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Metabolic investigation of patients with staghorn calculus: is it necessary?
[cystinuria]
To
evaluate
the
prevalence
of
metabolic
disorders
in
patients
with
staghorn
calculi
treated
at
the
Regional
Center
of
Lithiasis
Metabolic
Studies
in
central
region
of
SÃ¥o
Paulo
State
,
Brazil
.
Between
February
2000
and
February
2008
,
630
patients
with
urinary
calculi
were
evaluated
in
the
lithiasis
outpatient
clinic
.
Thirty
-
seven
of
them
had
staghorn
calculi
(
35
women
and
2
men
)
.
The
inclusion
criteria
for
the
metabolic
investigation
included
the
absence
of
urological
manipulation
30
days
before
the
examination
,
negative
urine
culture
and
creatinine
clearance
>
60
mL
/
min
.
The
protocol
for
metabolic
investigation
consisted
of
qualitative
search
for
cystinuria
.
Two
non-consecutive
24
-
hour
urine
samples
collected
to
measure
calcium
,
phosphorus
,
uric
acid
,
sodium
,
potassium
,
magnesium
,
oxalate
and
citrate
,
and
serum
calcium
levels
,
phosphorus
,
uric
acid
,
sodium
,
potassium
,
magnesium
,
chloride
,
parathormone
and
urine
pH
.
Among
patients
with
lithiasis
,
5
.
9
%
(
37
/
630
)
had
staghorn
calculus
and
in
48
.
6
%
(
18
/
37
)
were
diagnosed
with
urinary
infection
.
The
females
were
predominant
for
94
.
5
%
of
cases
.
The
calculi
were
unilateral
in
31
of
cases
and
bilateral
in
six
.
Metabolic
abnormalities
were
found
in
68
.
2
%
of
patients
with
hypercalciuria
(
64
.
2
%
)
and
hypocitraturia
(
53
.
3
%
)
being
the
most
common
disorders
.
The
presence
of
metabolic
disorders
in
nearly
70
%
of
patients
with
staghorn
calculus
reinforces
the
necessity
for
evaluation
of
these
patients
.
The
diagnosis
and
treatment
of
identified
metabolic
abnormalities
can
contribute
to
the
prevention
of
recurrent
staghorn
calculi
.
Diseases
Validation
Diseases presenting
"hypocitraturia"
symptom
cystinuria
This symptom has already been validated
