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Title: The importance of urine biochemistry and renal histopathology in the aetiology and management of upper urinary tract stones
Author: Inglis, J. A.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1992
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Urolithiasis is a condition known to Man for centuries, which once established, frequently pursues a recurring course. This might suggest a chronic underlying abnormality yet often no definite predisposing cause is found. Abnormalities in the urine, serum or renal histology of stone-forming patients are claimed by some to be aetiologically important while others continue to dispute this. This thesis comprises a review of previous work, an account of a prospective study carried out by the author on a group of stone formers to address this problem and a discussion of the results obtained. Prior to the advent of an extra corporeal shock wave lithotripsy service (ESWL) in Scotland in 1986, most kidney stones were treated by percutaneous nephrolithotomy (PCN). This procedure provided an ideal opportunity to biopsy the kidney allowing renal histology and the degree of microscopic renal calcification to be assessed and compared with control material. The biopsy findings of individual patients were considered in relation to subsequent serum and urinary biochemical data. As the relative importance of various urinary risk factors pertaining to stone formation remains controversial, assessment of 24hr urine excretion of Calcium, Urate, Oxalate, Citrate and Creatinine, serum concentrations of Urea, Creatinine, Calcium and Urate and blood gas analyses were also undertaken in this group of stone formers. A group of non-stoneforming adult out-patients acted as controls. Statistical analysis of all data was performed comparing the study group results both with our own controls as well as with other series. This has allowed us to form conclusions about the process of stone formation and to develop a plan for the rational investigation and management of patients presenting with urinary tract calculi in this area.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available