{"id":1098,"date":"2016-12-09T14:30:00","date_gmt":"2016-12-09T13:30:00","guid":{"rendered":"http:\/\/www.newslab.sk\/2016\/12\/09\/urolitiaza-ako-nasledok-metabolickych-ochoreni\/"},"modified":"2017-10-04T14:36:08","modified_gmt":"2017-10-04T12:36:08","slug":"urolithiasis-as-a-consequence-of-metabolic-diseases","status":"publish","type":"post","link":"https:\/\/www.newslab.sk\/en\/urolithiasis-as-a-consequence-of-metabolic-diseases\/","title":{"rendered":"Urolithiasis as a consequence of metabolic diseases"},"content":{"rendered":"<pre><span style=\"color: #ff0000;\"><strong>*All tables, charts, graphs and pictures that are featured in this article can be found in the .pdf \r\nattachment at the end of the paper. <\/strong><\/span><\/pre>\n<p>&nbsp;<\/p>\n<p><strong>\u00da<\/strong><strong>vod<\/strong><\/p>\n<p>Pre uroliti\u00e1zu je charakteristick\u00fd masov\u00fd v\u00fdskyt a tendencia \u00a0k recid\u00edvam. Pr\u00e1ve recid\u00edvy s\u00fa z\u00e1\u0165a\u017eou pre pacienta a zvy\u0161uj\u00fa finan\u010dn\u00e9 n\u00e1klady na jeho zdravotn\u00fa starostlivos\u0165. Z t\u00fdchto d\u00f4vodov je potrebn\u00e1 prevencia recid\u00edv cielenou metafylaxiou, a to na z\u00e1klade exaktnej anal\u00fdzy pri ka\u017edom konkremente (tabu\u013eka 1). Dodr\u017eiavan\u00edm \u00a0spr\u00e1vnej \u017eivotospr\u00e1vy, udr\u017eiavan\u00edm primeran\u00e9ho pH a hustoty mo\u010du, redukciou litog\u00e9nnych l\u00e1tok, pod\u00e1van\u00edm inhib\u00edtorov je mo\u017en\u00e9 redukova\u0165, pr\u00edpadne \u00faplne eliminova\u0165 v\u00fdskyt recid\u00edv pri uroliti\u00e1ze (1).<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Z<\/strong><strong>\u00e1<\/strong><strong>k<\/strong><strong>l<\/strong><strong>a<\/strong><strong>d<\/strong><strong>n<\/strong><strong>\u00e9 rozdelenie konkrementov pod\u013ea etiol\u00f3gie<\/strong><\/p>\n<p><em>Cyst\u00ednov\u00e9, ur\u00e1tov\u00e9, xant\u00ednov\u00e9 a struvit<\/em> \u2013 vznikaj\u00fa v d\u00f4sledku pres\u00fdtenia mo\u010du litog\u00e9nnymi l\u00e1tkami (tabu\u013eka 2).<br \/>\n<em>Kalciov\u00e9: Ca-oxal\u00e1ty, Ca-fosf\u00e1ty<\/em> \u2013 maj\u00fa multifaktor\u00e1lnu etiol\u00f3giu (1).<\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u00da<\/strong><strong>vodn\u00e9 diagnostick\u00e9 vy\u0161etrenia<\/strong><\/p>\n<ul>\n<li>S pr\u00e1vna a presn\u00e1 anal\u00fdza mo\u010dov\u00e9ho \u00a0konkrementu, komplexn\u00e1 anamn\u00e9za, fyzik\u00e1lne vy\u0161etrenie, zobrazovacie vy\u0161etrenia a cielen\u00e9 laborat\u00f3rne vy\u0161etrenie krvi a mo\u010du.<\/li>\n<\/ul>\n<p><em>Krv:<\/em> kreatin\u00edn, \u00a0Ca, Ca-ionizovan\u00e9, Mg, P, album\u00edn, kyselina mo\u010dov\u00e1\u00a0(KM), ABR (pH, pCO , HCO -)<br \/>\n<em>Mo\u010d jednorazov\u00fd:<\/em> chemicky a sediment, pH, \u0161pecifick\u00e1 hmotnos\u0165, kultiv\u00e1cia mo\u010du.<br \/>\n<em>Mo\u010d zbieran\u00fd:<\/em> odpady \u2013 dUCa, dUMg, dUKM, dUkreatin\u00edn \u00a0(1, 4).