ABSTRACT
INTRODUCTION: Metabolic investigation in patients with urinary lithiasis is very important for preventing recurrence of disease. The objective of this work was to diagnose and to determine the prevalence of metabolic disorders, to assess the quality of the water consumed and volume of diuresis as potential risk factors for this pathology. PATIENTS AND METHODS: We studied 182 patients older than 12 years. We included patients with history and/or imaging tests confirming at least 2 stones, with creatinine clearance > 60 mL/min and negative urine culture. The protocol consisted in the collection of 2, 24-hour urine samples, for dosing Ca, P, uric acid, Na, K, Mg, Ox and Ci, glycemia and serum levels of Ca, P, Uric acid, Na, K, Cl, Mg, U and Cr, urinary pH and urinary acidification test. RESULTS: 158 patients fulfilled the inclusion criteria. Among these, 151 (95.5 percent) presented metabolic changes, with 94 (62.2 percent) presenting isolated metabolic change and 57 (37.8 percent) had mixed changes. The main disorders detected were hypercalciuria (74 percent), hypocitraturia (37.3 percent), hyperoxaluria (24.1 percent), hypomagnesuria (21 percent), hyperuricosuria (20.2 percent), primary hyperparathyroidism (1.8 percent) secondary hyperparathyroidism (0.6 percent) and renal tubular acidosis (0.6). CONCLUSION: Metabolic change was diagnosed in 95.5 percent of patients. These results warrant the metabolic study and follow-up in patients with recurrent lithiasis in order to decrease the recurrence rate through specific treatments, modification in alimentary and behavioral habits.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Urinary Calculi/metabolism , Acidosis, Renal Tubular/metabolism , Brazil/epidemiology , Calcium/metabolism , Creatinine/metabolism , Hydrogen-Ion Concentration , Hypercalcemia/metabolism , Hyperoxaluria/metabolism , Hyperparathyroidism/metabolism , Magnesium/metabolism , Oxides/metabolism , Prevalence , Prospective Studies , Phosphorus/metabolism , Potassium/metabolism , Sodium/metabolism , Uric Acid/metabolism , Urinary Calculi/epidemiologyABSTRACT
Enteric hyperoxaluria manifests due to hyperabsorption of dietary oxalate, secondary to a variety of chronic gastrointestinal disorders. The potential use of chitosan immobilized oxalate oxidase-catalase conjugate to deplete the oxalate content of food materials, while they are in the digestive tract has been evaluated by treating rat stomach chyme with such an enzyme preparation. Oxalate oxidase, obtained from beet stem, was adsorbed on chitosan along with catalase and then cross linked with glutaraldehyde to stabilize the derivative. This chemical modification of oxalate oxidase brought about a shift in its optimal pH from 4.2 to 3.8 with a marginal increase in its K(m). Compared to native enzyme, the modified oxalate oxidase exhibited increased storage stability, higher thermal stability and enhanced resistance to proteolytic digestion and heavy metal inactivation. These improved properties of the immobilized oxalate oxidase possibly render it suitable for oral administration under hyperoxaluric conditions.