Diagnosis and management of obstructive urolithiasis in miniature pigs.

This article provides information to assist practitioners in the diagnosis, medical, and surgical management of obstructive urolithiasis in miniature pigs. The article focuses primarily on pigs managed as pets because production swine rarely undergo intensive treatment for urolithiasis. As much as possible, the information in this article is based on published literature, but given the limited number of publications addressing obstructive urolithiasis in pigs, some information is based on the authors' clinical experience. Medical and surgical management of obstructive urolithiasis of pigs is often similar to management in ruminant and small animal species, but differences in swine anatomy, handling, and temperament create unique challenges. Pigs tend to be more difficult to restrain and examine than other livestock and often require heavy sedation or anesthesia to facilitate physical examination and basic diagnostic procedures. Because pigs are monogastrics, some oral treatments used in small animals may be used effectively in pigs. Clinicians should follow AMDUCA and consult the Food Animal Residue Avoidance Databank prior to extralabel drug use because pet pigs are still considered a major food-producing species in the United States.

Litiasis urinaria en pediatria / Urinary lithiasis in pediatrics

Resumen La litiasis renal es una entidad infrecuente en la infancia y su incidencia va en aumento en los países desarrollados. Afecta más a los individuos de raza blanca que a los afroamericanos en una proporción 4:1, con predominio del sexo masculino. Existen factores geográficos, raciales, genéticos implicados en su patogenia, que depende también de factores fisicoquímicos (eliminación renal de agua y solutos, pH urinario, equilibrio entre factores estimulantes/inhibidores de la cristalización), alteraciones anatómicas, infecciones y cambios socioeconómicos; los cuales a lo largo del tiempo han producido cambios en los hábitos dietéticos, lo que ha modificado la frecuencia, composición química y localización de los cálculos. A pesar de su rareza se debe pensar en la litiasis, con el fin de evitar un daño renal irreversible. La disponibilidad de terapia menos agresiva ha reducido a un 5% las indicaciones quirúrgicas, abriendo nuevas perspectivas en el tratamiento de la urolitiasis en la infancia.

Abstract Renal lithiasis is an infrequent entity in childhood, and its incidence has decreased in developed countries. Affects white individuals more than African Americans in a 4: 1 ratio, with a predominance of males. There are geographic, racial, genetic factors involved in its pathogenesis, which also depends on physicochemical factors (renal elimination of water and solutes, urinary pH, balance between stimulating factors/inhibitors of crystallization), anatomical alterations, infections and socioeconomic changes. Over time, changes have occurred in dietary habits, which has changed the frequency, chemical composition and location of the stones. Despite its rarity, lithiasis must be considered in order to avoid irreversible kidney damage. The availability of less aggressive therapy has reduced surgical indications to 5%, opening new perspectives in the treatment of urolithiasis in childhood. The present article constitutes a bibliographic review about the organophosphorus intoxication, its clinical manifestations, diagnosis and treatment.

CLINICAL-EPIDEMIOLOGICAL PROFILE OF 106 PEDIATRIC PACIENTS WITH UROLITHIASIS IN RIO DE JANEIRO, BRAZIL. / PERFIL CLÍNICO-EPIDEMIOLÓGICO DE 106 PACIENTES PEDIÁTRICOS PORTADORES DE UROLITÍASE NO RIO DE JANEIRO.

OBJECTIVE: To describe the frequency, clinical profile and treatment of patients with urolithiasis in the Pediatric Nephrology Department of a public state hospital in Rio de Janeiro, Brazil. METHODS: Retrospective study. Data from pediatric patients (age: 1 month - 18 years) with urolithiasis admitted between January/2012 and December/2014 were reviewed from hospital charts. The studied variables were: demographic and anthropometric data, clinical status, family history of urolithiasis, urinary tract infection and use of lithogenic drugs, diagnostic procedures, associated abnormalities, metabolic disorders, treatment and recurrence. RESULTS: The frequency of urolithiasis was 13.6%. Main characteristics of the patients: male gender, white race, eutrophy, aged between 5 and 10 years, family history of urolithiasis, previous urinary infection and spontaneous stone passage. Abdominal and flank pain and macroscopic hematuria were the most common complaints. The most frequent metabolic disorders were hypercalciuria, hyperuricosuria and hypocitraturia. Hypocitraturia was associated with previous urinary infection (p=0.004). Abdomen/urinary tract ultrasonography was the most commonly used diagnostic test. Hydronephrosis occurred in 54.4% of the cases, 81.1% of the stones were in the kidneys, and bilateral stones were associated to a family history of urolithiasis (p=0.030). Recurrence rate was 29.3% (most patients had a metabolic disorder). In 12.3%, the patients underwent lithotripsy, 24.5% were surgically treated (mainly pyelolithotomy), and only 7.6% had their stones analyzed (calcium oxalate was the main finding in the examined stones). CONCLUSIONS: The frequency of urolithiasis in these pediatric patients was similar to that reported by the literature. A metabolic evaluation is required and the composition of stones should be better evaluated.

