Treatment of chronic tubulointerstitial disease: a new concept.
Treatment of chronic tubulointerstitial disease: a new concept.
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DOI：
10.1046/j.1523-1755.2002.00331.x
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发表时间：
2002-05
影响因子：
19.6
通讯作者：
K. Hruska
中科院分区：
文献类型：
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作者：
K. Hruska
一位41岁的白色男性于3年前因右输尿管中段梗阻结石接受输尿管镜碎石术后转诊至华盛顿大学肾结石中心。患者无症状，饮食无异常，病史长且复杂。他从小就患有反复发作的肾结石，并被诊断为胱氨酸尿症。24年前，他17岁时因鹿角形结石的肾切开术并发症接受了左肾切除术。直到11年前，他才停止形成肾结石，当时他患上了回结肠瘘，并被诊断为克罗恩病。在几次肠切除术和各种瘘道的发展后，他在6年前接受了回肠造口术。康复后，他的炎症性肠病通过药物控制。他体重增加，回肠造口排泄量稳定，约为1.5 L/天。然而，他出现复发性肾结石。四年前，他因肾绞痛在亚拉巴马大学泌尿系接受治疗。他的肾盂中有一个2.5 cm的结石，需要经皮肾镜取石术;取出的结石是97%的胱氨酸。当时，他的血清肌酐为1.6 mg/dL;肌酐清除率为90 mL/min;蛋白排泄量为100 mg/24 h。
A 41-year-old white man was referred to the Washington University renal stone center 3 years ago following a ureteroscopic lithotripsy for an obstructing right mid-ureteral stone 2 months earlier. The patient was asymptomatic and had an unremarkable dietary history.His medical history was long and complicated. He had had recurrent nephrolithiasis since his childhood, and he carried the diagnosis of cystinuria. He had undergone a left nephrectomy 24 years ago at age 17 for complications during a nephrolithotomy for a staghorn calculus. He had stopped forming renal stones until 11 years ago, when he developed an ileocolic fistula and was diagnosed with Crohn's disease. After several intestinal resections and development of various fistula tracks, he underwent an ileostomy 6 years ago. Following recovery, his inflammatory bowel disease was controlled by medications. He gained weight and developed a stable ileostomy excretory volume of approximately 1.5 L/day. However, he experienced recurrent nephrolithiasis. Four years ago, he was treated for renal colic in the Department of Urology at the University of Alabama. He had a 2.5 cm stone in the renal pelvis, which required percutaneous nephrolithotomy; the extracted stone was 97% cystine. At that time, his serum creatinine was 1.6 mg/dL; creatinine clearance, 90 mL/min; and protein excretion, 100 mg/24 h.