(精选)PREVALENCE OF KIDNEY STONE DISEASE IN DIFFERENT COUNTRIES IN THE THIRD MILLENIUM教学课件.pptVIP

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(精选)PREVALENCE OF KIDNEY STONE DISEASE IN DIFFERENT COUNTRIES IN THE THIRD MILLENIUM教学课件.ppt

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演示文稿演讲PPT学习教学课件医学文件教学培训课件

LA VALUTAZIONE METABOLICA Prof. Pasquale Strazzullo – Dr. Domenico Rendina Dipartimento di Medicina Clinica e Chirurgia Centro per le Malattie del Metabolismo Minerale Università di Napoli Federico II Milano, 9 maggio 2015 LA DIETA NEI PAZIENTI AFFETTI DA CALCOLOSI OGGI PREVALENCE OF KIDNEY STONE DISEASE IN DIFFERENT COUNTRIES IN THE THIRD MILLENIUM (first decade) Romero V et al, Reviews in Urology 2010 TIME TREND IN THE PREVALENCE OF KIDNEY STONE DISEASE Scales CD Jr. et al, European Urology 2012 Bushinsky DA, JASN 1998 RECURRENCE OF NEPHROLITHIASIS IN UNTREATED PATIENTS PRIMARY PREVENTION …. means to prevent a first episode ever of kidney stones; ….should be based on the knowledge of the most frequent causal factors of KSD; …should be implemented at the population level by supporting life styles and dietary habits known to be effective on most KSD risk factors. SECONDARY PREVENTION ….targets those who have suffered at least one KS event; …. takes advantage of the assessment of the risk factors operating in the individual patient; …. tries to overcome the problem in a case-specific fashion. Rendina D et al, NDT 2012 EAU Guideline 2015 AUA Guidelines 2014 MEDICAL HYSTORY DIETARY HYSTORY SERUM CHEMISTRY URINE CHEMISTRY INITIAL EVALUATION OF NEWLY DIAGNOSED PATIENT BLOOD - SERUM BLOOD SAMPLE SODIUM (EAU, AUA) POTASSIUM (EAU, AUA) CHLORIDE (EAU, AUA) BICARBONATE (EAU, AUA) CALCIUM (IF ↑: PTH, 25OHD3) (EAU, AUA) CREATININE (EAU, AUA) URIC ACID (EAU, AUA) URINE - DIPSTICK TEST RED CELLS (EAU, AUA) WHITE CELLS (EAU, AUA) NITRITE (EAU, AUA) URINE PH (EAU, AUA) URINE - MICROSCOPY (EAU, AUA) URINE - CULTURE (EAU, AUA) SERUM AND URINE CHEMISTRY INITIAL EVALUATION OF NEWLY DIAGNOSED PATIENT IDENTIFICATION OF HIGH-RISK PATIENT ADDITIONAL EVALUATION RECURRENT STONE FORMERS MULTIPLE STONES AT INITIAL PRESENTATION FAMILY HISTORY OF STONE DISEASE MEDICAL CONDITIONS PREDISPOSING TO STONE DISEASE PATIENTS WITH A SOLITARY KIDNEY ONE (AUA) OR TWO (EAU, AUA)