OBJETIVO: Descrever a frequência, o perfil clínico e condutas adotadas em portadores de urolitíase no setor de nefropediatria do Hospital Federal dos Servidores do Estado na cidade do Rio de Janeiro. MÉTODOS: Estudo retrospectivo dos prontuários de pacientes portadores de urolitíase, atendidos entre janeiro de 2012 e dezembro de 2014, com idade entre 1 mês e 18 anos. Variáveis estudadas: dados demográficos, antropométricos, quadro clínico, história familiar de urolitíase, infecção urinária e uso de medicamentos litogênicos, condutas diagnósticas, anomalias associadas, distúrbios metabólicos, terapêutica e recorrências. RESULTADOS: A frequência de urolitíase no período foi de 13,6%, e as características mais frequentes foram sexo masculino, cor da pele branca, eutrofia, idade entre 5 e 10 anos, história familiar de urolitíase, infecção urinária prévia e eliminação espontânea do cálculo. Dor abdominal, em flanco e hematúria macroscópica foram as queixas mais comuns. Distúrbios metabólicos mais frequentes: hipercalciúria, hiperuricosúria e hipocitratúria. A hipocitratúria foi associada à história de infecção urinária prévia (p=0,004). A ultrassonografia de abdome ou aparelho urinário foi o exame mais utilizado para diagnóstico. Hidronefrose ocorreu em 54,4% dos casos, 81,1% dos cálculos estavam nos rins e os bilaterais eram associados com história familiar de urolitíase (p=0,030). Houve recidiva em 29,3% dos casos (maior parte com distúrbio metabólico); 12,3% submeteram-se à litotripsia; 24,5%, à cirurgia, principalmente pielolitotomia; e apenas 7,6% dos pacientes tiveram cálculos analisados (mais frequente: oxalato de cálcio). CONCLUSÕES: A frequência de urolitíase nessa população pediátrica foi próxima à da literatura. Os achados sugerem a necessidade de investigação metabólica mais ampla e a análise mais frequente dos cálculos.

Perfil clínico-epidemiológico de 106 pacientes pediátricos portadores de urolitíase no rio de janeiro / Clinical-epidemiological profile of 106 pediatric pacients with urolithiasis in rio de janeiro, brazil

RESUMO Objetivo: Descrever a frequência, o perfil clínico e condutas adotadas em portadores de urolitíase no setor de nefropediatria do Hospital Federal dos Servidores do Estado na cidade do Rio de Janeiro. Métodos: Estudo retrospectivo dos prontuários de pacientes portadores de urolitíase, atendidos entre janeiro de 2012 e dezembro de 2014, com idade entre 1 mês e 18 anos. Variáveis estudadas: dados demográficos, antropométricos, quadro clínico, história familiar de urolitíase, infecção urinária e uso de medicamentos litogênicos, condutas diagnósticas, anomalias associadas, distúrbios metabólicos, terapêutica e recorrências. Resultados: A frequência de urolitíase no período foi de 13,6%, e as características mais frequentes foram sexo masculino, cor da pele branca, eutrofia, idade entre 5 e 10 anos, história familiar de urolitíase, infecção urinária prévia e eliminação espontânea do cálculo. Dor abdominal, em flanco e hematúria macroscópica foram as queixas mais comuns. Distúrbios metabólicos mais frequentes: hipercalciúria, hiperuricosúria e hipocitratúria. A hipocitratúria foi associada à história de infecção urinária prévia (p=0,004). A ultrassonografia de abdome ou aparelho urinário foi o exame mais utilizado para diagnóstico. Hidronefrose ocorreu em 54,4% dos casos, 81,1% dos cálculos estavam nos rins e os bilaterais eram associados com história familiar de urolitíase (p=0,030). Houve recidiva em 29,3% dos casos (maior parte com distúrbio metabólico); 12,3% submeteram-se à litotripsia; 24,5%, à cirurgia, principalmente pielolitotomia; e apenas 7,6% dos pacientes tiveram cálculos analisados (mais frequente: oxalato de cálcio). Conclusões: A frequência de urolitíase nessa população pediátrica foi próxima à da literatura. Os achados sugerem a necessidade de investigação metabólica mais ampla e a análise mais frequente dos cálculos.

