O que há de novo no diagnóstico e tratamento da litíase urinária?

Abstract

Objective. To review developments in the diagnosis and treatment of urinary lithiasis. MethOds. A review of the most important articles on the subject published in Medline indexed periodicals between 1979 and 2009. Results. Stones occur with greater frequency among people with BMI > 30. Computerized tomography without contrast provides the correct diagnosis in up to 98% of cases. Alpha-adrenergic blockers increase elimination of ureteral calculi smaller than 8 mm by 29%. The proportion of patients free from calculi after ESWL varies from 35% to 91%, depending on size and location. In between 60% and 100% of cases, renal calculi larger than 2 cm are eliminated with PCNL. Calculi of the distal ureter are successfully treated in up to 94% of cases using semi-rigid ureteroscopy, compared to 74% using ESWL. For calculi of the upper ureter success rates are around 77% and 91% for ureteroscopy and 41% and 82% for ESWL. cOnclusiOn. The association between urinary lithiasis and Diabetes mellitus, is well-established. Computerized tomography without contrast is currently the gold standard for diagnosis of urinary lithiasis. In Brazil, ESWL is the method of choice for treating renal calculi smaller than 2 cm and with tomographic density < 1000 HU, except those of the lower pole, where the ideal limit for treatment is 1 cm. Percutaneous nephrolithotripsy is the best method of treating renal calculi larger than 2 cm and semi-rigid ureteroscopy is the best treatment for calculi of the distal ureter. Flexible ureteroscopy is an option for calculi of the upper ureter and renal calculi smaller than 1.5 cm that do not respond to ESWL or where PCNL is contraindicated.

Metabolic investigation in patients with nephrolithiasis

“…The peak incidence of nephrolithiasis occurs between 40 and 60 years of age. ( 3 ) In this study, we noted that the mean age of patients at the time of metabolic investigation was 49 years, with a slight predominance of women, which could suggest greater compliance of women with the metabolic investigation.…”

“…( 2 ) Up to 15% of world population will experience one episode of renal calculus during their lifetime, and more than 50% will have a relapse within 10 years. ( 2 , 3 ) In females, the peak of occurrence is at approximately 30 years of age, and decreases after 50 years, whereas in men, the peak occurs between the fourth and sixth decade of life. ( 3 )…”

“…( 2 , 3 ) In females, the peak of occurrence is at approximately 30 years of age, and decreases after 50 years, whereas in men, the peak occurs between the fourth and sixth decade of life. ( 3 )…”

Temas transversais em saúde coletiva

“…Ainda em contradição com os dados apresentados por YU et al (2021a), Mazzucchi e Srougi (2009) identificam a terapia expulsiva através dos bloqueadores alfadrenérgicos, contribuem positivamente para eliminação dos cálculos renais menores que 8mm, além de reduzir os episódios de dor entre os pacientes.…”

O uso da planta “Canarana” (Costus arabicus L.) no tratamento de cálculo renal em uma comunidade tradicional do nordeste paraense-Amazônia-Brasil

“…Os cálculos renais são formações de pequenos cristais no trato urinário por ação de diferentes sais minerais semelhantes a verdadeiras pedras, ocasionando transtorno doloroso, causado pela concentração desses cristais nos rins (Ahmed;Hasan & Mahmood, 2016). Essa doença do sistema urinário acomete 12% da população mundial e ocupa o terceiro lugar entre Research, Society and Development, v. 9, n. 8, e582985637, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i8.5637 4 as doenças mais recorrentes do sistema geniturinário (Mazzucchi & Srougi, 2009), apresentando diferentes fatores para o seu aparecimento, como o sexo, a idade, a região geográfica, o clima, estilo de vida, a raça, ocorrendo prevalentemente em homens brancos (McDougal et al, 2015).…”