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Springer Calcium Urolithiasis Pathogenesis, Diagnosis, and Management 1st Editon 2012 Softbound by Charles Pak
'People . . . see you sweat in agony, turn pale, turn red, trem ble, vomit your very blood, suffer strange contractions and con vulsions, sometimes shed great tears from your eyes, discharge thick, black and frightful urine, or have it stopped up by some sharp rough stone that cruelly pricks and flays the neck of your penis. ' * These 16th century frustrations of Michel de Montaigne which most graphically reflect his experience with renal colic still plague approximately 1 per 1000 individuals in the United States annually. Since as many as 75% of clinically. apparent episodes of renal colic represent single nonrecurring events, physicians not in frequently approach the differential diagnosis of nephrolithiasis in a less than adequate fashion and assume that the incident may prob ably never recur after the single attack. However, the ureteral or bladder stone actually represents one form of abnormal crystalline precipitation; parenchymal nephrocalcinosis, silently progressive azotemia, and asymptomatic renal pelvic calculi may also stem from the same pathological process(es) which conditioned the for mation of the ureteral or bladder stone. In this regard it is worth emphasizing that the postmortem incidence of renal calculi is some tenfold greater than that presumed from surveys wherein a clinical attack of nephrolithiasis is the sole determinant. *In Familiar Medical Quotations. M. B. Strauss, Ed. Little Brown, Boston, 1968, p. 646. v vi FOREWORD The last decade has witnessed the birth of new knowledge in urolithiasis research. 1 Introduction.- 2 Physical Chemistry of Stone Formation.- Scheme for Stone Formation.- Process of Nucleation.- Crystal Growth.- Crystal Aggregation.- Heterogeneous Nucleation.- Inhibitors of Crystallization.- Promoters of Crystallization.- Organic Matrix of Stones.- Future Research in the Physical Chemistry of Stone Formation.- References.- 3 Hypercalciurias.- Role of Hypercalciuria in Stone Formation.- Causes of Hypercalciuria.- Historical Considerations.- Diagnostic Criteria for Hypercalciurias.- Association with Hyperuricosuria.- Genetics of Absorptive and Renal Hypercalciurias.- Clinical Course.- Causes of the Intestinal Hyperabsorption of Calcium.- Treatment of Hypercalciurias.- “Harmful” Drugs.- Rational Basis for Therapy of Hypercalciurias.- Future Research in Hypercalciurias.- References.- 4 Primary Hyperparathyroidism and Other Causes of Hypercalcemia.- Definition of Hypercalcemia.- Primary Hyperparathyroidism.- Normocalcemic Primary Hyperparathyroidism.- Other Causes of Hypercalcemia.- References.- 5 Hyperuricosuric Calcium Urolithiasis.- Historical Background.- Cause of Calcium Urolithiasis in Hyperuricosuria.- Clinical Presentation of Hyperuricosuric Calcium Urolithiasis.- Treatment with Allopurinol.- Future Studies.- References.- 6 Hyperoxaluric Calcium Urolithiasis.- Historical Background.- Cause of the Hyperoxaluria.- Cause of Stone Formation.- Clinical Presentation.- Treatment of Secondary Hyperoxaluria.- Future Studies.- References.- 7 Practical Guidelines for the Diagnosis and Management of Calcium Urolithiasis.- Ambulatory Evaluation.- Outline of the Procedure (Table IX).- Interpretation of Data.- Optimum Treatment of Calcium Urolithiasis.- Follow-Up Care.- Selection of Patients for Evaluation and Treatment.- References.