ABSTRACT Objective: To describe the frequency, clinical profile and treatment of patients with urolithiasis in the Pediatric Nephrology Department of a public state hospital in Rio de Janeiro, Brazil. Methods: Retrospective study. Data from pediatric patients (age: 1 month - 18 years) with urolithiasis admitted between January/2012 and December/2014 were reviewed from hospital charts. The studied variables were: demographic and anthropometric data, clinical status, family history of urolithiasis, urinary tract infection and use of lithogenic drugs, diagnostic procedures, associated abnormalities, metabolic disorders, treatment and recurrence. Results: The frequency of urolithiasis was 13.6%. Main characteristics of the patients: male gender, white race, eutrophy, aged between 5 and 10 years, family history of urolithiasis, previous urinary infection and spontaneous stone passage. Abdominal and flank pain and macroscopic hematuria were the most common complaints. The most frequent metabolic disorders were hypercalciuria, hyperuricosuria and hypocitraturia. Hypocitraturia was associated with previous urinary infection (p=0.004). Abdomen/urinary tract ultrasonography was the most commonly used diagnostic test. Hydronephrosis occurred in 54.4% of the cases, 81.1% of the stones were in the kidneys, and bilateral stones were associated to a family history of urolithiasis (p=0.030). Recurrence rate was 29.3% (most patients had a metabolic disorder). In 12.3%, the patients underwent lithotripsy, 24.5% were surgically treated (mainly pyelolithotomy), and only 7.6% had their stones analyzed (calcium oxalate was the main finding in the examined stones). Conclusions: The frequency of urolithiasis in these pediatric patients was similar to that reported by the literature. A metabolic evaluation is required and the composition of stones should be better evaluated.

Risk factors associated with feline urolithiasis.

Urinary tract diseases are among the main reasons for consultation in veterinary clinics and hospitals. It affects animals of any age, breed and gender. Among the diseases that affect this system, urolithiasis is the second largest cause of clinical signs compatible with feline urinary tract disease. The term urolithiasis refers to the presence of uroliths in any region of the urinary tract, but it is more commonly seen in the bladder and urethra. Uroliths are classified based on the type of mineral present in their composition, therefore, quantitative and qualitative analyzes are important for a better therapeutic approach. The animals may suffer from the disease and be asymptomatic, or show nonspecific clinical signs, making the diagnosis difficult. The disease should not be seen as a single problem, but as a consequence of various disorders. As dietary, metabolic, genetic and infectious causes, as well as factors that potentiate the chance of development of uroliths such as breed, age, sex, age range, obesity, sedentary lifestyle, geographic region and climate. Thus, the knowledge of the factors that influence the formation of uroliths, as well as the understanding of the pathophysiology, are key elements for better alternatives of therapy and prevention. The recognition of these factors helps to identify susceptible populations, minimizing exposure and increasing the protection factors, which facilitates the diagnosis and treatment of patients with urolithiasis. The objective of this paper is to present the main risk factors involved in the formation of urinary lithiasis in felines.

