Kidney Stones in Primary Hyperoxaluria: New Lessons LearntReportar como inadecuado




Kidney Stones in Primary Hyperoxaluria: New Lessons Learnt - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

To investigate potential differences in stone composition with regard to the type of Primary Hyperoxaluria PH, and in relation to the patient’s medical therapy treatment naïve patients versus those on preventive medication we examined twelve kidney stones from ten PH I and six stones from four PH III patients. Unfortunately, no PH II stones were available for analysis. The study on this set of stones indicates a more diverse composition of PH stones than previously reported and a potential dynamic response of morphology and composition of calculi to treatment with crystallization inhibitors citrate, magnesium in PH I. Stones formed by PH I patients under treatment are more compact and consist predominantly of calcium-oxalate monohydrate COM, whewellite, while calcium-oxalate dihydrate COD, weddellite is only rarely present. In contrast, the single stone available from a treatment naïve PH I patient as well as stones from PH III patients prior to and under treatment with alkali citrate contained a wide size range of aggregated COD crystals. No significant effects of the treatment were noted in PH III stones. In disagreement with findings from previous studies, stones from patients with primary hyperoxaluria did not exclusively consist of COM. Progressive replacement of COD by small COM crystals could be caused by prolonged stone growth and residence times in the urinary tract, eventually resulting in complete replacement of calcium-oxalate dihydrate by the monohydrate form. The noted difference to the naïve PH I stone may reflect a reduced growth rate in response to treatment. This pilot study highlights the importance of detailed stone diagnostics and could be of therapeutic relevance in calcium-oxalates urolithiasis, provided that the effects of treatment can be reproduced in subsequent larger studies.



Autor: Dorrit E. Jacob , Bernd Grohe, Michaela Geßner, Bodo B. Beck, Bernd Hoppe

Fuente: http://plos.srce.hr/



DESCARGAR PDF




Documentos relacionados