Hüsamettin ERDAMAR, Banu SANCAK, Neslihan BUKAN, Hatice PAŞAOĞLU

Nefrolitiazisli Hastalarda 24 Saatlik İdrar ve Serum Parametreleri Arasında İlişki

Amaç: Nefrolitiazis yaygın bir hastalık olmasına rağmen, böbrekteki taş oluşum mekanizması tam olarak anlaşılamamıştır. İdrarda yüksek konsantrasyonda oksalat, ürik asit, kalsiyum ve fosfor bulunması nefrolitiazis oluşma riskini arttırırken; sitrat, magnezyum, albumin düzeylerinin yüksekliği ve idrarın alkali olması ise bu riski azaltmaktadır. Bu çalışmada nefrolitiasizli hastalarda serum ve 24 saatlik idrar analizi sonucu elde edilen parametreler arasındaki muhtemel ilişkiyi tespit etmeyi amaçladık. Gereç ve Yöntem: 231 adet nefrolitiazisli hasta (18-65 yaşları arasında; 143 erkek, 88 kadın)retrospektif olarak incelendi. Bulgular: İdrar ve serum kreatinin değerleri ile idrar ve serum ürik asit değerleri arasında [sırasıyla r= 0.70, (p

Anahtar Kelimeler:

24 Saatlik idrar analizi, nefrolitiazis, sitrat, okzalat, fosfat

Relationship Between 24-Hour Urine and Serum Parameters in Patients with Nephrolithiasis

Objective: Nephrolithiasis is a common disease, whereas the mechanisms by which stones develop in the kidney are poorly understood. While high levels of oxalate, uric acid, calcium, and phosphate in the urine increase the formation of nephrolithiasis, increased urinary excretion of citrate, magnesium, albumin and alkali urine decrease this process. In this study, we aimed to identify the possible relationship between some serum and 24- hour urinary parameters in patients with nephrolithiasis. Materials and Methods: Two hundreds thirty-one patients with nephrolithiasis (aged 18-65 years; 143 men, 88 women) were retrospectively examined in this study. Results: Significant correlations observed between urine and serum levels of creatinine with urine and serum levels of uric acid [r= 0.70, (p

Keywords:

-,

PDF

___

Parks YJ, Coe LF: The financial effects of kidney stone prevention. Kidney International. 1996; 50: 1706-1712
Bisaz S, Felix R., Newman WF, Fleisch H: Quantitative determination of inhibitors of calcium phosphate precipitation in whole urine. Min Electrolyte Metab. 1978; 1:74
Tiselius HG: Urinary Excretion of Citrate in Normal Subjects and Patients with Urolithiasis. Plenum Press, New York, 1981
Welshman SG, Mc Geown MG: Urinary citrate excretion in stone-formers and normal controls. Br J Urol. 1976; 48: 7-11
Hodgkinson A: Citric Acid Excretion of Citrate in Normal Adults and in Patients with Renal Calculus. Clin Sci. 1962; 23: 203-212
Elliot JS, Riberio ME: The urinary excretion of citric, hippuric and lactic acid in normal adults and in patients with calcium oxalate urinary calculus disease. Invest Urol. 1972; 10: 102-106
Sehwille PO, Scholz D, Paulus M, Engelhardt W, Sigel A:. Citrate in Daily and fasting urine. Invest Urol. 1979; 16: 457-462
Robertson WG, Peacock M, Nordin BEC: Activity products in stone-forming urine. Clin Sci.1968; 32: 579-594
Welshman SG, Mc Geown MG: A quantitative investigation of the effects on the growth of calcium oxalate crystals of potential inhibitors. Br J Urol. 1972; 44: 677-680
Pylypchuk G, Ehrig U, Wilson DR: Idiopathic calcium nephrolithiasis. 1. Differences in urine crystalloids, urine saturation with brushite and urine inhibitors of calcification between persons with and persons without recurrent kidney stone formation. Can Med Assoc. J, 1979; 17: 658-665
Butz M: Oxalatsteinprophylaxe durch alkali-theriape. Urologe. 1982; 21: 142-146
Rudman D, Kutner MH, Redol SC, Waters WC, Gerron GG, Bleier J: Hypocitraturia in calcium nephrolithiasis. J Clin Endocrnol Metab. 1982; 55: 1052-1057
Nicar MJ, Skurla C, Sakhaec K, Pak CYC: Low urinary citrate excretion in nephrolithiasis. Urology. 1983; 21: 8-14
Menon M., Mahle CJ: Urinary citrate excretion in patients renal calculi. J Urol. 1983; 129: 1158-1160
Millan A, Conte A, Garcia Raso A, Grases F: Determination of Citrate in urine by simple direct photometry. Clin Chem. 1987; 33: 1259-1260
Robertson WG, Peacock M, Nordin BEC: Activity products in stone-forming and non stone-forming urine. Clin Sci. 1968; 32: 579-594
Robertson WG, Peacock M, Nordin BEC: Calcium oxalate crystalluria and urine saturation in recurrent renal stone-formers. Clin Sci. 1971; 40: 365-374
Robertson WG, Peacock M, Heyburn PJ, Marshall DH, Clark PB: Risk factors in calcium stone disease of the urinary tract. Br J Urol.1978; 50: 449-454
Marshall RW, Barry HH: Urine Saturation and the formation of calcium Containing Calculi. The effects of various forms of therapy. Karger, Basel 1973
Fellstrom B, Backman U, Danielson BG, Johansson G, Ljunghall S, Wikstrom B: Urinary excretion of urate in renal calcium stone disease and tubular acidification disturbances. J Urol. 1982; 127: 589-592
Dumoulin G, Haton D, Wolf JP, Henriet MT, Nguyen NU, Mougin C, Saint-Hiller Y, Combes M, Berthelay S: Comparative study of urinary calcium, oxalate and uric acid in calcium oxalate lithiasis. Nephrologie. 1984; 5: 189-191
Duranti E, Imperiali P, Badi M, Capiccioni S, Masi MG, Sasdelli M: Study of inhibitor and nucleator activities in calcium stone former. Proc Eur Dial Transplant Assoc. 1983; 20: 445-449
Conte A, Roca P, Gianotti M, Grases F: On the relation between citrate and calcium in normal and stone-former subjects. Int Urol Nephrol. 1990; 22: 7-12
Oehlschlager S, Albrecht S, Hakenberg OW, Schrodter S, Froehner M, Manseck A, Wirth MP: Early changes of oxalate and calcium urine excretion in those with calcium oxalate stone formation after extracorporeal shock wave lithotripsy. Adult Urology 2003;62: 17-21
Tefekli A, Esen T, Ziylan O, Erol B, Armagan A, Ander H, Akinci M: Metabolic Risk factors in pediatric and adult calcium oxalate urinary stone formers: is there any difference? Urol Int. 2003; 70: 273-277
Ogawa Y, Yonou H, Hokama S, Oda M, Moruzumi M, Sugaya K: Urinary saturation and risk factors for calcium oxalate stone disease based on spot and 24-hour urine specimens. Front Biosci. 2003; 8: A167-A176
Scholz D, Schwille PO, Ulbrich D, Bausch WM, Sigel A: Composition of renal stones and their frequency in a stone clinic: relationship to parameters of mineral metabolism in serum and urine. Urol Res. 1979; 7: 161-170.