Sensitivity of urolithiasis detection using urinary, radiography and ultrasound parameters / Sensibilidade da detecção da urolitíase utilizando parâmetros urinários radiográficos e ultrassonográficos

Although many information has been published regarding canine urolithiasis, sensitivity of radiography, ultrasound and urinary parameters have been poorly correlated with number, size, and composition of the stones. One hundred and thirteen clinical files of dogs with diagnosis of urolithiasis were retrospectively selected. Information regarding number, appearance, location, size, and composition of the stones were noted after surgical removed. Urolithiasis data was compared with radiographs and ultrasound images and urinalysis parameters. Pure struvite was found in 42.4% and calcium oxalate in 35.6%. Survey radiographs enabled the detection of radiopaque stones and when an ultrasound examination was also performed, the sensitivity was increased. Double contrast radiography enabled identification in 100% of radiolucent stones, and allowed for size measurement and number counts in 76.9% of radiolucent stones. Crystalluria had low sensitivity (31.5%) and specificity (58.8%). Hematuria (96.3%) and leukocyturia (61.1%) were the most common parameters found. We concluded that double contrast radiography can be considered the method of choice for detection of radiolucent stones. Crystalluria is not a good parameter to detect or predict type of stone. Hematuria and leukocyturia, although non-specific findings, can be used as triage for investigation of urolithiasis.

Embora várias informações já tenham sido publicadas sobre a urolitíase canina, a sensibilidade dos exames radiográficos, ultrassonográficos e urinários é pouco correlacionada com a composição, número e tamanho dos urólitos. Dessa forma, objetivou-se com esse estudo, analisar retrospectivamente cento e treze prontuários de cães com diagnóstico de urolitíase. Após a remoção cirúrgica dos cálculos, informações sobre o número, aspecto, localização, tamanho e composição foram comparados com os exames de imagens (raio-x e ultrassom) e achados da urinálise. Cálculos de estruvita foram encontrados em 42,4% dos pacientes e de oxalato de cálcio em 35,6%. Exames radiográficos foram capazes de detectar cálculos radiopacos e quando associado ao ultrassom tiveram melhores resultados. A radiografia de duplo contraste permitiu a identificação de 100% dos urólitos radiolucentes e foi capaz de estimar o tamanho e o número em 76,9% desses. Na urinálise a cristalúria apresentou baixa sensibilidade (31,5%) e especificidade (58,8%) na detecção de urólitos, já a hematúria (96,3%) e leucocitúria (61,1%) foram os parâmetros mais observados. Conclui-se que a radiografia de duplo contraste é o método de escolha para a detecção de urólitos radiolucentes e que a cristalúria não pode ser considerada um bom parâmetro para detectar ou prever o tipo de urólitos. Embora a hematúria e leucocitúria não sejam achados específicos,podem ser utilizados como triagem para a investigação da urolitíase.

Sensitivity of urolithiasis detection using urinary, radiography and ultrasound parameters / Sensibilidade da detecção da urolitíase utilizando parâmetros urinários radiográficos e ultrassonográficos

Although many information has been published regarding canine urolithiasis, sensitivity of radiography, ultrasound and urinary parameters have been poorly correlated with number, size, and composition of the stones. One hundred and thirteen clinical files of dogs with diagnosis of urolithiasis were retrospectively selected. Information regarding number, appearance, location, size, and composition of the stones were noted after surgical removed. Urolithiasis data was compared with radiographs and ultrasound images and urinalysis parameters. Pure struvite was found in 42.4% and calcium oxalate in 35.6%. Survey radiographs enabled the detection of radiopaque stones and when an ultrasound examination was also performed, the sensitivity was increased. Double contrast radiography enabled identification in 100% of radiolucent stones, and allowed for size measurement and number counts in 76.9% of radiolucent stones. Crystalluria had low sensitivity (31.5%) and specificity (58.8%). Hematuria (96.3%) and leukocyturia (61.1%) were the most common parameters found. We concluded that double contrast radiography can be considered the method of choice for detection of radiolucent stones. Crystalluria is not a good parameter to detect or predict type of stone. Hematuria and leukocyturia, although non-specific findings, can be used as triage for investigation of urolithiasis.(AU)

