Lithiases médicamenteuses

Characterization of a sulfadiazine-induced lithiasis calculus by physicochemical techniques

Currently available information on drug lithiasis usually describes the calculi based on the prescriptions given to the patient, but without a physicochemical characterization of the calculi themselves. We here have applied different, complementary, physicochemical techniques for a complete characterization of an unusual urolithiasis calculus. The calculus was characterized using powder X-ray diffraction, infrared spectroscopy, mass spectrometry, 1H-NMR spectroscopy, and scanning electron microscopy. The precise nature of the calculus was identified, being formed by N4-acetylsulfadiazine, so being related to the drugs prescribed to the patient. Analytical techniques widely used in laboratories of Materials Chemistry have proven to be useful tools for characterizing the chemical nature of unusual urolithiasis.

[Kidney injury biomarkers]

Over the last few decades, prevalence of renal diseases has grown continuously in occidental societies due to life conditions (age, life style, chronic disease, etc.) or potential exposure to nephrotoxic agents (drugs and environmental chemicals). Today, the knowledge of the nephropatology mechanism is improving. Nevertheless, considering it is a complex and multifunctional structure, the clinical strategy of this issue (prognostic, diagnostic or therapy) keeps posing a major challenge for clinicians mostly because classical markers are not sensitive enough and require hours before reaching significant levels. Furthermore, most of these markers provide information on function and not on structural integrity of the tissue. Identification and development of new biomarkers share promise of improvement in the rapid diagnostic of kidney diseases and development of new cures in order to optimize the clinical strategy associated to the renal failure.

Lithiasis and Risk Factors

Nephrolithiasis is a worldwide disease with high clinical and economic costs. The increasing incidence in industrialized countries seems to be related to several risk factors, which are partly inherited and partly acquired. Although risk factors in urolithiasis are still under discussion, their identification would provide a notable gain for the patient in terms of stone episodes, and for the health service in terms of costs. This article presents an easy classification of risk factors based on clinical background.