Trabajo recibido: 3 de enero 2006 Resumen.-OBJETIVO: La litiasis urinaria tiene un origen multifactorial en el que participan factores físico-químicos y anatómicos. factores físico-químicos de origen renal o prerrenal, consecuencia de agentes exógenos o endógenos que se integran bajo la denominación de enfermedades sistémicas relacionadas con litiasis urinaria. El objetivo del estudio metabólico urinario es conocer y analizar los factores fisico-químicos por los que cada una de estas enfermedades o entidades clínicas participan en la litogénesis. MÉTODOS: Realizamos un estudio sobre 320 casos distribuidos en dos grupos: Grupo A: 70 personas sanas, sin antecedentes familiares ni personales de litiasis urinaria. Grupo B: 250 pacientes con antecedentes de litiasis renal, que ha expulsado de forma espontánea, tras litotricia extracorpórea o cirugía. En todos los casos se realiza un estudio metabólico urinario informatizado (EMUSYS)
Background: Encrustation of ureteral double J stents is a common complication that may affect its removal. The aim of the proposed study is to evaluate the efficacy and safety of a new oral composition to prevent double J stent encrustation in indwelling times up to 8 weeks. Methods: A double-blinded, multicenter, placebo-controlled trial was conducted with 105 patients with indwelling double J stents enrolled across 9 public hospitals in Spain. The patients were randomly assigned (1:1) into intervention (53 patients) or placebo (52 patients) groups for 3 to 8 weeks and both groups self-monitored daily their morning urine pH levels. The primary outcome of analysis was the degree of stent ends encrustation, defined by a 4-point score (0none; 3global encrustation) using macroscopic and electron microscopy analysis of crystals, after 3 to 8-w indwelling period. Score was exponentially transformed according to calcium levels. Secondary endpoints included urine pH decrease, stent removal, and incidence of adverse events. Results: The intervention group benefits from a lower global encrustation rate of stent ends than placebo group (1% vs 8.2%; p < 0.018). Mean encrustation score was 85.12 (274.5) in the placebo group and 18.91 (102.27) in the intervention group (p < 0.025). Considering the secondary end points, treated patients reported greater urine pH decreases (p = 0.002). No differences in the incidence of adverse events were identified between the groups. Conclusions: Our data suggest that the use of this new oral composition is beneficial in the context of ureteral double J indwelling by decreasing mean, as well as global encrustation.
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