Embora várias informações já tenham sido publicadas sobre a urolitíase canina, a sensibilidade dos exames radiográficos, ultrassonográficos e urinários é pouco correlacionada com a composição, número e tamanho dos urólitos. Dessa forma, objetivou-se com esse estudo, analisar retrospectivamente cento e treze prontuários de cães com diagnóstico de urolitíase. Após a remoção cirúrgica dos cálculos, informações sobre o número, aspecto, localização, tamanho e composição foram comparados com os exames de imagens (raio-x e ultrassom) e achados da urinálise. Cálculos de estruvita foram encontrados em 42,4% dos pacientes e de oxalato de cálcio em 35,6%. Exames radiográficos foram capazes de detectar cálculos radiopacos e quando associado ao ultrassom tiveram melhores resultados. A radiografia de duplo contraste permitiu a identificação de 100% dos urólitos radiolucentes e foi capaz de estimar o tamanho e o número em 76,9% desses. Na urinálise a cristalúria apresentou baixa sensibilidade (31,5%) e especificidade (58,8%) na detecção de urólitos, já a hematúria (96,3%) e leucocitúria (61,1%) foram os parâmetros mais observados. Conclui-se que a radiografia de duplo contraste é o método de escolha para a detecção de urólitos radiolucentes e que a cristalúria não pode ser considerada um bom parâmetro para detectar ou prever o tipo de urólitos. Embora a hematúria e leucocitúria não sejam achados específicos,podem ser utilizados como triagem para a investigação da urolitíase.(AU)

Epidemiology of urolithiasis consultations in the Paraíba Valley / Epidemiologia dos atendimentos por urolitíase no Vale do Paraíba

ABSTRACT Objective: to know the epidemiological profile of patients with urolithiasis in the Paraíba Valley region, identifying its prevalence and spatial distribution. Method: we conducted a cross-sectional study, by residence location in the Paraíba Valley, on morbidity data due to urolithiasis obtained from the DATASUS, covering the period between 2010 and 2012. We aimed at identifying the general, male and female prevalence of urolithiasis, the distribution by age, type of visit, year season and spatial distribution. Results: there were 1,901 visits for urolithiasis in the 35 municipalities of the Paraíba Valley in the three years studied, 52.3% of them of female patients. Of the total, 70.1% of the visits were emergency ones. The feminine visits (67.2%) were mostly also urgent (p <0.01). The overall prevalence for urolithiasis was 31.7/100,000. Male prevalence was 30.7/100,000, and the female, 32.7/100,000 (p>0.05). The prevalence ratio was 0.9 men for every woman. The age group with the highest prevalence was between 30 and 39 years, with 23.1%. Warm seasons concentrated 51.6% of cases, while 48.8% occurred in the cold ones (p>0.05) . Conclusion: women are more affected by urolithiasis than the male in the Paraíba Valley region, an unprecedented in the literature. There was no relationship between the year season and the disease. We identified municipalities where preventive actions of urinary lithogenesis are required.

RESUMO Objetivo: conhecer o perfil epidemiológico dos pacientes com urolitíase, na região do Vale do Paraíba, identificando sua prevalência e distribuição espacial. Métodos: estudo transversal com dados de morbidade por local de residência decorrente de urolitíase no Vale do Paraíba, relativos ao período compreendido entre 2010 e 2012, obtidos do DATASUS. Os dados foram analisados para identificar a prevalência geral, masculina e feminina da urolitíase, a distribuição por idade, tipo de atendimento, estação do ano e sua distribuição espacial. Resultados: ocorreram 1901 atendimentos por urolitíase nos 35 municípios do Vale do Paraíba nos três anos estudados, sendo 52,3% dos pacientes do sexo feminino. Do total, 70,1% dos atendimentos foram em caráter de urgência. Os atendimentos femininos, na sua maioria (67,2%), também foram de urgência (p<0,01). A prevalência geral encontrada para a urolitíase foi 31,7/100.000 habitantes. A prevalência masculina foi 30,7/100.000 e a feminina de 32,7/100.000 (p>0,05). A relação de prevalência encontrada foi 0,9 homens para cada mulher. A faixa etária com o maior número de pacientes atendidos foi entre 30 e 39 anos, com 23,1% do total. Nas estações quentes ocorreram 51,6% dos atendimentos, enquanto nas frias 48,8% (p>0,05). Conclusões: foi possível identificar que na região do Vale do Paraíba o sexo feminino é mais acometido pela urolitíase do que o masculino, fato inédito na literatura. Não se encontrou relação entre a estação do ano e a doença. Foram identificados municípios onde ações de prevenção da litogênese urinária são necessárias.

