Urolitiáza u pacientů s idiopatickými střevními záněty

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

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Doručeno:
20. 11. 2015

Přijato:
27. 11. 2015

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
prolekare.web.journal.doi_sk: https://doi.org/10.14735/amgh2015561

Souhrn

Doručeno:
20. 11. 2015

Přijato:
27. 11. 2015

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