Prezioso Domenico, Di Martino Mario, Galasso Raffaele, Iapicca Gennaro
Department of Obstetrics, Gynecology and Urology, Federico II University, Naples, Italy.
Urol Int. 2007;79 Suppl 1:20-5. doi: 10.1159/000104437.
Nephrolithiasis has a multifactorial origin, and several disorders may coexist in the same patient. We made a basic and a specific laboratory evaluation. The complete metabolic evaluation consisted of a serum chemistry panel: blood sugar level, complete hemogram, serum electrolytes, GOT, GPT, calcium, phosphate, uric acid, and creatinine levels and RIA dosage of PTH, vitamin D3, cAMP, FT4, FT3 and TSH. The complete analyses of random urinalysis and culture are: (1) dip-stick test: pH, leukocytes/bacteria and Brand's test, and (2) 24-hour urine collection: calcium, magnesium, oxalate, phosphate, citrate, urea, urate, sodium, creatinine, chloride, potassium. It is possible with these tests to identify secondary causes of nephrolithiasis and uncover coexisting problems that may have an impact on patient management. The future for diagnosis, prevention and therapy will be the identification of genetic alterations and related specific dosage.
肾结石具有多因素起源,多种病症可能在同一患者中共存。我们进行了基础和特定的实验室评估。完整的代谢评估包括血清化学检查:血糖水平、全血细胞计数、血清电解质、谷草转氨酶、谷丙转氨酶、钙、磷、尿酸和肌酐水平以及甲状旁腺激素、维生素D3、环磷酸腺苷、游离甲状腺素、游离三碘甲状腺原氨酸和促甲状腺激素的放射免疫分析测定。随机尿液分析和培养的完整分析包括:(1)试纸条检测:pH值、白细胞/细菌及布兰德试验,以及(2)24小时尿液收集:钙、镁、草酸盐、磷酸盐、柠檬酸盐、尿素、尿酸盐、钠、肌酐、氯、钾。通过这些检测能够识别肾结石的继发原因,并发现可能影响患者管理的共存问题。诊断、预防和治疗的未来方向将是识别基因改变及相关特定剂量。