding an aluminum gel. J. Urol. 66: 6, 1951. CrossrefMedlineGoogle Scholar34. WELCHWAKEFIELDADAMS CSHGM: Function of the large intestine of man in absorption and excretion. Study of a subject with an ileostomy stoma and an isolated colon. Arch. Intern. Med. 58: 1095, 1936. CrossrefGoogle Scholar35. LEATHES JB: On the excretion of nitrogen, creatinine and uric acid in fever. J. Physiol. 35: 205, 1906. CrossrefGoogle Scholar36. INGBARKASSBURNETTRELMANBURROWSISSON SHEHCHASBAJJ: The effects of ACTH and cortisone on the renal tubular transport of uric acid, phosphorus and electrolytes in patients with normal renal and adrenal function. J. Lab. Clin. Med. 38: 533, 1951. MedlineGoogle Scholar37. BOGASHBOWDEN MRM: Low protein diet in the management of recurrent uric acid stones. J. Urol. 72: 1057, 1954. CrossrefMedlineGoogle Scholar38. PRIEN EL: Studies in urolithiasis. III. Physicochemical principles in stone formation and prevention. J. Urol. 73: 627, 1955. CrossrefMedlineGoogle Scholar39. MEDES G: Solubility of calcium oxalate and uric acid in solutions of urea. Proc. Soc. Exp. Biol. Med. 30: 281, 1932. CrossrefGoogle Scholar40. HAMMARSTEN G: On calcium oxalate and its solubility in the presence of inorganic salts with specific reference to the occurrence of oxaluric stones, C. R. Lab. Carlsberg (Chim.) 17: No. 11, 1929. Google Scholar41. SHORRALMYSLOANTAUSSKYTOSCANI ETPMHHV: The relation between the urinary excretion of citric acid and calcium: its implication for urinary calcium stone formation. Science 96: 587, 1942. CrossrefMedlineGoogle Scholar42. BUTT AJ: Role of protective urinary colloids in prevention of renal lithiasis. J. Urol. 67: 450, 1952. CrossrefMedlineGoogle Scholar43. SISKTOENHART IRO: Factors influencing the solubility of relatively insoluble salts in urine. J. Urol. 37: 595, 1937. CrossrefGoogle Scholar44. PETERSVAN SLYKE JPDD: Quantitative Clinical Chemistry, vol. I, The Williams & Wilkins Co., Baltimore, 1946, p. 417. Google Scholar45. HENNEMANWALLACHDEMPSEY PHSEF: Metabolic defect responsible for uric acid renal stone formation. J. Clin. Invest. 37: 901, 1958. Google Scholar46. ATSMONFRANKLAZEBNICKKOCHWADEURIES AMJSA: Uric acid stones. A study of 58 patients. J. Urol. 84: 167, 1960. CrossrefMedlineGoogle Scholar47. LEVITT MF: Unpublished observations. Google Scholar48. PITTSLOTSPEICH RFWD: Bicarbonate and the renal regulation of acid-base balance. Amer. J. Physiol. 147: 138, 1946. CrossrefMedlineGoogle Scholar49. NICHOLS HO: Urinary calculi. III. Further observations on calculi from patients in the south-east Texas area. Clin. Chem. 7: 175, 1961. MedlineGoogle Scholar50. BURKLANDROSENBERG CEM: Survey of urolithiasis in U. S. J. Urol. 73: 198, 1955. CrossrefMedlineGoogle Scholar51. PRIENFRONDEL ELC: Studies in urolithiasis. I. The composition of urinary calculi. J. Urol. 57: 949, 1947. CrossrefMedlineGoogle Scholar52. ELLIOTTQUAIDESHARPLEWIS JSWLRFL: Mineralogic studies of urine. The relationship of apatite, brushite and struvite to urinary pH. J. Urol. 80: 269, 1958. CrossrefMedlineGoogle Scholar53. ELLIOTTTODDLEWIS JSREL: Some aspects of calcium phosphate solubility. Trans. W. Sect. Amer. Urol. Ass. 27: 6, 1960. MedlineGoogle Scholar54. CHUTESUBY RRI: Prevalence and importance of urea splitting bacterial infections of the urinary tract in the formation of calculi. J. Urol. 44: 590, 1940. CrossrefGoogle Scholar55. JENSENBAGENSTOSSBARGEN EJAHJA: Renal lesions associated with chronic ulcerative colitis. Amer. J. Med. Sci. 219: 281, 1950. CrossrefMedlineGoogle Scholar56. MILWIDSKYMANOL HF: Urinary infection after colostomy. Surgery 15: 971, 1944. Google Scholar57. WOODSWELTHOLLANDERNEWTON JWLGWM: Susceptibility to experimental pyelonephritis during and after potassium depletion. J. Clin. Invest. 38: 1056, 1959. Google Scholar58. CARONEKASHGARIANEPSTEIN FAMFH: Effect of acute potassium deficiency on susceptibility to infection with particular reference to kidney. Yale J. Biol. Med. 32: 100, 1959. MedlineGoogle Scholar59. PRINCESCARDINO CLPL: A statistical analysis of ureteral calculi. J. Urol. 83: 561, 1960. CrossrefMedlineGoogle Scholar60. PRINCESCARDINOWOLAN CLPLCT: The effect of temperature, humidity and dehydration on the formation of renal calculi. J. Urol. 75: 209, 1956. CrossrefMedlineGoogle Scholar61. GROVEVERMEULENGOETZRAGINS WJCWRHD: Experimental urolithiasis. II. The influence of urine volume upon calculi experimentally produced upon foreign bodies. J. Urol. 64: 549, 1950. CrossrefMedlineGoogle Scholar62. HARDY TL: Order and disorder in the large intestine. Lancet 248: 519, 1945. CrossrefGoogle Scholar63. WELCHMASONWAKEFIELD CSICEC: Clinical and laboratory findings after excessive loss of intestinal fluid from the ileum. Surg. Gynec. Obstet. 