[Useful investigations for the prevention of recurring lithiasis (in the absence of anomalies of the urinary tract)].
The prevalence of renal lithiasis and the rate of recurrences in affected patients raises the problem of the minimum number of investigations really needed to arrive at an accurate diagnosis and establish a potentially effective treatment. Stone recuperation is very important as it allows to carry out an accurate analysis of its constituent(s) (frequently heterogenous). Such analysis already brings forth accurate indications as to the etiology. Other biological investigations should be limited after a first episode of kidney stone disease, but recurring lithiasis will necessitate a much more thorough work-up. Recurrences in certain lithiases, such as those caused by urate calculi, are readily prevented by conventional therapy (uricosuric agents, alkalinization of urine). Withdrawal of certain medicines is paramount in iatrogenic lithiasis. Regarding calcium stones associated with hypercalciuria, results from dynamic tests and their pertinence for differentiating between hypercalciuria due to abnormally high digestive absorption and that due to excessive elimination are currently strongly contested. The role of alimentary factors seems extremely important and prescription of adapted diets appears to be quite effective in view of the present lack of crystal formation inhibitors.
Service de Néphrologie, Hôpital Pasteur, Nice.
H
H
Duplay
J
J
Bracco
D
D
Barrillon
E
E
Cassuto-Viguier
N
N
Montagne
D000236:Adenoma / Q000175:diagnosis; D002118:Calcium / Q000652:urine*; D003404:Creatinine / Q000652:urine; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000175:diagnosis; D012008:Recurrence; D014545:Urinary Calculi / Q000175:diagnosis / Q000517:prevention & control* / Q000652:urine
D010281:Parathyroid Hormone; D003404:Creatinine; D002118:Calcium
Les investigations utiles pour la prévention des récidives des lithiases (en l'absence d'anomalies des voies urinaires).