Metabolic investigation of patients with urolithiasis in a specific region

Peres, Luís Alberto Batista; Molina, Angie; Galles, Marcos Henrique Lima

doi:10.1590/s1677-55382003000300004

Cited by 10 publications

(9 citation statements)

References 10 publications

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“…Cystinuria is an autosomal recessive disorder affecting 1% of adults and 10% of children with kidney stones. In Brazil, screening for this disorder is usually done with sodium nitroprusside 5,6 . The test is considered positive when the concentration of cystine in the urine is above 100mg/L 14 .…”

Section: Morphological Analysismentioning

confidence: 99%

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Chemical and morphological analysis of kidney stones: a double-blind comparative study

et al. 2010

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Purpose:To compare chemical to morphological kidney stone composition analysis based on a sample of 50 stones retrieved from patients at a nephrology service. Methods: The chemical analysis was performed with a Bioclin ® kit, while a 10-mm magnifying glass (10x; Prolabo, Paris, France) was employed in the morphological analysis. Findings obtained with the two methods were compared and classified as concordant (100% agreement), partly concordant (concordant for major components, discordant for minor components) or discordant (discordant for major components). Results: In the chemical analysis, the most commonly observed major component was calcium (70%), followed by oxalate (66%), ammonium (56%), urate (28%) and carbonate (24%). In the morphological analysis, the most commonly observed major components were calcium phosphate and magnesium (32% each), followed by calcium oxalate monohydrate (24%), uric acid and urates (20% each), calcium oxalate dihydrate (18%) and cystine (6%). Infectious kidney stones were identified in 34% and 24% of cases by morphological and chemical analysis, respectively. Thirty-eight percent of the samples were classified as concordant, 52% were partly concordant and 10% were discordant. Conclusion: We suggest kidney stones be routinely submitted to both types of analysis for a better understanding of the mechanisms involved in lithogenesis. Key words: Morphology. Urinary Calculi. Urinary Bladder Calculi. RESUMO Objetivo:Comparar a análise química com a análise morfológica de 50 cálculos urinários provenientes de pacientes em um serviço de nefrologia. Métodos: A análise química foi realizada utilizando o kit da Bioclin ® , enquanto que a morfológica foi realizada com auxílio de uma lupa de 10mm (Prolabo, Paris, France). A comparação entre as técnicas foi classificada em concordante (100% de concordância), parcialmente concordante (componentes majoritários concordantes e minoritários discordantes) e discordante (discordância nos componentes majoritários). Resultados: Na análise química os principais componentes majoritários foram cálcio (70%), oxalato (66%), amônio (56%), urato (28%) e carbonato (24%). Na análise morfológica os principais componentes majoritários foram fosfato cálcico (PCa) e magnesiano-PCa (32%), oxalato de cálcio monohidratado (24%), ácido úrico e uratos (20%), oxalato de cálcio dihidratado (18%) e cistina (6%). Cálculos de infecção foram identificados em 34% e 24% casos pela análise morfológica e química, respectivamente. Concordância total foi observada em 38%, concordância parcial em 52% e discordância em 10%. Conclusão: Sugere-se a utilização simultânea das duas técnicas para melhor compreensão dos mecanismos litogênicos.

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Section: Morphological Analysismentioning

confidence: 99%

“…The main related metabolic changes observed are hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia and hypomagnesiuria [4][5][6] . These metabolic disorders are risk factors for lithiasis, but may occur in patients who never develop kidney stones.…”

Section: Introductionmentioning

confidence: 99%

Chemical and morphological analysis of kidney stones: a double-blind comparative study

et al. 2010

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“…In this study, hypercalciuria was the prevalent metabolic change. In the West of Paraná, the ingestion of milk and dairy products is not expressive; meanwhile, the ingestion of salt and protein is frequent, which probably contributes to the occurrence of hypercalciuria 10 .…”

Section: Discussionmentioning

confidence: 99%

“…Hypercalciuria, hyperuricosuria, hypocitraturia, hyperoxaluria, cystinuria and urinary infection are the main causes of calculus formation 9,10 .…”