64: 617, 1937. Google Scholar64. WHITTAKERBARGEN CDJA: Observations on the human being following colectomy or colonic exclusion with ileostomy. Surg. Gynec. Obstet. 64: 849, 1937. Google Scholar65. KASS EH: Bacteriuria and the diagnosis of infections of the urinary tract. Arch. Intern. Med. 100: 709, 1957. CrossrefGoogle Scholar66. FREEDMAN LR: The effect of an acidifying salt on susceptibility of the kidney to infection, in Biology of Pyelonephritis, ed. by Quinn, E. L., and Kass, E. H., Little, Brown and Compnay, Boston, 1960. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New YorkFrom the Department of Medicine of Maimonides Hospital of Brooklyn, and the Departments of Medicine and Radiology of The Mount Sinai Hospital, New York, New York.Supported by a grant (A-277) from the National Institute of Arthritis and Metabolic Diseases, National Institutes of Health.Dr. Porush was a Postdoctoral Research Fellow, United States Public Health Service, when this work was done.Requests for reprints should be addressed to Marvin F. Levitt, M.D., The Mount Sinai Hospital, New York 29, New York. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPrevalence of Renal Stones Among Patients With Inflammatory Bowel Disease in Saudi ArabiaNephrolithiasis in Patients with Gastrointestinal DisordersBacteria, Bones, and Stones: Managing Complications of Short Bowel SyndromeMalabsorptive Disorders and Inflammatory Bowel Disease: Assessing and Improving Nutritional Stone RiskEtiopathogenesis of Nephrolithiasis in Ulcerative Colitis Patients with the Ileal Pouch Anal AnastomosisEpidemiology and clinical pathophysiology of uric acid kidney stonesModern Stone ScienceUric Acid Nephrolithiasis: Uric Acid or Urine pH?Risk factors for nephrolithiasis in patients with ileal pouchesIntestinal StomasIntra-tubular deposits, urine and stone composition are divergent in patients with ileostomyINTESTINAL STOMASUrinary stones in subjects with a permanent ileostomyAnuric, obstructive uropathy in the absence of obvious radiological evidence of obstructionHepatobiliary, renal and bone complications of intestinal failureUrine stone risk factors in nephrolithiasis patients with and without bowel diseaseStones from bowel diseaseFrequency of extraintestinal manifestations in patients with inflammatory bowel disease in Northwest Greece and review of the literatureExtraintestinal manifestations of inflammatory bowel diseaseUlcerative ColitisUrinary and Sexual ComplicationsTHE PHYSIOLOGIC APPROACH TO THE MEDICAL MANAGEMENT OF STONE DISEASERenal and Urologic Complications of Inflammatory Bowel DiseaseGASTROINTESTINAL DISEASES IN WOMENUrinary changes in patients following restorative proctocolectomyComparison of relative risks of urinary stone formation after surgery for ulcerative colitis: Conventional ileostomy vs. J-pouchThe Clinical Spectrum of Ammonium Urate Renal CalculiBeethoven's Renal Disease Based on His Autopsy: A Case of Papillary NecrosisInflammatory Bowel DiseaseUric Acid Nephrolithiasis: Pathogenesis and TreatmentUrolithiasis Complicating Inflammatory Bowel DiseaseProphylaxis of uric acid stone in patients with inflammatory bowel disease following extensive colonic resectionNephrolithiasis and urine ion changes in ulcerative colitis patients undergoing colectomy and endorectal ileal pullthroughUse of photochemical reactions in flow injection: determination of oxalate in urinePrevention of uric acid stone formation by sodium bicarbonate in an ileostomy patient —A case reportEnteric and Other Secondary HyperoxaluriasDetermination of oxalic acid in urine: A reviewRenal disease from excess uric acidUrolithiasis and Enteric Hyperoxaluria in a Child With SteatorrheaPharmacologic Treatment of Uric Acid CalculiPathophysiology of Nonhypercalciuric Causes of StonesEnteric Hyperoxaluria and UrolithiasisNephrolithiasis Associated with Intestinal DiseasePathogenesis of UrolithiasisKolon und RektumNutrition after IleostomyResorption von Oxalsäure und intestinale