RESUMO
In 43 patients with recent-onset calcium oxalate nephrolithiasis (25 male, 18 female; age range: 17-61 yr), urine saturation with calcium oxalate (CaOx) was calculated using a computer program (Equil-AT). The results in kJ/mol (normal < or = 2.0) were compared with those obtained with a simple test consisting of the addition of increasing amounts of calcium and oxalate to 3 tubes containing 10 ml urine. Development of turbidity in tube I denotes urine supersaturation with CaOx; turbidity in tubes II or III indicates lesser degrees of saturation, while a lack of turbidity (NT: no turbidity) shows undersaturation. Both saturation estimates were performed using aliquots of 24-hour urine collections. Twenty-one samples developed turbidity in tube I, 9 in tube II, and 6 in tube III, while 7 showed NT. There were no significant differences in Equil-AT values between II and III and between III and NT (p < 0.05 for I vs II and I vs III). High computer-calculated saturation values were found in 86% of group I samples and 22% of group II samples. None of the urines exhibiting turbidity in tube III or NT had high saturation values as estimated by Equil-AT. The turbidity test was also performed using freshly voided morning urine samples from the same patients. The results agreed with those obtained using the same test on aliquots of 24-hour collections, although in 10.8% of patients the morning test indicated higher levels of saturation. It is concluded that the turbidity test is a rapid, inexpensive and accurate way of estimating urine saturation with CaOx in the outpatient clinic.
Assuntos
Oxalato de Cálcio/urina , Cálculos Renais/química , Adolescente , Adulto , Idoso , Cristalização , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Software , Fatores de Tempo , Urina/químicaRESUMO
The long-term hemodynamic and renal effects of propranolol were compared with those of propranolol plus isosorbide dinitrate in 44 portal-hypertensive alcoholic cirrhotic patients. Eight control patients, 8 patients receiving propranolol and 14 patients receiving propranolol plus isosorbide dinitrate were hemodynamically evaluated. Renal function was studied in a fourth group of 14 patients receiving propranolol plus isosorbide dinitrate. Portal pressure decreased more (p < 0.05) with combined therapy (-21.6%, from 19.5 +/- 4.8 to 15.4 +/- 4.3 mm Hg) than with propranolol alone (-12.5%, from 19.9 +/- 1.2 to 17.4 +/- 1.8 mm Hg). Serum urea and creatinine levels, plasma sodium concentration, urine volume and urinary sodium excretion showed nonsignificant changes in all groups studied. Combined therapy induced a significant (p < 0.05) decrease in plasma renin activity (from 4.42 +/- 4.7 to 1.59 +/- 1.9 ng/ml/hr) and nonsignificant reductions in plasma aldosterone concentration and creatinine clearance. None of the eight patients with ascites or history of ascites not receiving isosorbide dinitrate showed evidence of impairment in renal sodium metabolism during the study period. In contrast, 8 of the 14 patients (57%) with ascites or history of ascites receiving isosorbide dinitrate showed impairment in renal sodium metabolism (p < 0.01), as reflected by the development or worsening of ascites and the need of higher diuretic requirements. Long-term combined administration of propranolol plus isosorbide dinitrate is superior to propranolol alone in the pharmacological treatment of portal hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Hemodinâmica/efeitos dos fármacos , Hipertensão Portal/tratamento farmacológico , Hipertensão Portal/fisiopatologia , Dinitrato de Isossorbida/uso terapêutico , Rim/fisiopatologia , Propranolol/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Quimioterapia Combinada , Feminino , Seguimentos , Frequência Cardíaca/efeitos dos fármacos , Humanos , Rim/efeitos dos fármacos , Testes de Função Renal , Circulação Hepática/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resistência Vascular/efeitos dos fármacosRESUMO
This study was performed to determine urinary sulphate excretion in patients with renal stone disease. Stone formers showed a significantly higher fractional excretion of sulphate than control subjects; 80% of stone formers had fractional excretions > 0.26. No significant relationship was established between increased urinary sulphate excretion and any identifiable metabolic disorder, or the recurrence rate of stone episodes. The increase in fractional excretion of sulphate appears to be a more prevalent tubular defect among stone formers than has hitherto been reported.