結石腎の病態 第1編: 結石腎の機能的観察

Abstract

The following results were obtained by renal and he p atic function tests, urinalysis, hematology and serum physicochemical tests on 64 patients with nephrolithiasis . 1) On macroscopic urinary findings cloudy urine was detected in 67.2 per c e nt of the patients, protein in 84.4 per cent and urobilinogen in 32.8 per cent. Microscopically hematuria was detected in 87.5 per cent of the patients, white blood cell in 79.7 per cent, and bacteria in 48.8 per cent. Of the bacteria detected in urine coli bacillus was found in 18 cases, coccus in 7 cases, diplococcus in 4 cases, staphylococcus and saprophyte in 3 cases of each, bacillus in 2 cases, small coccus and Gram positive coccus. 2) Dilution test revealed defect of concentration power in 57.8 per cent and defect of dilution power in 46.9 per cent. It is found that concentration power is more liable to be affected than dilution power. On PSP test those patients who excrete dye more than 25 per cent at 15 minutes after injection were 29.7 per cent and who excrete more than 55 per cent of dye at 120 minutes after injection were 81.3 per cent of total patients . In those cases which excrete more than 25 per cent of dye at 15 minutes after inje ction, each fractional dye excretion and total amount of dye excreted were within nor mal limits. On indigo carmine test, 19 per cent of the patients were within normal ra nge on diseased kidney, while abnormal excretion of the dye on unaffected kidney was found in 24.1 per cent of the patients. Since the test revealed abnormal excreti on of the dye unilaterally in the patients with bilateral nephrolithiasis , abnormal findings of the test does not always occur on the diseased kidney. 3) Hematology : A nemia was found in 79.7 per cent and abnormal leuco-index was found in 21.9 per cent of the patients . Highly disturbed renal function was found in the patients with hyperchloremic anemia. 4) Semru mle veplh yisni c3o3ch.3e mpeirc al c e ntets tos f : thHe igphat iseondtsiu.m Hleivgehl cwhlaosr ifdoeu ndle vinel 13w.9as p efor ucnedn ti, n w 4hs7ilo.e2d liouw per cent, while low chloride level in 2.8 per cent of the patients . Slightly high level of calcium was found only 1 case . Low A/G ratio was found in 75 per cent , high NPN level in 44.4 per cent. High TP level was found in 8.3 per cent, while low TP level 11.1 per cent of the patients. High Tch level was found in 32.1 per cent, while low Tch level in 3.5 per cent of the patients. Low Ch.E level was found in only 1 case. 5) Hepatic function : Slightly to severely disturbed hepatic fu n ction was found in 73.2 per cent of the patients. Parenchymatous dysfunction was founction was simultaneously accompanied by renal dysfunction. Arterial hypertension was found in 3 cases. However, there seemed no relationship between arterial hypertension and renal function.