Avaliação metabólica em litíase urinária: papel do magnésio e sódio urinários como fatores de risco na litogênese
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Data
2003
Autores
Amaro, Carmen Regina Petean Ruiz [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A urolitíase é a terceira causa de afecção do trato urinário, com recorrência em torno de 50% em 5 anos após o primeiro cálculo. Afeta de 1 a 20% da população mundial, estando envolvidos fatores genéticos, epidemiológicos, diferenças geográficas, hábitos alimentares e, menos comumente, distúrbios hormonais. As investigações metabólicas têm grande importância na prevenção desta patologia. Os objetivos deste trabalho foram: diagnosticar os distúrbios metabólicos de pacientes litiásicos do Serviço de Litotripsia do Departamento de Urologia do Hospital das Clínicas da Faculdade Medicina de Botucatu-UNESP, estudar o sódio e o magnésio urinários como fatores de risco e conhecer aspectos epidemiológicos dessa população. PACIENTES E MÉTODOS: Foram estudados 158 pacientes com idade superior a 12 anos, no período de Fevereiro de 2000 a Dezembro de 2001. Foram incluidos pacientes com história e exames por imagem comprobatórios de no mínimo 2 cálculos, clearance de creatinina ≥ 60 ml/min e urocultura negativa. O protocolo consistiu da coleta não simultânea de 2 amostras de urina de 24h, para dosagens de Ca, P, AcU, Na, K, , Mg, Ox e Ci e dosagens séricas de glicemia, Ca, P, FA, AcU, Na, K, Cl, Mg, U, Cr; Realização do índice Ca/Cr urinários; índice Ca/Mg em urina 24h; índice de recorrência; pH urinário; prova de acidificação urinária. RESULTADOS: Os resultados obtidos foram: dos 158 pacientes estudados, 151 apresentaram pelo menos uma alteração metabólica. Destes,94(62,2%) apresentaram alteração metabólica isolada e 57(37,8%) alterações mistas. Os principais distúrbios encontrados foram: hipercalciúria(74,0%), hipocitratúria(37,3%), hiperoxalúria(24,1%), litíase úrica(20,2%), hiperparatireoidismo 1ario(1,8%) 2 ario (0,6%) e ATR(0,6%). A hipernatriúria esteve presente em 50% dos pacientes e a hipomagnesúria...
Urolithiasis is the third cause of urinary tract disease, with about 50% reoccurrence within five years of the first calculus. It affects between 1 and 20% of the world’s population, involving genetic and epidemiological factors, such as race; geographic differences; eating habits; and less commonly hormone disorders. Metabolic investigations are very important in preventing this pathology. The objectives of this work were to diagnose metabolic disorders in lithiasic patients from the Lithotripsy Service, Urology Department HC, FMB-UNESP, study sodium and magnesium as risk factors, and look at epidemiological aspects of this population. PATIENTS AND METHODS: We studied 158 patients all over 12 years old between February 2000 and December 2001. Patients were included with history and image exam confirmation of a minimum of 2 calculi, creatinine clearance ≥ 60 ml/min, and negative uroculture. The protocol consisted of non-simultaneous collect of two 24 hour urine samples for Ca, P, AcU, Na, K, Mg, Ox, and Ci levels, and serum levels of glycemia, Ca, P, FA, AcU, Na, K, Cl, Mg, U, and Cr; calculation of urine Ca/Cr index; 24h urine Ca/Mg index; recurrence index; urine pH; and urine acidity test. RESULTS: From the 158 patients studied, 151 presented at least one metabolic alteration; of these 94 were isolated alterations and 57 mixed. The main disorders were: hypercalciuria (74.0%); hypocitraturia (37.3%); hyperoxaluria (24.1%); uric acid lithiasis (20.2%); primary hyperparathyroidism (1.8%), secondary (0.6%); and ATR (0.6%). Hypernatriuria was present in 59% of patients and hypomagnesuria in 20.9%. Consumed water and urine volume did not show as risk factors. Hypernatriuria showed significant positive correlation in the male group only. There was no significant correlation between hypomagnesuria and...(Complete abstract click electronic address below)
Urolithiasis is the third cause of urinary tract disease, with about 50% reoccurrence within five years of the first calculus. It affects between 1 and 20% of the world’s population, involving genetic and epidemiological factors, such as race; geographic differences; eating habits; and less commonly hormone disorders. Metabolic investigations are very important in preventing this pathology. The objectives of this work were to diagnose metabolic disorders in lithiasic patients from the Lithotripsy Service, Urology Department HC, FMB-UNESP, study sodium and magnesium as risk factors, and look at epidemiological aspects of this population. PATIENTS AND METHODS: We studied 158 patients all over 12 years old between February 2000 and December 2001. Patients were included with history and image exam confirmation of a minimum of 2 calculi, creatinine clearance ≥ 60 ml/min, and negative uroculture. The protocol consisted of non-simultaneous collect of two 24 hour urine samples for Ca, P, AcU, Na, K, Mg, Ox, and Ci levels, and serum levels of glycemia, Ca, P, FA, AcU, Na, K, Cl, Mg, U, and Cr; calculation of urine Ca/Cr index; 24h urine Ca/Mg index; recurrence index; urine pH; and urine acidity test. RESULTS: From the 158 patients studied, 151 presented at least one metabolic alteration; of these 94 were isolated alterations and 57 mixed. The main disorders were: hypercalciuria (74.0%); hypocitraturia (37.3%); hyperoxaluria (24.1%); uric acid lithiasis (20.2%); primary hyperparathyroidism (1.8%), secondary (0.6%); and ATR (0.6%). Hypernatriuria was present in 59% of patients and hypomagnesuria in 20.9%. Consumed water and urine volume did not show as risk factors. Hypernatriuria showed significant positive correlation in the male group only. There was no significant correlation between hypomagnesuria and...(Complete abstract click electronic address below)
Descrição
Palavras-chave
Aparelho urinario - Cálculos - Metabolismo, Urolitíase, Urolithiasis
Como citar
AMARO, Carmen Regina Petean Ruiz. Avaliação metabólica em litíase urinária: papel do magnésio e sódio urinários como fatores de risco na litogênese. 2003. 107 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2003.