MEDICAL THERAPY : Calcium Oxalate Urolithiasis - 11/09/11

Doi : 10.1016/S0094-0143(05)70358-X

Lisa A. Ruml, MD ^{^{*
From the Center for Mineral Metabolism and Clinical Research, and the Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas}}, Margaret S. Pearle, MD, PhD ^{^{*
From the Center for Mineral Metabolism and Clinical Research, and the Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas}}, Charles Y.C. Pak, MD ^{^{*
From the Center for Mineral Metabolism and Clinical Research, and the Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas}}

Resumen

Nephrolithiasis is a common disorder with a lifetime recurrence rate as high as 80%.^{4 Almby B., Meirik O., Schönebeck J. Incidence, morbidity and complications of renal and ureteral calculin (sic) a well defined geographical area Scand J Urol Nephrol 1975 ; 9 : 249 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 13 Blacklock N.J. The pattern of urolithiasis in the Royal Navy Renal Stone Research Symposium London: Churchill (1969).
33

Haga clic aquí para ir a la sección de Referencias, 59 Henriksson C., Geterud K., Pettersson S. , y al. Stone recurrences in kidneys made stone-free by percutaneous extraction Scand J Urol Nephrol 1993 ; 27 : 151 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 66 Johnson C.M., Wilson D.M., O'Fallon W.M. , y al. Renal stone epidemiology: A 25 year study in Rochester, Minnesota Kidney Int 1979 ; 16 : 624

Haga clic aquí para ir a la sección de Referencias, 85 Norlin A., Lindell B., Granberg P. , y al. Urolithiasis. A study of its frequency Scand J Urol Nephrol 1976 ; 10 : 150 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 140 Williams R.C. Long-term survey of 538 patients with upper urinary tract stones Br J Urol 1963 ; 35 : 416 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} Along with the great strides that have been made in the surgical management of nephrolithiasis, with the advent of shock wave lithotripsy and the resurgence of percutaneous procedures, refinements in the medical management of stone disease have resulted in a significant reduction in the rate of stone formation. Most patients with kidney stones have at least one identifiable physiologic derangement that results in abnormal levels of one or more stone-forming constituents, promoters, or inhibitors; often, these derangements are correctable. Consequently, not only can stone formation be reduced^{90 Pak C.Y.C. Sodium cellulose phosphate: Mechanism of action and effect on mineral metabolism J Clin Pharmacol 1973 ; 13 : 15

Haga clic aquí para ir a la sección de Referencias} but also the postsurgical stone-free rate can be improved.^{24 Cicerello E., Merlo F., Gambaro G. , y al. Effect of alkaline citrate therapy on clearance of residual renal stone fragments after extracorporeal shock wave lithotripsy in sterile calcium and infection nephrolithiasis patients J Urol 1994 ; 151 : 5

Haga clic aquí para ir a la sección de Referencias, 127 Suzuki K., Tsugawa R., Ryall R.L. Inhibition by sodium-potassium citrate (CG-120) of calcium oxalate crystal growth on to kidney stone fragments obtained from extracorporeal shock wave lithotripsy Br J Urol 1991 ; 68 : 132

Haga clic aquí para ir a la sección de Referencias} The causes of urolithiasis have been reviewed elsewhere and are mentioned here only as they pertain to medical management strategies.

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Esquema

CONSERVATIVE MEASURES

Resorptive Hypercalciuria

Primary Hyperoxaluria

Enteric Hyperoxaluria

Idiopathic Hyperoxaluria

ANATOMIC ABNORMALITIES

CONCLUSION

Address reprint requests to Margaret S. Pearle, MD, PhD, University of Texas, Southwestern Medical Center, Division of Urology, 5323 Harry Hines Boulevard, Dallas, TX 75235–9110