Urolitiáza u pacientů s idiopatickými střevními záněty
Autoři:
V. Teplan; M. Lukas
Působiště autorů:
IBD Clinical and Research Centre, ISCARE Lighthouse and 1st Medical Faculty of Charles University, Prague
Vyšlo v časopise:
Gastroent Hepatol 2015; 69(6): 561-569
Kategorie:
IBD: přehledová práce
doi:
https://doi.org/10.14735/amgh2015561
Souhrn
Zánětlivá onemocnění střeva jsou typicky doprovázena průjmy a malabsorpcí, což představuje predisponující faktory pro tvorbu ledvinných kamenů. Prevalence urolitiázy činí kolem 1,5– 5 %, ale u nemocných po resekci střeva 3,7– 16 %. Enterická hyperoxalurie je častou komplikací zánětlivých onemocnění střeva, ileální resekce a Roux-En-Y – gastického bypassu a je známou příčinou nefrolitiázy a nefrokalcinózy. Nadbytek oxalátů je primárně vylučován ledvinami. Zvýšené močové vylučování oxalátů vede k zvýšené saturaci moči Ca oxaláty, agregaci krystalů a vzniku urolitiázy či nefrokalcinózy. Prevence oxalátové litiázy zahrnuje vedle zvýšeného příjmu tekutin perorální podávání citrátu, magnézia, suplementu Ca, nutričně bilanční nízkooxalátové nízkotučné diety a též biologické ovlivnění střevní flóry (Oxalobacter formigenes, Bifidobacterium lactis apod.). Nové léčebné postupy u nemocných se zánětlivými onemocněními střeva zásadním způsobem změnily průběh onemocnění. Zda však tato příznivá změna ovlivní prevalenci a rizikové faktory pro tvorbu močových kamenů, není dosud známo.
Klíčová slova:
zánětlivá onemocnění střeva – urolitiáza – hyperoxalurie – střevní flora – prevence
Autoři deklarují, že v souvislosti s předmětem studie nemají žádné komerční zájmy.
Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do biomedicínských časopisů.
Doručeno:
20. 11. 2015
Přijato:
27. 11. 2015
Zdroje
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Štítky
Dětská gastroenterologie Gastroenterologie a hepatologie Chirurgie všeobecnáČlánek vyšel v časopise
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