<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Krit\u00e9ri\u00e1 na zaradenie pacienta do skupiny s vysok\u00fdm rizikom recid\u00edv:<\/strong><br \/>\n\u2013 <em>vysok\u00fd po\u010det recid\u00edv:<\/em> 3 a viac za 3 roky<br \/>\n\u2013 rodinn\u00fd v\u00fdskyt liti\u00e1zy, liti\u00e1za v detskom\/mladistvom veku<br \/>\n\u2013 infek\u010dn\u00e9 konkrementy, ur\u00e1tov\u00e1 liti\u00e1za<br \/>\n\u2013 <em>ochorenia spojen\u00e9 s tvorbou konkrementov:<\/em> hyperparatyre\u00f3za (HPTH), nefrokalcin\u00f3za, stav po intestin\u00e1lnej resekcii a bypasse, Crohnova choroba, malabsorb\u010dn\u00fd syndr\u00f3m, sarkoid\u00f3za<br \/>\n\u2013 <em>geneticky podmienen\u00e1 tvorba konkrementov:<\/em> cyst\u00ednuria, prim\u00e1rna hyperoxal\u00faria, ren\u00e1lna tubul\u00e1rna acid\u00f3za (RTA), xantin\u00faria, cystick\u00e1 fibr\u00f3za<br \/>\n\u2013 pod\u00e1vanie rizikov\u00fdch medikamentov, ktor\u00fdch akt\u00edvne zlo\u017eky kry\u0161talizuj\u00fa v mo\u010di (amoxicil\u00edn, ciplox, efedr\u00edn, sulfonamidy), alebo medikamenty nepriaznivo ovplyv\u0148uj\u00face zlo\u017eenie mo\u010du (kortikoidy, cytostatik\u00e1, vitam\u00edn D, laxat\u00edva, tablety s obsahom Ca).<br \/>\n\u2013 <em>anatomick\u00e9 abnormality spojen\u00e9 s tvorbou konkrementov:<\/em> dre\u0148ov\u00e1 cyst\u00f3za, ob\u0161trukcia pyeloureter\u00e1lneho spojenia, devertikuly kalichov, strikt\u00fary mo\u010dovodu, vezikoureter\u00e1lny reflux, ureterok\u00e9la, podkovovit\u00e1 obli\u010dka (2).<\/p>\n<p>&nbsp;<\/p>\n<p><strong>C<\/strong><strong>a<\/strong><strong>&#8211;<\/strong><strong>oxal\u00e1tov\u00e9 konkrementy \u2013 roz\u0161\u00edren\u00e9 metabolick\u00e9 vy\u0161etrenie<\/strong><\/p>\n<p><em>Krv:<\/em> PTH (pri zv\u00fd\u0161enej hodnote \u00a0Ca), Na, K, Cl<br \/>\n<em>Mo\u010d:<\/em> denn\u00fd profil pH (minim\u00e1lne 4-kr\u00e1t denne), 2-kr\u00e1t 24-hodinov\u00fd zber mo\u010du: diur\u00e9za, \u0161pecifick\u00e1 hmotnos\u0165, odpady: Ca, oxal\u00e1ty, KM, citr\u00e1ty, Mg (1).<\/p>\n<p>&nbsp;<\/p>\n<p><strong>L<\/strong><strong>i<\/strong><strong>t<\/strong><strong>og<\/strong><strong>\u00e9<\/strong><strong>nn<\/strong><strong>e rizikov\u00e9 faktory pre Ca-oxal\u00e1ty<\/strong><\/p>\n<ol>\n<li><strong>Hyperkalci\u00faria (dUCa &gt; 5,0 mmol\/24):<\/strong><\/li>\n<\/ol>\n<ul>\n<li>absorp\u010dn\u00e1 \u2013 zv\u00fd\u0161en\u00e9 vstreb\u00e1vanie Ca v \u010dreve<\/li>\n<li>ren\u00e1lna \u2013 porucha reabsorpcie Ca ren\u00e1lnymi bunkami<\/li>\n<li>resorp\u010dn\u00e1 \u2013 zv\u00fd\u0161en\u00e9 uvo\u013e\u0148ovanie Ca z kost\u00ed do krvi, odkia\u013e filtr\u00e1ciou prech\u00e1dza do mo\u010du<br \/>\n&#8211;\u00a0<em>Hyperkalci\u00faria sprev\u00e1dzan\u00e1 RTA:<\/em> neschopnos\u0165 tubul\u00e1rnych buniek secernova\u0165 \u00a0H+ i\u00f3ny proti koncentra\u010dn\u00e9mu sp\u00e1du do mo\u010du. Uvo\u013e\u0148uje sa Ca z kost\u00ed do krvi a v mo\u010di doch\u00e1dza k zv\u00fd\u0161en\u00e9mu \u00a0sp\u00e4tn\u00e9mu \u00a0vstreb\u00e1vaniu citr\u00e1tov. Laborat\u00f3rnym prejavom RTA je metabolick\u00e1 \u00a0acid\u00f3za (v krvi pokles K), vysok\u00e9 pH mo\u010du nala\u010dno (&gt; 5,8), vysok\u00e9 dUCa\/24, dUP\/24 a pokles dUcitr\u00e1tov\/24.