Urolithiasis in pregnancy.

Urolithiasis in pregnancy is a major health concern and can potentially affect the well-being of both mother and foetus. Management of this condition often entails simultaneous multidisciplinary involvement of obstetrician, radiologist and urologist. Additionally, adverse effects with usage of anaesthesia, radiation, medications and surgery on mother and foetus, limit utilisation of the full armamentarium of diagnostic and therapeutic modalities that are commonly used in non-pregnant women. This review was conducted using an electronic literature search of peer reviewed journal articles. Clinical studies were identified in the bibliographic database- PubMed (Medline), Ovid and eMedicine(WebMD) using the keywords: hydronephrosis, urolithiasis, kidney stone, urinary tract infection, pregnancy and ultrasound, incidence and epidemiology of renal stones.

Epidemiology of urolithiasis consultations in the Paraíba Valley.

OBJECTIVE: to know the epidemiological profile of patients with urolithiasis in the Paraíba Valley region, identifying its prevalence and spatial distribution. METHOD: we conducted a cross-sectional study, by residence location in the Paraíba Valley, on morbidity data due to urolithiasis obtained from the DATASUS, covering the period between 2010 and 2012. We aimed at identifying the general, male and female prevalence of urolithiasis, the distribution by age, type of visit, year season and spatial distribution. RESULTS: there were 1,901 visits for urolithiasis in the 35 municipalities of the Paraíba Valley in the three years studied, 52.3% of them of female patients. Of the total, 70.1% of the visits were emergency ones. The feminine visits (67.2%) were mostly also urgent (p <0.01). The overall prevalence for urolithiasis was 31.7/100,000. Male prevalence was 30.7/100,000, and the female, 32.7/100,000 (p>0.05). The prevalence ratio was 0.9 men for every woman. The age group with the highest prevalence was between 30 and 39 years, with 23.1%. Warm seasons concentrated 51.6% of cases, while 48.8% occurred in the cold ones (p>0.05) . CONCLUSION: women are more affected by urolithiasis than the male in the Paraíba Valley region, an unprecedented in the literature. There was no relationship between the year season and the disease. We identified municipalities where preventive actions of urinary lithogenesis are required.

Urolitíase em Schnauzer: uma abordagem clínica e cirúrgica / Urolithiasis in Schnauzer: a clinical and surgical approach

The urolithiasis in dogs is a very common disease in the veterinary clinic. It is characterized by mineralized salt accumulation in some region of the urinary tract and is more common in areas of the bladder and urethra, but rare in the kidneys and ureters. This study aims to report a case of urolithiasis in dog. It was answered in Clinical Veterinary ETAVE, Fortaleza, Ceará, a female, race Schnauzer, 10 years old, whose diet consisted of food and home cooking. There were made physical and complementary examinations of the animal, establishing the diagnosis of urolithiasis. Cystotomy was prescribed to remove the uroliths of the bladder, as well as medicine and the animal dietary modification. The uroliths were characterized as mixed. Surgical treatment associated with therapeutic diets is an excellent option for the control of relapses.(AU)

Urolitíase em Schnauzer: uma abordagem clínica e cirúrgica / Urolithiasis in Schnauzer: a clinical and surgical approach

The urolithiasis in dogs is a very common disease in the veterinary clinic. It is characterized by mineralized salt accumulation in some region of the urinary tract and is more common in areas of the bladder and urethra, but rare in the kidneys and ureters. This study aims to report a case of urolithiasis in dog. It was answered in Clinical Veterinary ETAVE, Fortaleza, Ceará, a female, race Schnauzer, 10 years old, whose diet consisted of food and home cooking. There were made physical and complementary examinations of the animal, establishing the diagnosis of urolithiasis. Cystotomy was prescribed to remove the uroliths of the bladder, as well as medicine and the animal dietary modification. The uroliths were characterized as mixed. Surgical treatment associated with therapeutic diets is an excellent option for the control of relapses.

