Seasonal changes in serum and erythrocyte potassium among renal stone formers from northeastern Thailand.

Hypocitraturia, hypokalemia and low urinary excretion of potassium are common findings in nephrolithiasis in Northeastern Thailand. However, intracellular potassium has not been studied. We measured serum potassium, erythrocyte potassium, 24-hour urinary excretion of sodium, potassium, citrate, ammonium, titratable acid and pH in 17 nephrolithiasis patients from Northeastern Thailand during 2 seasons: the cool and hot months. There were no significant differences in urinary pH, ammonium, titratable acid, citrate and potassium during these 2 seasons. However, hypocitraturia and hypokaliuria were observed in the majority of cases in both periods. Seasonal variation in serum potassium, erythrocyte potassium, urine volume and urinary excretion of sodium was observed. Values were significantly lower in the hot months. In the cool months, the urinary excretion of citrate correlated linearly with that of potassium (r = 0.696, p < 0.002). Such a correlation was not found in the hot months. We concluded that extracellular and intracellular potassium depletion might be present in these patients and is greater during the hot than during the cool months. The pathogenesis may be multi-factorial.

Increased lipid peroxidation in the erythrocytes of kidney stone formers.

The level of lipid peroxidation was significantly increased in erythrocytes and erythrocyte membrane in patients with stone disease. Increased activities of catalase and acetylcholinesterase in the erythrocyte membrane were observed, while hemolysate displayed no significant change in superoxide dismutase activity. The amount of phospholipids in the RBC membrane of patients was significantly increased. Peroxidation was stimulated by oxalate in vitro and was further enhanced in the presence of ferrous ion. The changes in lipid peroxidation and antioxidant enzymes are suggestive of chemical alteration of the RBC membrane during urolithiasis.

Litiasis urinaria en pacientes de la clinica El Bosque / Urinary lithiasis in patients of clinica El Bosque

Se llevo a cabo un estudio descriptivo retrospectivo en 77 pacientes con litiasis urinaria que consultaron al departamento de urologia de la clinica el Bosque de Bogota entre junio de 1979 a diciembre de 1987. Se encontro que la urolitiasis es mas frecuente en el sexo masculino en la poblacion que se encuentra entre los 21 a 40 anos y que realiza poca actividad fisica, ademas se vio mayor incidencia de la entidad en habitantes de clima frio siendo este el unico dato desacorde con los estudios revisados. En cuanto a la presencia de antecedentes se establecio que el 20.7% de pacientes habian presentado un episodio previo y el 212.6% tenian antecedentes personales cercanos. En el cuadro clinico se vio que los sintomas mas frecuentes acusados por los pacientes fueron el dolor abdominal 77% nauseas y vomito 24%, dolor lumbar 22%, hematuria 17%, disuria 13%. La irradiacion del dolor en la mayoria de los casos fue a los genitales 24.6%, region lumbar 14.2% y muslo 12%. Como ayudas diagnosticas fueron solicitadas el cuadro hematico, el parcial de orina y medios radiologicos. En las historias clinicas revisadas no se encontraron datos acerca del tipo de alimentacion del paciente, farmacos que venian rcibiendo y el analisis de los calculos excretados, por lo que no se pudo trabajar sobre estos puntos. Tomando como base el trabajo realizado propusimos un esquema de enfoque y manejo de la entidad, para la Clinica el Bosque (Bogota).