<br \/>\n&#8211; <em>Hyperpartyre\u00f3za (HPT):<\/em> naj\u010dastej\u0161ou pr\u00ed\u010dinou\u00a0 je aden\u00f3m pri\u0161t\u00edtnych teliesok. Laborat\u00f3rne \u00a0prejavy:<br \/>\nV krvi: vysok\u00e9\u00a0 Ca aj PTH a n\u00edzka hladina fosforu.<br \/>\nV mo\u010di: vysok\u00e9 straty dUCa\/24 \u00a0aj dUP\/24, n\u00edzka hustota mo\u010du.<\/li>\n<\/ul>\n<ol start=\"2\">\n<li><strong>Hyperoxal\u00faria\u00a0 (dUoxal\u00e1tov \u00a0&gt; 5,0 mmol\/24).<\/strong><\/li>\n<\/ol>\n<ul>\n<li>Prim\u00e1rna hyperoxal\u00faria: enzymatick\u00fd defekt sp\u00f4sobuj\u00faci \u00a0endog\u00e9nnu nadprodukciu oxal\u00e1tov s n\u00e1sledn\u00fdm ukladan\u00edm oxal\u00e1tov do tkan\u00edv postihuj\u00facich \u00a0najm\u00e4 obli\u010dky.<\/li>\n<li>Sekund\u00e1rna \u00a0hyperoxal\u00faria \u00a0(dUoxal\u00e1tov \u00a00,5 \u2013 1,0 mmol\/24) m\u00f4\u017ee by\u0165 sp\u00f4soben\u00e1 nadmern\u00fdm pr\u00edvodom oxal\u00e1tov v potrave \u010di nadmern\u00fdm \u00a0vstreb\u00e1van\u00edm \u010drevn\u00fdmi bunkami. Nedostatok Ca v \u010drevnom obsahu vedie k zv\u00fd\u0161en\u00e9mu obsahu vo\u013en\u00fdch oxal\u00e1tov a ten sa m\u00f4\u017ee vo\u013ene vstreb\u00e1va\u0165 do krvi a filtrova\u0165 sa do mo\u010du.<\/li>\n<\/ul>\n<ol start=\"3\">\n<li><strong>Hyperurikoz\u00faria<\/strong> (dUKM &gt; 4,0 mmol\/24). Vplyvom podobnej kry\u0161taliz\u00e1cie m\u00f4\u017ee ma\u0165 vyso\u013eovac\u00ed efekt na Ca-oxal\u00e1t.<\/li>\n<li><strong>Hypocitrat\u00faria<\/strong> (dUcitr\u00e1tov &lt; 2,5 mmol\/24). Citr\u00e1ty s\u00fa najsilnej\u0161ie inhib\u00edtory kry\u0161taliz\u00e1cie Ca-oxal\u00e1tu, via\u017ee na seba Ca i\u00f3ny, zvy\u0161uje pH mo\u010du, a t\u00fdm rozpustnos\u0165 \u00a0kyseliny mo\u010dovej, zni\u017euje v mo\u010di supersatur\u00e1ciu Ca-oxal\u00e1tu a\u017e o 50 %.<\/li>\n<li><strong>Deficit \u00a0magn\u00e9zia<\/strong>. Magn\u00e9zium v \u010dreve i mo\u010di \u00a0je schopn\u00e9 \u00a0vytv\u00e1ra\u0165 s oxal\u00e1tmi komplexy, a tak zni\u017eova\u0165 mno\u017estvo vo\u013en\u00fdch oxal\u00e1tov (1).<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p><strong>C<\/strong><strong>a<\/strong><strong>&#8211;<\/strong><strong>fo<\/strong><strong>s<\/strong><strong>f\u00e1<\/strong><strong>t<\/strong><strong>ov\u00e9 konkrementy<\/strong><\/p>\n<p><em>K<\/em><em>arboapatit <\/em><em>(<\/em><em>D<\/em><em>ahlit): <\/em>vznik\u00e1 pri pH mo\u010du &gt; 6,8 a pri hyperkalci\u00farii a hyperfosfat\u00farii, k \u010domu \u00a0prich\u00e1dza najm\u00e4 pri RTA alebo mo\u010dovej \u00a0infekcii.