Jean-Philippe Haymann1. 1. Service d'Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la chine, 75020, Paris, France, jean-philippe.haymann@tnn.aphp.fr.
Abstract
INTRODUCTION: Metabolic syndrome, type 2 diabetes, and primary hyperparathyroidism are metabolic disorders that should deserve a special focus in renal stone patients as a pathogenic link is established with some stone components. Indeed, an acidic urinary pH due to a decreased ammonium bioavailability explains the high prevalence of uric acid stones in patients with metabolic syndrome or diabetes and, primary hyperparathyroidism induced hypercalciuria increases the risk of calcium phosphate stones. MATERIALS AND METHODS: We report here four clinical cases of renal stone patients with metabolic disorders encountered in a daily practice. Clinical and metabolic findings altogether with stone analysis components presented here, illustrate relevant pathophysiological links. CONCLUSION: 24 hours urine evaluation and stone analysis which includes both morphological typing and infrared spectroscopy, are key diagnostic steps for early recognition of metabolic disorders. Metabolic screening allows diet related stone identification, points out stone risk factors and identifies patients'comorbidity. The occurrence of nephrocalcinosis with or without chronic renal failure should require a more detailed metabolic evaluation in order to identify uncommon etiologies such as renal tubular acidosis.
INTRODUCTION:Metabolic syndrome, type 2 diabetes, and primary hyperparathyroidism are metabolic disorders that should deserve a special focus in renal stonepatients as a pathogenic link is established with some stone components. Indeed, an acidic urinary pH due to a decreased ammonium bioavailability explains the high prevalence of uric acid stones in patients with metabolic syndrome or diabetes and, primary hyperparathyroidism induced hypercalciuria increases the risk of calcium phosphate stones. MATERIALS AND METHODS: We report here four clinical cases of renal stonepatients with metabolic disorders encountered in a daily practice. Clinical and metabolic findings altogether with stone analysis components presented here, illustrate relevant pathophysiological links. CONCLUSION: 24 hours urine evaluation and stone analysis which includes both morphological typing and infrared spectroscopy, are key diagnostic steps for early recognition of metabolic disorders. Metabolic screening allows diet related stone identification, points out stone risk factors and identifies patients'comorbidity. The occurrence of nephrocalcinosis with or without chronic renal failure should require a more detailed metabolic evaluation in order to identify uncommon etiologies such as renal tubular acidosis.
Authors: Anize D von Frankenberg; Filipe V do Nascimento; Lucas Eduardo Gatelli; Bárbara L Nedel; Sheila P Garcia; Carolina Sv de Oliveira; Pedro Saddi-Rosa; André F Reis; Luis H Canani; Fernando Gerchman Journal: Diabetol Metab Syndr Date: 2014-02-26 Impact factor: 3.320
Authors: Pedro Valente; Hélder Castro; Inês Pereira; Fernando Vila; Paulo Barros Araújo; Cristina Vivas; Ana Silva; Ana Oliveira; Joaquim Lindoro Journal: Cent European J Urol Date: 2019-09-16