Hydrogen ion excretion and urine osmolality in patients with obstructive uropathy secondary to Schistosoma...

Sixty-one patients with urinary schistosomiasis were studied to determine the effects of obstruction and bacteriuria on renal function. 39 (12 with bacteriuria) had demonstrable obstruction and 22 (5 with bacteriuria) had no obstruction. Total hydrogen ion excretion (T.H.+) for obstructed patients with sterile urine did not differ from that in controls; patients with bacteriuria with and without obstruction had a significantly lower T.H.+ (all P values less than 0.05). Obstructed patients (with or without bacteriuria) had significant impairment of maximal (U max) and minimal (U min) urine osmolality. Patients with bilateral obstruction and bacteriuria had a significantly lower U max (P less than 0.01 than obstructed patients without bacteriuria. The T.H.+ is mainly associated with bacteriuria but that the effects of unilateral or bilateral obstruction and bacteriuria on urine osmolality are additive. These abnormalities are usually corrected after therapy.