Get Calcium Urolithiasis: Pathogenesis, Diagnosis, and PDF

By Charles Pak

ISBN-10: 1468424513

ISBN-13: 9781468424515

ISBN-10: 146842453X

ISBN-13: 9781468424539

"People . . . see you sweat in suffering, flip light, flip crimson, trem­ ble, vomit your very blood, endure unusual contractions and con­ vulsions, occasionally shed nice tears out of your eyes, discharge thick, black and frightful urine, or have it stopped up through a few sharp tough stone that cruelly pricks and flays the neck of your penis. " * those sixteenth century frustrations of Michel de Montaigne which so much graphically replicate his event with renal colic nonetheless plague nearly 1 in keeping with one thousand contributors within the usa each year. on account that as many as seventy five% of clinically. obvious episodes of renal colic symbolize unmarried nonrecurring occasions, physicians no longer in­ often method the differential prognosis of nephrolithiasis in a lower than sufficient model and think that the incident may possibly prob­ ably by no means recur after the one assault. although, the ureteral or bladder stone truly represents one kind of irregular crystalline precipitation; parenchymal nephrocalcinosis, silently innovative azotemia, and asymptomatic renal pelvic calculi can also stem from a similar pathological process(es) which conditioned the for­ mation of the ureteral or bladder stone. during this regard it truly is worthy emphasizing that the postmortem prevalence of renal calculi is a few tenfold more than that presumed from surveys in which a scientific assault of nephrolithiasis is the only real determinant. *In ordinary clinical Quotations. M. B. Strauss, Ed. Little Brown, Boston, 1968, p. 646. v vi FOREWORD the decade has witnessed the start of recent wisdom in urolithiasis research.

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Extra info for Calcium Urolithiasis: Pathogenesis, Diagnosis, and Management

Example text

In renal hypercalciuria, the two sexes were equally affected, and bone disease (osteoporosis) as well as Ca urolithiasis may be present. Some patients may give a history of recurrent urinary tract infections, which sometimes preceded the onset of stone disease. 1 I FAST ... CoLood I II ••• ~ ~ 5 ::::> a:: - 3

28. 29. 30. 31. 32. 33 biological "calcification" (deposition) of hydroxyapatite crystals. Trans. Assoc. Am. Physicians 79: 137-144. Howard, J. , and Thomas, W. , Jr. 1968. Control of crystallization in urine. Am. 1. Med. 45:693-699. Nancollas, G. 1976. The kinetics of crystal growth and renal stone-formation. In Urolithiasis Research. H. Fleisch, W. G. Robertson, L. H. Smith, and W. Vahlensieck, Eds. Plenum Press, New York, pp. 5-23. Pak, C. Y. C. 1976. Disorders of stone formation. In The Kidney.

During the fasting state, when absorbed Ca does not contribute significantly to urinary Ca, the renal Ca excretion was 44 CHAPTER 3 found to be normal,25,28 a finding that indicated that the renal handling of Ca was not defective. Following an oral load of Ca, the increase in urinary Ca excretion was exaggerated, a result that suggested that Ca was absorbed excessively from the intestinal tract. 28 Moreover, parathyroid function as measured by renal excretion of cyclic AMP (cAMP) and serum immunoreactive PTH (iPTH) was normal or suppressed, and became more suppressed with an oral Ca load.

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Calcium Urolithiasis: Pathogenesis, Diagnosis, and Management by Charles Pak


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