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Published on: July 18, 2017
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Metabolic evaluation in patients with infected nephrolithiasis: Is it necessary?
Elisa Cicerello1, Mario Mangano, Gian Davide Cova
1Unità Complessa di Urologia, Ospedale Ca'Foncello, Treviso. elisa.cicerello@tin.it.
Summary
Infected kidney stones are linked to metabolic issues, especially mixed stones. Urinary tract infections may promote pure struvite stone formation by altering urine chemistry.
Area of Science:
- Nephrology
- Urology
- Biochemistry
Background:
- Infected renal lithiasis, particularly struvite stones, poses a significant clinical challenge.
- Understanding the metabolic factors contributing to infected stone formation is crucial for effective management.
Purpose of the Study:
- To investigate the prevalence of metabolic abnormalities in patients with infected renal lithiasis.
- To compare metabolic profiles between patients with pure infected stones and mixed infected stones.
Main Methods:
- Fifty-four patients with infected renal lithiasis underwent comprehensive metabolic evaluation.
- Evaluations included urine analysis and culture to identify contributing factors.
- Statistical analysis was performed to compare metabolic parameters between stone types.
Main Results:
- Metabolic abnormalities were significantly more prevalent in patients with mixed infected stones (struvite+/-apatite and calcium oxalate) compared to pure infected stones (struvite+/-carbonate apatite).
- Specific abnormalities included hypercalciuria (40%), hyperoxaluria (34%), and hyperuricosuria (28%) in mixed stone formers (p < 0.05).
- Low urinary citrate excretion was observed in both groups, with no statistically significant difference.
Conclusions:
- Mixed infected stones are associated with a higher burden of metabolic abnormalities.
- Urinary tract infections alone may alter urine chemistry, promoting the formation of pure struvite stones.
- Further research into metabolic profiles can aid in personalized treatment strategies for infected renal lithiasis.
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