{"id":4903,"date":"2015-10-28T13:17:24","date_gmt":"2015-10-28T13:17:24","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=4903"},"modified":"2015-10-28T13:17:24","modified_gmt":"2015-10-28T13:17:24","slug":"tratamente-recomandate-in-litiaza-calcica-si-urica","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/tratamente-recomandate-in-litiaza-calcica-si-urica\/","title":{"rendered":"Tratamente recomandate \u00een litiaza calcic\u0103 \u0219i uric\u0103"},"content":{"rendered":"

Lithoren \u2013 compozi\u021bie recomandat\u0103 de Ghidul European de Urolitiaz\u0103<\/p>\n

\"logo<\/a><\/p>\n

Litiaza de oxalat de calciu reprezint\u0103 circa 80% din totalul cazurilor de urolitiaz\u0103. Cea mai frecvent\u0103 tulburare metabolic\u0103 \u00eent\u00e2lnit\u0103 la ace\u0219ti pacien\u021bi e reprezentat\u0103 de hipercalciurie. Aceasta e definit\u0103 ca o concentra\u021bie a calciului \u00een urina din 24 de ore mai mare de 250 mg la femei \u0219i de 300 mg la b\u0103rba\u021bi.<\/p>\n

Riscul de apari\u021bie a calculilor exist\u0103 \u0219i la concentra\u021bii mai sc\u0103zute. \u00cen cazul \u00een care m\u0103surile dietetice aplicate pacien\u021bilor hipercalciurici nu au efectul scontat iar tulbur\u0103rile compozi\u021biei urinii din 24 de ore persist\u0103, ace\u0219tia pot fi candida\u021bi pentru un tratament farmacologic.<\/p>\n

Aportul de citrat de potasiu cre\u0219te pH-ul urinar prin cre\u0219terea excre\u021biei de bicarbonat. Citratul e metabolizat la nivelul ficatului \u00een bicarbonat, cre\u0219terea concentra\u021biei serice a bicarbonatului scade reabsorb\u021bia citratului urinar la nivelul tubului contort proximal.<\/p>\n

Calculii de acid uric se reg\u0103sesc la 5-10% dintre pacien\u021bi. Acidul uric e rezultatul final al metabolismului purinelor. Acidul uric e un acid organic slab care e de 11 ori mai solubil la pH 6,5 dec\u00e2t la pH 5. De\u0219i volumul de urin\u0103 poate influen\u021ba uricozuria, pH-ul urinii r\u0103m\u00e2ne cel mai important determinant al solubilit\u0103\u021bii acidului uric.<\/p>\n

Datorit\u0103 faptului c\u0103 pH-ul urinar joac\u0103 rolul principal \u00een litogeneza uric\u0103, tratamentul alcalinizant e esen\u021bial pentru chemoliza \u00een aceste cazuri. Alcalinizarea urinii prin tratament per os se poate face cu bicarbonat de sodiu sau citrat de potasiu.<\/p>\n

\u00cen cazul bicarbonatului doza recomandat\u0103 e de 650-1000 mg de trei-patru ori pe zi. Marele dezavantaj e reprezentat \u00eens\u0103 de aportul de sodiu. Dup\u0103 cum se \u0219tie un aport de sodiu crescut duce la cre\u0219terea calciuriei. De asemenea, excesul de sodiu poate agrava unele afec\u021biuni cardiovasculare precum hipertensiunea arterial\u0103 sau insuficien\u021ba cardiac\u0103.<\/p>\n

Tratamentul cu citrat de potasiu e de preferat pentru pacien\u021bii cu litiaz\u0103 uric\u0103. Acesta scade excre\u021bia de calciu sc\u0103z\u00e2nd riscul apari\u021biei litiazei de oxalat de calciu precum \u0219i de acid uric. E necesar\u0103 \u00eens\u0103 precau\u021bie la cei cu insuficien\u021b\u0103 renal\u0103. Pentru a cre\u0219te pH-ul urinar \u00een general o doz\u0103 zilnic\u0103 de 30-60 mEq pe zi e suficient\u0103. Obiectivul tratamentului alcalinizant e ob\u021binerea unui pH urinar de circa 6,5.<\/p>\n

\"logo<\/a><\/p>\n

Compania Solartium Group<\/strong> a lansat anul acesta primul produs farmaceutic de pe pia\u021ba din Rom\u00e2nia ce respect\u0103 recomand\u0103rile Asocia\u021biei Europene de Urolitiaz\u0103, produs comercializat sub denumirea de Lithoren\u00ae.<\/p>\n

\"300xH_780_tema-dny-pochki-zahod\"<\/a><\/p>\n

Lithoren\u00ae reprezint\u0103 o op\u021biune terapeutic\u0103 eficace \u0219i sigur\u0103 \u00een tratamentul \u0219i preven\u021bia litiazei calcice \u0219i urice, sus\u021binut de numeroase studii clinice interna\u021bionale.<\/p>\n