<\/p>\n<p><em>K<\/em><em>alciumhydrogenfosf\u00e1tdihydr\u00e1t (Brushit): <\/em>vznik\u00e1 pri pH mo\u010du \u00a06,5 \u2013 6,8 a pri hyperkalci\u00farii a hyperfosfat\u00farii, k \u010domu \u00a0prich\u00e1dza pri RTA a HPT.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>C<\/strong><strong>a<\/strong><strong>&#8211;<\/strong><strong>fo<\/strong><strong>s<\/strong><strong>f\u00e1<\/strong><strong>t<\/strong><strong>ov\u00e9 konkrementy \u2013 roz\u0161\u00edren\u00e9 metabolick\u00e9 vy\u0161etrenie<\/strong><\/p>\n<p><em>Krv:<\/em> PTH (pri zv\u00fd\u0161enej hodnote \u00a0Ca), Na, K, Cl<br \/>\n<em>Mo\u010d:<\/em> denn\u00fd profil pH (minim\u00e1lne\u00a0 4-kr\u00e1t denne), 2-kr\u00e1t 24-hodinov\u00fd zber mo\u010du: diur\u00e9za, \u0161pecifick\u00e1 hmotnos\u0165, odpady: Ca, citr\u00e1ty, fosfor.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>In<\/strong><strong>f<\/strong><strong>e<\/strong><strong>k<\/strong><strong>\u010d<\/strong><strong>n<\/strong><strong>\u00e9 konkrementy<\/strong><\/p>\n<p>Vznikaj\u00fa pri infekcii mo\u010dov\u00fdch \u00a0ciest bakt\u00e9riami, ktor\u00e9 tvoria ure\u00e1zu (<em>P<\/em><em>r<\/em><em>o<\/em><em>t<\/em><em>eus, Providencia rettgeri, Morganella morganii, Ureaplasma <\/em><em>u<\/em><em>r<\/em><em>ealyticum, Klebsiela spp., Enterobacter, Serratia marcescens, Stafylococcus \u00a0spp<\/em>.). Tento enz\u00fdm \u0161tiepi ureu, a tak doch\u00e1dza \u00a0k zv\u00fd\u0161eniu hladiny amoniaku a pH.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>K<\/strong><strong>o<\/strong><strong>nkrementy z kyseliny mo\u010dovej (ur\u00e1tov\u00e9 konkrementy)<\/strong><\/p>\n<p>Vznikaj\u00fa pri trvalo zn\u00ed\u017eenom pH mo\u010du &lt; 6,0 a hyperurikoz\u00farii (dUKM &gt; 4,0 mmol\/24). Je zn\u00e1ma priama exponenci\u00e1lna \u00a0z\u00e1vislos\u0165 kry\u0161taliz\u00e1ciu kyseliny mo\u010dovej pri n\u00edzkom pH mo\u010du.<br \/>\nRizikov\u00fd faktor \u2013 hyperurik\u00e9mia (KM v s\u00e9re &gt; 380 \u00b5mol\/l) (1).<\/p>\n<p>&nbsp;<\/p>\n<p><strong>U<\/strong><strong>r\u00e1<\/strong><strong>t<\/strong><strong>ov\u00e9 konkrementy \u2013 roz\u0161\u00edren\u00e9 metabolick\u00e9 vy\u0161etrenie<\/strong><\/p>\n<p><em>Krv:<\/em> KM, kreatin\u00edn<br \/>\n<em>Mo\u010d:<\/em> denn\u00fd profil pH (minim\u00e1lne\u00a0 4-kr\u00e1t denne), 2-kr\u00e1t 24-hodinov\u00fd zber mo\u010du: diur\u00e9za, \u0161pecifick\u00e1 hmotnos\u0165, odpady: (dUKM\/24)<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Cy<\/strong><strong>s<\/strong><strong>t<\/strong><strong>\u00ed<\/strong><strong>n<\/strong><strong>ov\u00e9 konkrementy<\/strong><\/p>\n<p>Vznikaj\u00fa kry\u0161taliz\u00e1ciou cyst\u00ednu v mo\u010di v pr\u00edpade cystin\u00farie (dUcyst\u00ednu &gt; 0,8 mmol\/24).<\/p>\n<p>Jeho rozpustnos\u0165 z\u00e1vis\u00ed od pH mo\u010du: medzi 5 \u2013 7 je nerozpustn\u00fd, pri vy\u0161\u0161\u00edch hodnot\u00e1ch rozpustnos\u0165 st\u00fapa.