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2016, Número 3

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Acta Med 2016; 14 (3)


Avances y retos en la fisiopatología y tratamiento de la nefrolitiasis

Peña RJC

Idioma: Español
Referencias bibliográficas: 53
Paginas: 155-161
Archivo PDF: 150.49 Kb.


RESUMEN

Esta revisión refleja la gran incidencia y prevalencia de nefrolitiasis y los procesos que hay que seguir para su prevención. Estudios epidemiológicos recientes demuestran que la nefrolitiasis se asocia con otras enfermedades, todas ellas factores de riesgo de daño cardiovascular y renal. Esto sugiere que la enfermedad no es sólo una alteración urinaria sino una enfermedad metabólica sistémica y con repercusiones orgánicas. Se resumen las terapias en el manejo del cólico renal. También se hace mención del nomograma de Rule et al, que es un instrumento que permite predecir la recidiva de cálculos. Con dieta, hidratación y los medicamentos con los que ya contamos, el manejo de la nefrolitiasis es exitoso. Es crítico diagnosticar el trastorno metabólico causal de litiasis, sobre todo en enfermos metabólicamente activos. El depósito intersticial renal de CaP, conocido como placa de Randall, ocurre en presencia de hipercalciuria y es un factor promotor de nucleación y agregación de sales de oxalato de calcio. Se discute el manejo de la hiperuricosuria y su control con alopurinol y febuxostat, el papel del citrato en el tratamiento de la litiasis cálcica y por ácido úrico; y finalmente la litiasis y su manejo en la cistinuria.


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