Etiological Classification of Renal Lithiasis: A Study Based on 1936 Patients

Abstract

A series of 1936 patients were studied between November 1968 and October 1975. The requirements for the inclusion in this study were the radiographic finding of stone (s) in the urinary tract (excluding primitive bladder stones) and/or the spontaneous passing or surgical removal of urinary calcul i.In all the cases the protocol included a clinical history with emphasis on dietary habits; a general biochemical study and the appropiate X-rays; assessment in blood and in 24-hour urine of creatinine, uric acid, phosphorus, calcium, magnesium and, in urine, pH, oxal ic acid and cystine; and the analysis of the stone by chemical and infrared spectrophotometry methods (1), and also the study of a 30 mm-thick section of the stone by polarization microscopy (2).In certain cases the diagnosis was confirmed by purine or amino acids paper chromatography in the urine; a functional study of the acid/base balance, and renal or bone biopsies. When possible, a familial study was carried out. The methods used and the selection criteria of each etiological type have already been reported (3-5). Table I shows the etiological classification of the 1936 patients with renal I ithiasis. Almost one third of the cases were of metabol ic origin and in nearly one half the cause of the disease was demonstrated. RESULTS AND DISCUSSIONThe higher incidence within the metabolic group corresponds to uric acid I ithiasis, a common finding in other Mediterranean countries (6, 7). It also was related to the large number of gouty patients

Drug Therapy of Urinary Calculi and Prevention of Recurrence

“…More recent publications by ROSE and HARRISON (1974), RAPADO et al (1976), PAK et al (1978) and by , JACOBSON et al (1979), LJUNGHALL et al (1981), andSCHOLZ et al (1981) have tended to confirm the effectiveness of thiazides in the treatment of hypercalciuria and their influence on the frequency of stone recurrence, whilst stressing the need to appreciate their side effects.…”

“…Definition: Hypercalciuria is excessive urinary calcium excretion, exceeding the upper limit of normal at 250 mg124 hrs in women and 300 mg124 hrs in men (DENT et al 1964;HAUTMANN et al 1978;HAYASHI et al 1975;NORDIN 1976;PARFITT et al 1964;RAPADO et al 1976;YENDT et al 1966). Since the values given take no account of body weight, standard computed surface, renal function or fluid intake, it is of some advantage to quote hypercalciuria in terms of the calcium-creatinine quotient.…”

Chemical Analysis of Renal Stones from 377 Belgian Patients by Using Qualitative or Quantitative Methods

“…Uric acid stones occurred in our patients and in groups from the USA (Prien, 1963), Great Britain (Murphy and Pyrah, 1962;Hodgkinson and Mar shall, 1975) and Australia (Lavan et ai, 1971) with similar frequency, whereas uric acid-containing cal culi accounted for higher proportions, ranging from 11 to 40%, in series from France (Cottet and Weber, 1959), Germany (Ebbinghaus and Prieber, 1962;May and Braun, 1976), Czechoslovakia (Krizek, 1957), Sweden (Lagergren, 1956), Spain (Rapado et al, 1976) and Israel (Atsmon et al, 1963).…”