Metabolic Diagnosis of Nephrolithiasis. Clinical Cases (Part II)

Authors

  • Corrado Vitale SC Nefrologia e Dialisi, AO Ordine Mauriziano di Torino, Torino
  • Amelia Rodofili SC Nefrologia e Dialisi, AO Ordine Mauriziano di Torino, Torino
  • Francesca Bermond SC Nefrologia e Dialisi, AO Ordine Mauriziano di Torino, Torino
  • Alberto Tricerri SC Nefrologia e Dialisi, AO Ordine Mauriziano di Torino, Torino
  • Martino Marangella Fondazione Scientifica Mauriziana ONLUS, Torino

DOI:

https://doi.org/10.33393/gcnd.2017.616

Keywords:

Cystinuria, Hyperoxaluria, Nephrolithiasis, Primary hyperparathyroidism, Urolithiasis

Abstract

This is the second part of an article on the metabolic diagnosis of nephrolithiasis, the first part of which was published in the previous issue of this journal. Here we report on three clinical cases representative of a rational diagnostic workup of nephrolithiasis in specific clinical contexts: secondary hyperuricemia, cystinuria, and primary hyperoxaluria. Nephrolithiasis is one of the most frequent causes of hospitalization in nephrology and urology units in our country and is an important source of discomfort in affected patients. Despite the availability of modern, minimally invasive endourological procedures to remove stones from the urinary tract, prevention of stone recurrences remains an essential strategy. Chemical analysis of stones, whether passed spontaneously or removed surgically, is a crucial step in etiological diagnostics aimed at devising adequate prevention strategies. Modern endoscopic lithotripsy techniques provide complete fragmentation of stones and, compared to extracorporeal shock wave lithotripsy, have the advantage of avoiding painful elimination of fragments through the urinary tract. This means, however, that stone fragments are often unavailable for analysis, thereby depriving the nephrologist of an important tool for diagnosis. As a consequence, metabolic evaluation tends to be the only means of establishing the etiology of stones and preventing their recurrence. We conclude that close collaboration between nephrologists and urologists is a prerequisite for optimizing the diagnosis and treatment of stone disease.

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Published

2016-11-09

How to Cite

Vitale, C., Rodofili, A., Bermond, F., Tricerri, A., & Marangella, M. (2016). Metabolic Diagnosis of Nephrolithiasis. Clinical Cases (Part II). Giornale Di Clinica Nefrologica E Dialisi, 29(1), 24–31. https://doi.org/10.33393/gcnd.2017.616

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Short Communications

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