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>N<\/strong><strong>a<\/strong><strong>\u010d<\/strong><strong>as<\/strong><strong>ovanie roz\u0161\u00edren\u00e9ho metabolick\u00e9ho vy\u0161etrenia<\/strong><\/p>\n<p>\u2013\u00a0\u00a0 \u00a0Roz\u0161\u00edren\u00e9 metabolick\u00e9 vy\u0161etrenia u pacientov s uroliti\u00e1zou vy\u0161etrujeme ide\u00e1lne v \u010dase, ke\u010f konkrement v mo\u010dov\u00fdch \u00a0cest\u00e1ch nie je pr\u00edtomn\u00fd alebo je najmenej 20 dn\u00ed, ide\u00e1lne tri mesiace od vymo\u010denia\/odstr\u00e1nenia.<\/p>\n<p>\u2013\u00a0\u00a0 \u00a0Na vy\u0161etrenie odpadov v mo\u010di sa \u0161tandardne vyu\u017e\u00edvaj\u00fa dva 24-hodinov\u00e9 po sebe nasleduj\u00face zbery. Zbern\u00e9 n\u00e1doby by mali by\u0165 po\u010das zberu uchov\u00e1van\u00e9 pri teplote \u2264 8 \u00b0C. Ur\u00fdchlen\u00e9 doru\u010denie zbieran\u00e9ho mo\u010du do laborat\u00f3ria minimalizuje pr\u00edpadn\u00e9 predanalytick\u00e9 chyby.<\/p>\n<p>\u2013\u00a0\u00a0 \u00a0Op\u00e4tovn\u00e1 \u00a0kontrola 24-hodinov\u00e9ho \u00a0zbieran\u00e9ho mo\u010du by sa mala realizova\u0165 medzi 8. \u2013 12. t\u00fd\u017ed\u0148om \u00a0od za\u010datia lie\u010dby (farmakologickej, dietetickej). Po zaznamenan\u00ed normaliz\u00e1cie mo\u010dov\u00fdch \u00a0parametrov, a teda uspokojivom p\u00f4soben\u00ed lie\u010dby je kontrola \u00a024-hodinov\u00e9ho zbieran\u00e9ho mo\u010du dosta\u010duj\u00faca raz za 12 mesiacov (2).<\/p>\n<p>&nbsp;<\/p>\n<p><strong>P<\/strong><strong>r<\/strong><strong>e<\/strong><strong>d<\/strong><strong>an<\/strong><strong>a<\/strong><strong>l<\/strong><strong>y<\/strong><strong>t<\/strong><strong>i<\/strong><strong>c<\/strong><strong>k<\/strong><strong>\u00e9 inform\u00e1cie<\/strong><\/p>\n<p>Konkrement \u00a0treba doda\u0165 do laborat\u00f3ria v \u010distej a suchej n\u00e1dobe, zbaven\u00fd hrub\u00fdch ne\u010dist\u00f4t a krvi.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>I<\/strong><strong>n<\/strong><strong>t<\/strong><strong>e<\/strong><strong>r<\/strong><strong>f<\/strong><strong>e<\/strong><strong>r<\/strong><strong>e<\/strong><strong>n<\/strong><strong>c<\/strong><strong>i<\/strong><strong>a<\/strong><\/p>\n<p>Krv pr\u00edtomn\u00e1 na kameni. Mokr\u00fd kame\u0148 (dodan\u00fd v nezn\u00e1mom roztoku).<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Me<\/strong><strong>t<\/strong><strong>\u00f3d<\/strong><strong>a<\/strong><\/p>\n<p>Polariza\u010dn\u00e1 mikroskopia. Infra\u010derven\u00e1 spektroskopia.