Etiología de la urolitiasis en niños mayores de un mes a dieciocho años de edad, en el período comprendido entre los meses de enero 2008 hasta diciembre 2012, en la consulta externa de nefrología del Hospital Nacional de Niños Benjamín Bloom / Etiology of urolithiasis in children older than one month to eighteen years of age, in the period from January 2008 to December 2012, in the outpatient nephrology consultation of the Benjamín Bloom National Children's Hospital

La litiasis renal es definida como la presencia de cálculos en el tracto urinario y es una entidad poco frecuente en la infancia. Su incidencia ha disminuido en los países desarrollados. Consiste en la precipitación de sustancias cristalinas que normalmente están disueltas en la orina, de distinta composición química. Tiene una etiología multifactorial e implica factores genéticos, ambientales, raciales y estructurales además de mecanismos fisicoquímicos complejos, el objetivo del presente estudio se basa en determinar la etiología de urolitiasis en niños mayores de un mes a menores de dieciocho años de edad que se han diagnosticado en la consulta externa del HNNBB, dicho estudio es de importancia ya que no se cuenta con análisis previos sobre el tema en dicho centro. El estudio es de tipo descriptivo, retrospectivo de corte transversal, en el cual se investigó a 59 pacientes con diagnóstico de litiasis renal entre las edades de 1 mes a 18 años, proveyendo datos relevantes sobre la patología, se realizó tabla de vaciamiento de datos en donde se utilizaron variables como: edad, sexo, procedencia, métodos diagnóstico de litiasis renal, así como para conocer la etiología que con mayor frecuencia predispone a la aparición Urolitiasis se utilizaron los parámetros tanto urinarios y sanguíneos que conlleva a la manifestación de la enfermedad. Los resultados que se obtuvieron de los 59 pacientes investigado sobresalen: El género más frecuente afectado es el masculino con una relación M/F: 2.9:1. La edad promedio de los pacientes fue de 5.36 ± 3.6 años, siendo el grupo atareo más afectado para la predisposición de litiasis renal son los preescolares que corresponde a los rangos de edades de 3 a 5 años, siendo un total de 19 pacientes (32.2%). La zona geográfica del país con más predisposición de litiasis renal es la central, el síntoma inicial para la predisposición de la enfermedad es el dolor, el método diagnóstico más utilizado es la USG abdominal, las causas metabólicas que se asocian son la Hipercalciuria y la hipocitraturia, además se encontraran más datos de interés para el lector del presente trabajo. El estudio concluye que la alteración metabólica relacionada al padecimiento de litiasis renal es la hipercalciuria como causa principal para padecer litiasis renal, además el dolor abdominal es considerada en el presente trabajo la razón por la cual consultaron los pacientes a los cuales se le toma USG abdominal para coincidir con diagnóstico de litiasis de la vía urinaria. Datos importantes para evaluar a futuros pacientes que consulten en nuestro hospital

Urolithiasis and pregnancy.

The diagnosis of urolithiasis during pregnancy is common, even though no additional measures are required in asymptomatic cases. Renal colic or complications of urinary lithiasis occur more frequently during the last months of pregnancy, and there are several particularities for the diagnosis and treatment of this subset of women. The present manuscript aim to review the current knowledge concerning this subject and present authors personal experience.

Litíase urinária e gestação / Urolithiasis and pregnancy

A litíase urinária é frequentemente diagnosticada durante a gestação. O diagnóstico de nefrolitíase assintomática durante a gestação não requer medidas adicionais, apenas o seguimento do pré-natal normal. Contudo, quando ocorre cólica renal ou complicações decorrentes da litíase urinária, medidas adicionais tornam-se necessárias. Nestes eventos, mais comuns nos últimos meses de gestação, há particularidades relacionadas ao quadro clínico, diagnóstico e tratamento específicos para esta população de pacientes. O presente artigo tem como objetivo revisar estes aspectos de litíase urinária na gestação à luz do conhecimento atual e da experiência pessoal dos autores.

The diagnosis of urolithiasis during pregnancy is common, even though no additional measures are required in asymptomatic cases. Renal colic or complications of urinary lithiasis occur more frequently during the last months of pregnancy, and there are several particularities for the diagnosis and treatment of this subset of women. The present manuscript aim to review the current knowledge concerning this subject and present authors personal experience.