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[Urinary lithiasis of medical origin]
F Cohen-Solal1, J Abdelmoula, M P Hoarau
1Laboratoire de Biochimie A, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75743 Paris, France.
Therapie
|March 7, 2002
Summary
Drug-induced urolithiasis analysis reveals two types: drugs embedded in stones, like indinavir, and metabolic nephrolithiasis from supplements. Diagnosis relies on physical analysis and patient history for effective management.
Area of Science:
- Nephrology
- Pharmacology
- Urology
Context:
- Analysis of 22,510 urinary calculi from 1991-2000 using infrared spectroscopy.
- Identified drug-induced urolithiasis as approximately 1.6% of all calculi in France.
Purpose:
- To categorize and analyze drug-induced urolithiasis.
- To understand the composition of stones based on inducer drugs and patient metabolic state.
Summary:
- Two categories of drug-induced stones were identified: drugs physically embedded (1.0%) and metabolic nephrolithiasis (0.6%).
- Prominent embedded drugs include indinavir monohydrate, triamterene, sulphonamides, and amorphous silica.
- Metabolic nephrolithiasis involved calcium/vitamin D supplements and carbonic anhydrase inhibitors.
Impact:
- Highlights the importance of physical analysis and therapeutic history for diagnosing drug-induced stones.
- Management strategies include drug avoidance, dose adjustment, increased diuresis, and urinary pH modification.