Renal stone disease: causes, evaluation and medical treatment

The purpose of the present review is to provide an update about the most common risk factors or medical conditions associated with renal stone formation, the current methods available for metabolic investigation, dietary recommendations and medical treatment. Laboratory investigation of hypercalciur...

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Detalles Bibliográficos
Autores: Heilberg, Ita Pfeferman [UNIFESP], Schor, Nestor [UNIFESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2006
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:inglés
OAI Identifier:oai:repositorio.unifesp.br:11600/3178
Acceso en línea:http://dx.doi.org/10.1590/S0004-27302006000400027
http://repositorio.unifesp.br/handle/11600/3178
Access Level:acceso abierto
Palabra clave:Kidney stones
Nephrolithiasis
Hypercalciuria
Osteopenia
Calcium
Oxalate
Cálculos renais
Nefrolitíase
Hipercalciúria
Cálcio
Oxalato
Descripción
Sumario:The purpose of the present review is to provide an update about the most common risk factors or medical conditions associated with renal stone formation, the current methods available for metabolic investigation, dietary recommendations and medical treatment. Laboratory investigation of hypercalciuria, hyperuricosuria, hyperoxaluria, cystinuria, hypocitraturia, renal tubular acidosis, urinary tract infection and reduction of urinary volume is based on the results of 24-hr urine collection and a spot urine for urinary sediment, culture and pH. Blood analysis for creatinine, calcium and uric acid must be obtained. Bone mineral density has to be determined mainly among hypercalciurics and primary hyperparathyroidism has to be ruled out. Current knowledge does not support calcium restriction recommendation because it can lead to secondary hyperoxaluria and bone demineralization. Reduction of animal protein and salt intake, higher fluid intake and potassium consumption should be implemented. Medical treatments involve the use of thiazides, allopurinol, potassium citrate or other drugs according to the metabolic disturbances. The correction of those metabolic abnormalities is the basic tool for prevention or reduction of recurrent stone formation.