Hospitalización en paciente con cólico renal: Caracterización clínico-epidemiológica en el Hospital Clínico Herminda Martín, período marzo 2014 - marzo 2019 / Hospitalization in a patient with renal colic: Clinical-epidemiological characterization at the Herminda Martín Clinical Hospital, period March 2014 - March 2019

INTRODUCCIÓN: El cólico renal es una condición médica común en los servicios de urgencia. Representa la manifestación clínica más frecuente de urolitiasis, cuya patogenia es multifactorial, con tasas de prevalencia varía de 1% a 20% y una recurrencia a 10 años del 42% al 50%. OBJETIVO: Establecer el perfil clínico-epidemiológico, como también el diagnóstico y manejo de los pacientes hospitalizados por cólico renal en el Hospital Clínico Herminda Martín (HCHCM). MATERIAL Y MÉTODO: Estudio descriptivo retrospectivo en pacientes hospitalizados con diagnóstico de cólico renal en el HCHM de Chillán en el período marzo 2014-marzo 2019. Se estudiaron las variables: sexo, edad, presentación clínica de ingreso, factores de riesgo asociados, motivo de hospitalización, resultados imagenológicos y manejo clínico. Resultados. El 52,45% correspondió a pacientes de sexo masculino, encontrándose la mayor cantidad de pacientes en el intervalo de 40-49 años. La obesidad, antecedente de urolitiasis e hipertensión arterial fueron las patologías asociadas más frecuentes. En la mayoría de los pacientes, el motivo de la hospitalización fue la refractariedad al tratamiento analgésico, alcanzando un 86,76%. El 56,37% de los pacientes recibió manejo médico expulsivo y a un 19,11% de los pacientes se le realizó una intervención quirúrgica durante la hospitalización. CONCLUSIÓN: El perfil de éstos pacientes no sólo permite establecer medidas que podrían evitar un evento litiásico, sino que además se demuestra la necesidad de realizar un manejo óptimo que puede evitar reconsultas, sobrecarga de los servicios de urgencia, aumento de días cama y complicaciones.

INTRODUCTION: Renal colic is a common condition in the emergency department. It represents the most frequent clinical manifestation of urolithiasis, whose prevalence rate varies between 1% to 20%. Its pathogenesis is multifactorial, with a recurrence of 10 years from 42-50%. OBJECTIVE: Establish the clinical-epidemiological profile, as well as the diagnosis and management of patients hospitalized for renal colic at the Herminda Martín Clinical Hospital(HCHM). MATERIALS AND METHODS: A retrospective descriptive study of hospitalized patients diagnosed with renal colic at the HCHM, March 2014-March 2019, the variables were studied: sex, age, the clinical presentation of admission, associated risk factors, the reason for hospitalization, imaging results, and management. Results: 52.45% were male patients, with the highest number of patients in the range of 40-49 years. Obesity, a history of urolithiasis and hypertension, occurred more frequently within the associated pathologies. In most patients, refractable to analgesic treatment was the reason for hospitalization, reaching 86.76%. 56.37% of patients received expulsion medical management, and 19.11% of patientshad surgeryduring hospitalization. CONCLUSION: The profile of these patients not only allows them to establish measures that could prevent a lithiasis event but also shows the need for effective management of patients who can avoid reconsults, an overload of emergency services, increasedbed days and complications

Ultrasonography, X-ray and intravenous urography [IVU]

