Hess B, Jaeger P
Policlinique médicale universitaire, hôpital de l'Ile, Berne, Suisse.
Rev Prat. 1991 Oct 1;41(21):2037-42.
Under the term "non-calcium nephrolithiasis", three types of renal stone formation are considered. (1) Infected nephrolithiasis, which is due to bacteriological ureolysis. Its treatment includes lowering of oversaturation by antibiotics, urease inhibition and/or acidification of the urine; lowering of crystallization by eradicating concomitant infections caused by non-ureolytic organisms; prevention of crystal adherence by exogenous glycosaminoglycans, and prevention of bacterial adherence by glycolipids. (2) Uric acid lithiasis is defined on physico-chemical and physiopathological grounds. Medical treatment consists of increasing water intake, reducing puric acid intake, alkalinizing the urine inhibiting xanthine-oxidase. (3) Cystinuria is described as a nephrolithogenic proximal tubulopathy. Medical treatment includes reduction of urinary cystine concentration by a strong increase of water intake; reduction of urinary cystine excretion by diet and increase of cystine solubility by urinary alkalinization or administration of some thiol compounds.
在“非钙性肾结石”这一术语下，考虑了三种类型的肾结石形成。（1）感染性肾结石，这是由于细菌脲解所致。其治疗包括通过抗生素降低过饱和度、抑制脲酶和/或酸化尿液；通过根除由非脲解性生物体引起的伴随感染来降低结晶；通过外源性糖胺聚糖防止晶体黏附，以及通过糖脂防止细菌黏附。（2）尿酸结石是根据物理化学和生理病理学依据定义的。药物治疗包括增加水的摄入量、减少嘌呤酸摄入量、碱化尿液以及抑制黄嘌呤氧化酶。（3）胱氨酸尿症被描述为一种致肾结石的近端肾小管病。药物治疗包括通过大量增加水的摄入量来降低尿胱氨酸浓度；通过饮食减少尿胱氨酸排泄，并通过尿液碱化或给予一些硫醇化合物来增加胱氨酸溶解度。
