Metabolic assessment in pure struvite stones formers: is it necessary?

Autor:	Danilovic A; Universidade de São Paulo, Faculdade de Medicina, Divisão de Urologia, São Paulo, SP, Brasil., Ferreira TAC; Universidade de São Paulo, Faculdade de Medicina, Divisão de Urologia, São Paulo, SP, Brasil., Gomes SA; Universidade de São Paulo, Faculdade de Medicina, Departamento de Clínica Médica, Laboratório de Nefrologia Celular, Genética e Molecular, São Paulo, SP, Brasil., Wei IA; Universidade de São Paulo, Faculdade de Medicina, Divisão de Urologia, São Paulo, SP, Brasil., Vicentini FC; Universidade de São Paulo, Faculdade de Medicina, Divisão de Urologia, São Paulo, SP, Brasil., Torricelli FCM; Universidade de São Paulo, Faculdade de Medicina, Divisão de Urologia, São Paulo, SP, Brasil., Marchini GS; Universidade de São Paulo, Faculdade de Medicina, Divisão de Urologia, São Paulo, SP, Brasil., Mazzucchi E; Universidade de São Paulo, Faculdade de Medicina, Divisão de Urologia, São Paulo, SP, Brasil., Srougi M; Universidade de São Paulo, Faculdade de Medicina, Divisão de Urologia, São Paulo, SP, Brasil., Nahas WC; Universidade de São Paulo, Faculdade de Medicina, Divisão de Urologia, São Paulo, SP, Brasil.
Jazyk:	English; Portuguese
Zdroj:	Jornal brasileiro de nefrologia [J Bras Nefrol] 2021 Apr-Jun; Vol. 43 (2), pp. 200-206.
DOI:	10.1590/2175-8239-JBN-2020-0106
Abstrakt:	Background and Objective: Magnesium ammonium phosphate stones (MAP), also known as struvite stones, are associated with urinary infection and impairment of renal unit. The aim of this study is to evaluate the urinary metabolic risk factors for recurrence of renal calculi in patients submitted to nephrectomy due to MAP stones. Methods: We retrospectively reviewed the charts of patients > 18 years old submitted to total nephrectomy due to pure MAP stones and pure calcium oxalate (CaOx) stones from July 2006 to July 2016. Urinary metabolic parameters were assessed through 24-hour urine exams ≥ 3 months after nephrectomy. Urinary metabolic parameters and new event related to lithiasis were compared. Results: Twenty-eight and 39 patients were included in MAP and CaOx group, respectively. Abnormalities in 24-hour urine samples were similar between groups. Hypercalciuria occurred in 7.1 and 10.3% of patients in MAP and CaOx group, respectively (p = 0.66), whereas hypocitraturia was present in 65.2 and 59.0% of patients with MAP and CaOx group, respectively (p = 0.41). No significant difference in new events was found between MAP and CaOx groups (17.9 vs. 23.1%, respectively; p = 0.60). Conclusion: A 24-hour urine evaluation should be offered to patients submitted to nephrectomy due to pure MAP stones in order to detect metabolic risk, improve treatment, and prevent stone recurrence.
Databáze:	MEDLINE
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