To know the sensitivity and specificity of ultrasound with plan abdominal film [X-ray KUB] compared to IVU in evaluation of renal colic. To develop a protocol for investigations of renal colic. Experimental. Department of Urology and Renal Transplantation, Quaid-I-Azam Medical College/ Bahawal Victoria Hospital, Bahawalpur. From July 2010 to December 2011. The number of cases for the study were one hundred and fifty. Patients of either sex of age range from 10 to 50 years with suspected urinary tract stone disease, PUJ obstruction and structure ureterovesical junction were included in this study. While patients of age <10 years, renal failure and with history of hypersensitivity to contrast media were excluded from the study. After routine investigations, ultrasonography, plain X-ray KUB and IVU were performed in every patient at radiology department, Bahawal Victoria hospital, Bahawalpur. The mean age of patients was 41.14 +/- 1.30 years. The ratio of male to female was 2.8:1. Presenting complaints of patients were flank pain. Maximum duration of complaint was 5-6 years. USG + X-ray KUB findings were obstructing renal stone, ureteric stone and PUJO in 97[64.67%], 25[16.67%] and 28 [18.67%] patients respectively. While on IVU, obstructing renal stone, PUJO and ureteric stone was found in 87[58%], 31[20.67%] and 32[21.33%] patients respectively. this study shows that ultrasonography and plain X-ray abdomen [KUB] in sufficient for the diagnosis of renal disease presenting with renal colic

Comparative study of non-contrast-enhanced spirat CT scan to ultrasonography in the diagnosis of acute renal colic

To evaluate the sensitivity and specificity of noncontrast spiral CT scan in ureteric colic with comparative evaluation of ultrasonography. Prospective comparative study. This study was conducted at the Dept. of Radiology, Nishtar Medical College and Hospital, Multan from June, 2010 to June 2011. 62 patients with flank pain were examined with both ultrasonography and non contrast enhanced 16 slice spiral CT scan over a period of one year. Both techniques were used to determine the presence, size, and location of ureteric stone, and the presence or absence of secondary signs like ureteral and calyceal dilatation, stranding of perinephric, periureteric fat and soft tissue rim sign. 43 of the 62 patients were confirmed as having ureteric calculi based on stoned recovery or urological intervention. Ultrasound showed 93% sensitivity and 95% specificity in the diagnosis of ureterolithiasis. CT scan showed 91% sensitivity and 95% specificity respectively. hydronephrosis was seen in all patients that were positive for ureteric calculi. Most common site of calculus was distal ureter. Perinephric fluid was demonstrated in three patients. Perinephric stranding was seen in 26 cases, and periureteric stranding in three patients on CT scan. Pathology unrelated to urinary stone disease was demonstrated in six patients. Although both modalities were excellent for detecting ureteric stones, consideration of cost and radiation lead us to suggest that ultrasound be employed first and CT scan be reserved for when ultrasound is unavailable or non-diagnostic

Relationship between renal stone formation, mitral annular calcification and bone resorption markers

Mitral annular calcification [MAC] is associated with osteoporosis and there is evidence of reduced bone mineral density [BMD] in patients with renal stone formation [RSF]. Therefore, we designed this study to test if RSF was associated with MAC and if this association could be linked to bone resorption. Fifty-nine patients [mean age, 41.5 years] with RSF and 40 healthy subjects [mean age, 44.2 years] underwent screening for MAC and BMD, and measuurements were taken of serum and urine electrolytes, parathyroid hormone, alkaline phosphatase and urine dypyridoline. MAC was diagnosed in 11 [18%] patients with RSF compared with 1 [2.5%] control [P=.01]. Urine phosphorus, magnesium, sodium, potassium and chloride levels were lower [P<.001, P=.02, P<.001, P<.001 and P<.001, respectively], but serum alkaline phosphatase, calcium and potassium levels were higher [P=.008, P=.007 and P=.001, respectively] in patients with RSF versus those without RSF. None of these abnormalities were found in patients or subjects with MAC. Urine pyridoline levels were higher and T-scores were more negative [more osteopenic] in patients and subjects with MAC than in those without MAC [P=.01 and P=.004, respectively]. In a multivariate analysis, only T-scores and urine dipyridoline level were predictive of MAC [P=.03 and P=.04, respectively]. Screening for MAC and bone resorption markers in patients with RSF demonstrated a high incidence of MAC in these patients. The presence of MAC in patients with RSF was associated with bone resorption markers. This seemingly complex interrelationship between RSF, MAC and bone loss needs to be clarified in further studies