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>K<\/strong><strong>\u00f3<\/strong><strong>d vy\u0161etrenia<\/strong><\/p>\n<p>Mo\u010dov\u00fd kame\u0148 \u2013 4139<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Z<\/strong><strong>\u00e1<\/strong><strong>ver<\/strong><\/p>\n<p>Uroliti\u00e1za je internistick\u00e9 ochorenie s urologick\u00fdmi n\u00e1sledkami. Opakuj\u00face sa recid\u00edvy s\u00fa nepr\u00edjemn\u00e9 pre pacienta a zvy\u0161uj\u00fa n\u00e1klady na jeho zdravotn\u00fa starostlivos\u0165. Je preto potrebn\u00e9 zmeni\u0165 poh\u013ead na t\u00fato problematiku a rie\u0161i\u0165 ju komplexne. Cielen\u00e9 laborat\u00f3rne vy\u0161etrenia, modern\u00e1 anal\u00fdza zlo\u017eenia mo\u010dov\u00fdch kame\u0148ov, ako aj spr\u00e1vna interpret\u00e1cia v\u00fdsledkov, spolupr\u00e1ca odborn\u00edkov a compliance pacientov je iste vhodn\u00e1 cesta k zn\u00ed\u017eeniu v\u00fdskytu recid\u00edv a k \u00fa\u010dinne nastavenej metafylaxii.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Literat\u00fara<br \/>\n<\/strong><br \/>\n1. Rajmon P, Mucha Z, Vr\u00e1na J, Kr\u00e1l M. Metafylaxe uroliti\u00e1zy v roce 2013. Urologie pro praxi. 2014;15(1):12\u201317.<br \/>\n2. T\u00fcrk C, Knoll T, Petrik A, Sarica K, Skolarikos A, Straub M, Seitz C. Guidelines on Urolithiasis. European Association of Urology. 2014.<br \/>\n3. Masopust J. Klinick\u00e1 biochemie \u2013 po\u017eadov\u00e1n\u00ed a hodnocen\u00ed biochemick\u00fdch vy\u0161et\u0159en\u00ed. \u010c\u00e1st II. 1. vyd. Praha: Karolinum; 1998: 258\u2013264.<br \/>\n4. Milichovsk\u00fd I, Kron I, Valansk\u00fd L. Uroliti\u00e1za v ambulantnej a klinickej praxi. Via practica.<br \/>\n2015;2(10):389.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>*All tables, charts, graphs and pictures that are featured in this article can be found in the .pdf attachment at the end of the paper. &nbsp; \u00davod Pre uroliti\u00e1zu je charakteristick\u00fd masov\u00fd v\u00fdskyt a tendencia \u00a0k recid\u00edvam. Pr\u00e1ve recid\u00edvy s\u00fa z\u00e1\u0165a\u017eou pre pacienta a zvy\u0161uj\u00fa finan\u010dn\u00e9 n\u00e1klady na jeho zdravotn\u00fa starostlivos\u0165. Z t\u00fdchto d\u00f4vodov je<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false,"footnotes":""},"categories":[289],"tags":[707,706,704,705,703],"class_list":["post-1098","post","type-post","status-publish","format-standard","hentry","category-biochemistry","tag-calculus","tag-laboratory-examination","tag-metabolic-disorders","tag-relapses","tag-urolithiasis","typ_clanku-review-article"],"acf":{"abstrakt":"<p>Urolithiasis represents the presence of calculus in the renal tubular system or in the efferent urinary tract. Urolithiasis is not a disease on its own, but rather a symptom of a metabolic disorder. The author deals with targeted laboratory tests performed in the most commonly occurring types of urinary stones that help detect metabolic disorders thereby contributing to targeted metaphylaxis.