Update analytic program for laboratory investigation in urinary tract calculosis

Abstract

Urinary tract calculosis due to it's high recurrence rate (50-100% in untreated patients) and possibility to cause chronic renal failure in 20% still represents a great social and medical problem. From that aspect, an adequate clinical evaluation in stone forming patients is of paramount importance. An effective and rational attitude in detecting possible causes of stone formation demands the adequate analytic program in biochemical investigations. Presented program is adjusted to the guidelines on urolithiasis, recommended by Board EAU (European Association of Urologists) Healthcare Office, for year 2003. Regarding to known chemical stone composition, category of stone former and presence of an specific risk factor, analytic program could be minimal (fasting morning spot urine sample analysis, urineculture and blood analysis (calcium, albumine, creatinine and urate and stone analysis) and extended (quantification of all parameters in serum and in two consequtive 24h urine collections, relevant for stone formation and evaluation of renal function). In order to identify metabolic disorders, an quantification of parathormone in serum, cAMP in urine and absorption/loading tests with calcium, NH4Cl and [12C2] oxalate are recommended.