Section: Nephrolithiasismentioning

confidence: 99%

Investigação de nefrolitíase no Oeste do Paraná

Peres¹,

Almeida²,

Bolson³

et al. 2011

J. Bras. Nefrol.

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ResumoIntrodução: Nefrolitíase é comum e tem alta taxa de recorrência. Objetivos: Avaliar a prevalência das principais alterações metabólicas e anatômicas e a análise química do cálculo encontrado em pacientes com nefrolitíase na região Oeste do Paraná. Métodos: Foi realizado um estudo retrospectivo em 681 pacientes adultos com nefrolitíase. A investigação laboratorial incluiu pelo menos duas amostras de urina de 24 horas, com dosagens de cálcio, ácido úrico, citrato, oxalato, sódio e creatinina; cistinúria qualitativa, pH urinário após 12 horas de jejum e restrição hídrica, urocultura e análise química do cálculo, quando disponível. Técnicas de imagem renal incluíram pelo menos ultrassonografia e urografia excretora. Resultados: As alterações metabólicas mais frequentemente encontradas foram: hipercalciúria (51,8%), hiperuricosúria (27,6%) e hipocitratúria (23,5%). A análise química dos cálculos mostrou oxalato de cálcio em 85,7% dos casos. As alterações anatô-micas mais frequentes foram: cisto renal, duplicação pieloureteral e obstrução da junção pieloureteral. Conclusões: Este trabalho serviu de base para o conhecimento das características de pacientes com nefrolitíase na região Oeste do Paraná. Palavras-chave: nefrolitíase, hipercalciúria, oxalato de cálcio. AbstRActIntroduction: Nephrolithiasis is common and has a high rate of recurrence. Objectives: To assess the prevalence of the main metabolic and anatomical changes and the chemical analysis of stone found in patients with nephrolithiasis in the West region of Paraná. Methods: Retrospective study with 681 adult patients with nephrolithiasis. The laboratory investigation included at least two samples of 24-hour urine test with doses of calcium, uric acid, citrate, oxalate, sodium and creatinine; qualitative cystinuria, urinary pH following 12-hour fast and water restriction, urine culture and chemical analysis, when the stones were available. Renal imaging techniques included at least renal ultrasound and excretory urogram. Results: The metabolic changes most frequently found were: hypercalciuria (51.8%), hyperuricosuria (27.6%), and hypocitraturia (23.5%). Chemical analysis of stones showed calcium oxa late in 85.7% of the cases. The most frequently anatomical changes were renal cyst, duplicated ureter, and ureteropelvic junction obstruction. Conclusions: This paper served as a base for knowing the characteristics of patients with nephrolithiasis in the West area of Paraná.

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“…However, these disorders are not routinely investigated in these patients, and its frequency varies widely according to ethnical and environmental factors. Different studies of metabolic assessment in patients with urinary lithiasis have reported a high incidence of metabolic disorders as a causal factor (3,4). Recently, Akagashi and others (5) evaluated 82 Japanese patients with staghorn calculus and found the following metabolic alterations: hypercalciuria in 37.8% and cistinuria in 2.4%.…”

Section: Commentsmentioning

confidence: 99%

Metabolic investigation of patients with staghorn calculus: is it necessary?

Amaro¹,

Goldberg²,

Agostinho³

et al. 2009

Int. braz j urol.

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Objective: To evaluate the prevalence of metabolic disorders in patients with staghorn calculi treated at the Regional Center of Lithiasis Metabolic Studies in central region of São Paulo State, Brazil. Materials and Methods: Between February 2000 and February 2008, 630 patients with urinary calculi were evaluated in the lithiasis outpatient clinic. Thirty-seven of them had staghorn calculi (35 women and 2 men). The inclusion criteria for the metabolic investigation included the absence of urological manipulation 30 days before the examination, negative urine culture and creatinine clearance > 60 mL/min. The protocol for metabolic investigation consisted of qualitative search for cystinuria. Two non-consecutive 24-hour urine samples collected to measure calcium, phosphorus, uric acid, sodium, potassium, magnesium, oxalate and citrate, and serum calcium levels , phosphorus, uric acid, sodium, potassium, magnesium, chloride, parathormone and urine pH. Results: Among patients with lithiasis, 5.9% (37/ 630) had staghorn calculus and in 48.6% (18/37) were diagnosed with urinary infection. The females were predominant for 94.5% of cases. The calculi were unilateral in 31 of cases and bilateral in six. Metabolic abnormalities were found in 68.2% of patients with hypercalciuria (64.2%) and hypocitraturia (53.3%) being the most common disorders. Conclusions: The presence of metabolic disorders in nearly 70% of patients with staghorn calculus reinforces the necessity for evaluation of these patients. The diagnosis and treatment of identified metabolic abnormalities can contribute to the prevention of recurrent staghorn calculi.

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Metabolic investigation of patients with urolithiasis in a specific region

Cited by 10 publications

References 10 publications

Chemical and morphological analysis of kidney stones: a double-blind comparative study

Chemical and morphological analysis of kidney stones: a double-blind comparative study

Investigação de nefrolitíase no Oeste do Paraná

Metabolic investigation of patients with staghorn calculus: is it necessary?

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