<\/p>\n<p><strong>Key words:<\/strong> urolithiasis, metabolic disorders, relapses, laboratory examination, calculus<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","casopis":[{"ID":995,"post_author":"7","post_date":"2016-11-16 12:14:30","post_date_gmt":"2016-11-16 11:14:30","post_content":"<h4><strong>Biochemistry <\/strong><\/h4>\r\n<ul>\r\n \t<li>Biochemical inflammation markers<\/li>\r\n \t<li>Biochemical examinations in liver diseases<\/li>\r\n \t<li>Biochemical diagnosis in diseases of GIT<\/li>\r\n \t<li>Hypoglycemia<\/li>\r\n \t<li>Urolithiasis as a result of metabolic diseases<\/li>\r\n \t<li>Indication and application of tumor markers in clinical practice<\/li>\r\n \t<li>Monoclonal gammopathies \u2013 laboratory examinations in diagnosis and monitoring<\/li>\r\n \t<li>Hormones in diagnosis of reproductive function disorders<\/li>\r\n \t<li>Cerebrospinal fluid diagnosis of diseases affecting the nervous system<\/li>\r\n \t<li>Determining trace elements in blood serum<\/li>\r\n<\/ul>\r\n<h4><strong>Genetics<\/strong><\/h4>\r\n<ul>\r\n \t<li>Assessing the therapeutic response in patients with chronic myelocyte leukemia treated with tyrosine kinase inhibitors<\/li>\r\n \t<li>Hormones in diagnosis of reproductive functions\u2019 disorders<\/li>\r\n<\/ul>\r\n<h4><strong>Hematology <\/strong><\/h4>\r\n<ul>\r\n \t<li>Anemias \u2013 laboratory diagnosis of the most frequently prevalent types of anemia<\/li>\r\n \t<li>Laboratory and hematological technical equipment<\/li>\r\n<\/ul>\r\n<h4><strong>Immunology <\/strong><\/h4>\r\n<ul>\r\n \t<li>Paraneoplastic neurological syndromes and in vitro diagnosis of onconeural antibodies<\/li>\r\n<\/ul>","post_title":"newslab","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"newslab","to_ping":"","pinged":"","post_modified":"2017-08-16 21:40:20","post_modified_gmt":"2017-08-16 19:40:20","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.newslab.sk\/casopis\/newslab\/","menu_order":0,"post_type":"casopis","post_mime_type":"","comment_count":"0","filter":"raw"}],"strana":"42","upload_clanok":{"ID":1099,"id":1099,"title":"nottna_urolitiaza","filename":"Nottn\u00e1_Uroliti\u00e1za.pdf","filesize":133233,"url":"https:\/\/www.newslab.sk\/wp-content\/uploads\/2016\/12\/Nottn\u00e1_Uroliti\u00e1za.pdf","link":"https:\/\/www.newslab.sk\/en\/urolithiasis-as-a-consequence-of-metabolic-diseases\/nottna_urolitiaza\/","alt":"","author":"7","description":"","caption":"","name":"nottna_urolitiaza","status":"inherit","uploaded_to":1098,"date":"2016-12-09 13:15:57","modified":"2016-12-09 13:15:57","menu_order":0,"mime_type":"application\/pdf","type":"application","subtype":"pdf","icon":"https:\/\/www.newslab.sk\/wp-includes\/images\/media\/document.png"}},"_links":{"self":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/1098","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/comments?post=1098"}],"version-history":[{"count":0,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/1098\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/media?parent=1098"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/categories?post=1098"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/tags?post=1098"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}