Produsul Lithoren\u00ae con\u021bine: citrat tribazic de potasiu 25 mEq (975 mg\/plic), citrat tribazic de magneziu 5 mEq (60mg\/plic) \u0219i 25 mg\/plic de piridoxina. Lithoren\u00ae nu con\u021bine sodiu.<\/p>\n

Lithoren\u00ae, prin compozi\u021bia sa de 30mEq de citra\u021bi, previne suprasatura\u021bia urinei cu complexe insolubile \u00een ap\u0103 de oxalat de calciu \u0219i fosfat de calciu prin formarea complexelor hidrosolubile de citrat de calciu \u0219i totodat\u0103 ionii citrat, \u00eenc\u0103rca\u021bi negativ, resping electrostatic ionii carboxilic \u00eenc\u0103rca\u021bi negativ \u0219i ionii fosforic de pe suprafa\u021ba cristalelor de CaOx \u0219i CaP, inhib\u00e2nd astfel cre\u0219terea lor. Acest lucru este critic pentru eliminarea fragmentelor reziduale de calculi \u00een urma tratamentelor de litotripsie.<\/p>\n

Ionii de magneziu din compozi\u021bia Lithoren\u00ae convertesc ionii oxalat \u00een oxalat de magneziu solubil \u00een ap\u0103, inhib\u0103 cre\u0219terea cristalelor de fosfat de calciu \u0219i inhib\u0103 formarea cristalelor de fosfat de calciu monohidrogenat-(brushite).<\/p>\n

Piridoxina (Vitamina B6) din compozi\u021bia Lithoren\u00ae inhib\u0103 produc\u021bia endogen\u0103 de oxalat, prin modularea secre\u021biei enzimei hepatice AGT (alanil glioxilat transferaza) cu rol \u00een oxidarea glioxilatului \u00een glicin\u0103 \u0219i \u00eempiedic\u0103 transformarea glioxilatul \u00een oxalat \u0219i implicit \u00eempiedic\u0103 hiperoxaluria \u0219i respectiv apari\u021bia litiazei cu oxalat de calciu. Totodat\u0103, Lithoren\u00ae solubilizeaz\u0103 calculii de acid uric prin normalizarea pH-ului urinar \u0219i men\u021binerea acestuia \u00een intervalul 6.2-6.8.<\/p>\n

\"cauzele-pietrelor-la-rinichi---colica-renala\"<\/a><\/p>\n

Prin toate aceste mecanisme, Lithoren\u00ae este recomandat \u0219i \u00een corectarea tulbur\u0103rilor metabolice frecvent asociate cu urolitiaza (hipocitraturie <320mg\/zi, hipomagneziurie <72mg\/zi, hiperoxalurie >40mg\/zi, hipercalciurie >300mg la barbati si >250mg la femei\/zi).<\/p>\n

Evaluarea pH-ului urinar este crucial\u0103 pentru pacien\u021bii formatori de calculi, astfel \u00eenc\u00e2t, utilizarea benzilor indicatoare de pH cu o \u00eenalt\u0103 acurate\u021be reprezint\u0103 o modalitate facil\u0103 ce permite ajustarea dozei administrate \u00een func\u021bie de pH-ul ini\u021bial al pacientului dar \u0219i de r\u0103spunsul la tratamentul Lithoren\u00ae.<\/p>\n

Lithoren\u00ae se recomand\u0103 a fi administrat 1 plic\/zi \u00eenainte de litotritie \u0219i 2 plicuri\/zi pe toat\u0103 durata \u0219edin\u021belor de litotritie, minim 3 luni de zile, cu evaluarea pH-ului urinar ce se poate efectua cu ajutorul celor 14 benzi indicatoare ce se g\u0103sesc \u00een cutia Lithoren\u00ae.<\/p>\n","protected":false},"excerpt":{"rendered":"

Lithoren \u2013 compozi\u021bie recomandat\u0103 de Ghidul European de Urolitiaz\u0103 Litiaza de oxalat de calciu reprezint\u0103 circa 80% din totalul cazurilor de urolitiaz\u0103. Cea mai frecvent\u0103 tulburare metabolic\u0103 \u00eent\u00e2lnit\u0103 la ace\u0219ti […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[33,154],"tags":[],"class_list":["post-4903","post","type-post","status-publish","format-standard","category-articole","category-urologie"],"yoast_head":"\nTratamente recomandate \u00een litiaza calcic\u0103 \u0219i uric\u0103 - Jurmed - Medici<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jurmed.ro\/medici\/tratamente-recomandate-in-litiaza-calcica-si-urica\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Tratamente recomandate \u00een litiaza calcic\u0103 \u0219i uric\u0103 - Jurmed - Medici\" \/>\n<meta property=\"og:description\" content=\"Lithoren \u2013 compozi\u021bie recomandat\u0103 de Ghidul European de Urolitiaz\u0103 Litiaza de oxalat de calciu reprezint\u0103 circa 80% din totalul cazurilor de urolitiaz\u0103. 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