Metabolic study. How to make it accessible, useful and generalized.Authors:
Juan Alberto Lancina MartÝn.
Arch. Esp. Urol. 2017; 70 (1): 71-90
Vol. 70, Number. 1, Jan/Feb 2017
Risk factors should be evaluated in all
patients with urinary lithiasis. The kind of evaluation,
simplified or extended, depends on stone composition
and, in patients with calcium lithiasis, on the clinical
presentation. These studies are done in an outpatient
regimen, are easy to perform and accessible for most
Patients with uric acid, infectious and cystine stones
only require a selective more abbreviated evaluation.
In calcium lithiasis we perform an extended metabolic
evaluation in recurrent patients and also in singleepisode
patients when they have high recurrence risk.
The extended evaluation has demonstrated to be costeffective
in patients with highly recurrent lithiasis.
There is not enough clinical evidence yet on what would
be the most convenient study methodology for a proper
metabolic evaluation, and proposed clinical guidelines
are mainly based on expert committee opinions.
With these studies, we can diagnose systemic and renal
diseases of lithogenic nature, and they also enable the
adoption of precise prophylactic measures that achieve
recurrence control in a great number of patients.
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