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PubMed1990

[The significance of hypocitruria in calcium oxalate induced nephrolithiasis].

The citrate concentration of the daily collected urine was measured by citrate lyase method in 25 untreated patients with recurrent calcium stone disease (10 hypercalciuric and 15 normocalciuric) and in 11 patients with stone disease treated with hydrochlorothiazide and in 16 healthy controls. We found a great variancy of the results what rather looks like biological than methodic type. The concentration (1.99 +/- 1.33 mmol/l in normocalciuric and 2.77 +/- 1.62 in hypercalciuric stone formers but 5.06 +/- 2.81 in controls) and the daily output of the urinary citrate (2.74 +/- 1.38 mmol/d and 4.24 +/- 1.69 vs. 4.41 +/- 1.85) but not the citrate/creatinine ratio was significantly less in about the half of stone formers. The hypocitraturia was frequent in the normocalciuric and very rare in the hypercalciuric group of the renal stone patients. Measurement of the urine citrate concentration is more sensitive tool in the diagnosis of hypocitraturic state than daily citrate output while the latter is more characteristic for the patient, so common study of the two parameters is recommended.

Adult↗
PubMed1990

Low specific gravity urine with crystalluria as discriminant index for nephrolithiasis.

A community-based study for crystalluria in morning urine (MU) specimens was carried out under light microscopy. The MU specimens were collected from 29 males with renal stones (GI), 36 age-and sex-matched normal controls (GII) and 27 household members of GI who did not have stones (GIII). The findings can be summarized as follows. 1. In the groups as a whole, almost all crystal and crystal aggregate found was oxalate type and with highest prevalence in GI. 2. In urine with low specific gravity (SG) i.e. less than or equal to 0.010, prevalence of oxalate crystals in GI (57.7%) was significantly higher (p less than 0.05) than in both GII (5.9%) and GIII (13%). Furthermore, at this range of SG, 15 per cent of the MU specimens in GI showed aggregation of oxalate crystals, whereas, the condition was neither found in GII nor GIII. 3. Our data suggest urine supersaturation with respect to calcium oxalate was found in both renal stone patients and normal subjects but more frequently in the former and also suggests more deficiency or lack of inhibitors for oxalate crystal nucleation and aggregation in urine of renal stone patients. The occurrence of oxalate crystals and crystal aggregates in urine of low SG may be useful as an index to discriminate stone patients from normal subjects or as an index to indicate the high risk group in the community.

Adult↗
PubMed1990

Blood pressure changes following extracorporeal shock wave lithotripsy and other forms of treatment for nephrolithiasis.

Hypertension has been reported as a possible sequela of extracorporeal shock wave lithotripsy (ESWL). To evaluate this issue as well as the risk of hypertension following other current non-ESWL treatment options for urolithiasis (percutaneous nephrostolithotomy [PCNL], combined PCNL and ESWL, ureteroscopy, and spontaneous stone passage), detailed blood pressure measurements were made in 961 patients at least 1 year after treatment. All follow-up blood pressures were measured with random-zero blood pressure devices. This study includes 731 patients who received ESWL only (with an unmodified lithotriptor), 171 patients treated with ureteroscopy or spontaneous stone passage (control subjects), 25 patients who received PCNL only, and 34 patients treated with both ESWL and PCNL. In patients who received ESWL only, the annualized incidence of hypertension (2.4%) did not differ significantly from that in control patients (4.0%). Among patients who received ESWL, no correlation was found between the incidence of hypertension and unilateral vs bilateral treatments, the number of shock waves administered, the kilovoltage applied, or the power (number of shock waves times kilovoltage). However, there was a significant rise in diastolic blood pressure after treatment with ESWL (0.78 mm Hg), but not in the control group (-0.88 mm Hg). The long-term significance of this change in diastolic blood pressure following ESWL is unknown and requires further study.

Blood Pressure↗
PubMedDate not supplied

[Resection of the kidney in nephrolithiasis].

The results of 155 partial nephrectomies performed in 149 patients during the years 1962-1981 are discussed. Indications, surgical technique, complications and results are presented. The results show that partial nephrectomy has an acceptably low risk and late results show lower recurrence of stone formation as compared with pyelolithotomy or nephrolithotomy. The rate of true ipsilateral recurrences was 18.69 per cent in 123 followed kidneys.

Adolescent↗
PubMed1990

Percutaneous litholapaxy. Indications and limitations of the technique in complex nephrolithiasis.

In the present study, the authors analyze the radical change in the treatment of complex renal lithiasis. They advocate the use of this combined approach in patients with a large stone mass or those with obstructive problems of the urinary tract. They discuss the contraindications of this technique; i.e., pelvic kidney, septic urinary infections and severe cardiopulmonary disease. From 1983 to June 1988, a total of 5,657 stone patients were treated at their department; 921 were treated by PCNL combined with ESWL. In 92% of the cases, PCNL was successful in removing most of the stone mass. The complications encountered were fever, hemorrhage, colon perforation, stenosis of UPJ post-PCNL and intrathoracic extravasation. Nephrectomy was warranted in 2 cases due to complication.

Humans↗
PubMed1989

Nephrolithiasis.

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Humans↗
PubMed1989

[Results of radionuclide study of the single kidney remaining after nephrectomy in nephrolithiasis].

Computerized dynamic gamma scintigraphy with indirect radionuclide angiography was carried out in 29 patients with a single kidney. It was found that patients with a single kidney show already at the stage of "intact" organ persistent disorders of intrarenal hemodynamic processes as well as chronic urostasis. This variant of radionuclide examination may be used in the prophylactic management of this category of patients.

Humans↗