HyperoxalurieEnterohepatischer Kreislauf der GallensäurenKurzdarmsyndromIleostomieThe Clinical Chemistry of Oxalate MetabolismDiet and health of people with an ileostomySystemische KomplikationenEnterostomien bei Erkrankungen des DickdarmsEffective Therapy of Enteric Hyperoxaluria: In Vitro Binding of Oxalate by Anion-Exchange Resins and Aluminum HydroxideUrinary Stone Formation in Bowel DiseasePrevalence of Nephrolithiasis in Malabsorptive SyndromesOxalate-induced acute renal failure in Crohn's diseaseOxalate uptake by everted sacs of rat colon. Regional differences and the effects of pH and ricinoleic acidUric Acid CalculiEnteric Hyperoxaluria: Dependence on Small Intestinal Resection, Colectomy, and Steatorrhoea in Chronic Inflammatory Bowel DiseaseEnterale HyperoxalurieUrolithiasis in Chronic Inflammatory Bowel DiseaseRenal oxalate excretion following oral oxalate loads in patients with ileal disease and with renal and absorptive hypercalciuriasUric Acid NephrolithiasisOperations for Inflammatory Bowel DiseaseHyperoxaluria and intestinal diseaseImportance of the Colon in Enteric HyperoxaluriaIntestinal oxalate absorptionUrological complications of regional enteritisThe Management of Patients after Small Bowel ResectionEffect of Bile Salts and Fatty Acids on the Colonic Absorption of OxalateUrologic Complications of Inflammatory Bowel DiseaseUrolithiasis in Inflammatory Bowel DiseaseReply of the authors–Urolithiasis in Inflammatory Bowel DiseaseUrinary tract calculi associated with enteritis and intestinal bypassThe Importance of Bile Acids in Human DiseasesIntestinal Oxalate AbsorptionMyopericarditis complicating ulcerative colitis.Hyperoxaluria in Patients with Ileal Resection: An Abnormality in Dietary Oxalate AbsorptionAcquired Hyperoxaluria, Urolithiasis, and Intestinal Disease: A New Digestive Disorder?Excretion Of Calcium And Citric Acid In Patients With Small Bowel DiseaseRenal Lithiasis in Gastrointestinal DiseaseGEORGE N. AAGAARD, M.D.Urinary tract stone after small bowel bypass for morbid obesityAcquired Hyperoxaluria with Regional Enteritis After Ileal Resection Role of Dietary OxalateJOHN Q. STAUFFER, M.D., MICHAEL H. HUMPHREYS, M.D., G. JOHN WEIR, M.D., F.A.C.P.Proceedings of the Surgical Research Society of AustralasiaUric Acid Lithiasis in the Ileostomy PatientTuberculosis, Crohn's Disease and Villous Papilloma of the RectumUrinary Tract Calculi in ChildrenDissolution of Renal Uric Acid Stones Complicating IleostomyAcquired Hyperoxaluria, Nephrolithiasis, and Intestinal DiseaseUric Acid Calculi Associated with Ileostomy for Ulcerative ColitisGranulomatous bowel disease presenting as a bladder tumorThe complications of enterocolitisThe roentgenographic features of ureteral obstruction secondary to granulomatous disease of the bowelL'Allopurinolo in Urologia Nota 2 A : La Calcolosi UricaCalculiAssociated Systemic DiseasesClinical Observations on Inflammatory Bowel DiseaseILEOSTOMY AND THE RISK OF URINARY URIC ACID STONESAbsorption and secretion by the colonObstructive HydronephrosisNephrolithiasis in inflammatory bowel diseaseUric acid nephrolithiasisSurgery and clinical progression in patients with Crohn's disease of the small and large intestineCHRONIC DEHYDRATION AND SODIUM DEPLETION IN PATIENTS WITH ESTABLISHED ILEOSTOMIESIntestinal Adaptation to Salt Depletion in a Patient with an IleostomyUrolithiasis as a complication of chronic diarrheal diseaseColitis ulcerosaURIC ACID STONE FORMATION FOLLOWING ILEOSTOMY*Extracolonic Manifestations of Chronic Ulcerative ColitisSuccessful Management of Massive Small-Bowel Resection Based on Assessment of Absorption Defects and Nutritional NeedsEnvironment and the KidneyUrolithiasis as a complication of the surgical treatment of ulcerative colitisThe Association of Chronic "Nonspecific" Inflammatory Bowel Disease with Lupus ErythematosusDONALD J. KURLANDER, M.D., JOSEPH B. KIRSNER, M.D., PH.D.Some Points in the Management of Uric Acid StonesUlcerative Colitis: A Report of Progress, Based upon the Recent LiteratureCase 48-1963Kidney Stones: A Medical Approach to Diagnosis (With Some Brief Comments on Some Treatments) 1 June 1962Volume 56, Issue 6Page: 843-853KeywordsCalciumEnteritisHospital medicineMilkPeptic ulcersPyelonephritisRenal diseasesUlcerative colitisUric acidUrinary tract infections Issue Published: 1 June 1962 PDF downloadLoading ...