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margin-left:198.0pt; text-indent:-9.0pt;} @list l4:level7 {mso-level-tab-stop:none; mso-level-number-position:left; margin-left:234.0pt; text-indent:-18.0pt;} @list l4:level8 {mso-level-number-format:alpha-lower; mso-level-tab-stop:none; mso-level-number-position:left; margin-left:270.0pt; text-indent:-18.0pt;} @list l4:level9 {mso-level-number-format:roman-lower; mso-level-tab-stop:none; mso-level-number-position:right; margin-left:306.0pt; text-indent:-9.0pt;} ol {margin-bottom:0cm;} ul {margin-bottom:0cLITIASIS URINARIA
INTRODUCCION
INTRODUCCION
La litiasis urinaria puede comprometer todo el tracto urinario, desde la pelvis renal hasta la uretra.
La clínica es variable desde pacientes totalmente asintomáticos con hallazgo casual de litiasis en estudios de imágenes por otros motivos, hasta pacientes con cólico renoureterales complicados.
En general, el riesgo de padecer un nuevo cuadro de cólico renouretal tras un primer episodio es de un 50 %. Los casos con alto riesgo de recurrencia son solo el 10 % de los pacientes, en quienes influye principalmente la composición de la litiasis y la severidad de la enfermedad que la produce.
GRUPOS DE RIESGO PARA SEVERIDAD Y RECURRENCIA
FACTORES GENERALES
1. Presentación temprana. Especialmente si se presenta en niños o en adolecentes.
2. Historia familiar de litiasis.
3. Composición de litiasis que contenga Bruxita.
4. Composición de litiasis que contenga ácido úrico o urato.
5. Litiasis infectivas.
6. Riñón único
DETERMINANTES GENÉTICOS
1. Cistinuria
2. Hiperoxaliuria primaria
3. Acidosis Tubular Renal tipo I (ATR I)
4. 2,8 dihydroxyadenine
5. Xanthinuria
6. Lesch – Nyhan síndrome
7. Fibrosis quística
Enfermedades asociadas a formación de litiasis
1. Hiperparatiroidismo
2. Nefrocalcinosis
3. Enfermedad gastrointestinal (bypass jejuno ileal, resección de intestino, enfermedad de Crohn, malabsorción, hiperoxaliuria entérica asociada a derivación urinaria).
4. Cirugía bariátrica
5. Sarcoidosis
Anormalidades Anatómicas
1. Riñón en esponja medular (ectasia tubular)
2. Obstrucción de unión ureteropelvico
3. Divertículo calicial quiste calicial
4. Estenosis uretral
5. Reflujo vesico uretero renal
6. Riñón cabaño
7. Ureterocele
Drogas asociadas a litiasis
Alopurino, amoxicilina, ampicilina ceftriaxone, efedrina, Indinavir, sulfamidas Triampetere, acetazolamida, acido ascórbico laxativos, vitamina D.
PREVENCION GENERAL
1. Hidratación adecuada
2. Disminución de la dieta rica en proteínas Reducción de ingesta de sal
3. Ingesta de alimentos que aumenten el citrato en orina (zumos de naranja y limón)
4. Restringir el consumo de oxalatos (salvado de trigo, espinacas, ruibarbo, coco, nueces)
No se recomienda eliminar ningún tipo de alimento de la dieta, excepto recomendación explicita por su Urólogo. La dieta debe ser balanceada.
Artículos relacionados:
– LEOC. Litotricia extracorporea con ondas de choque. MU
– URS. Ureterorenoscopia flexible más litotricia intracorporea. MU
– NLP. Nefrolitotomía Percutánea. MU
Artículos asociados:
– Litiasis renal. Factores de Riesgo. MU
– Enfermedad litiásica. Grupos de Riesgo y Prevención. MU
– Litiasis urinaria. Pruebas de imágenes. MU
– Microlitiasis renal.
– LEOC. Litotricia extracorporea con ondas de choque. MU
– URS. Ureterorenoscopia flexible más litotricia intracorporea. MU
– NLP. Nefrolitotomía Percutánea. MU
Artículos asociados:
– Litiasis renal. Factores de Riesgo. MU
– Enfermedad litiásica. Grupos de Riesgo y Prevención. MU
– Litiasis urinaria. Pruebas de imágenes. MU
– Microlitiasis renal.
¿ENFERMEDAD LITIASICA?
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