Urolithiasis Research by George H. Nancollas (auth.), H. Fleisch, W. G. Robertson, L.

By George H. Nancollas (auth.), H. Fleisch, W. G. Robertson, L. H. Smith, W. Vahlensieck (eds.)

In fresh years, a starting to be curiosity has triggered expanding numbers of study guides and medical meetings with regards to urolithiasis. The goals of this symposium have been 3: a) to check and inte­ grate fresh growth in significant topic components, b) to debate present examine advancements and c) to stimulate interchange among investigators in Europe and in the USA. In a sequence of morning lectures, invited, well-known specialists provided finished studies of significant fields of urolithiasis examine comparable to the actual chemistry of crystal formation, the metabolism of stone forming elements, and modes of treatment. a different emphasis was once given to normal renal body structure and the renal excretion of Ca++, Pi, Mg, oxalate and urate. regardless of its noticeable value, renal functionality has been rather overlooked in uro­ lithiasis study. New study effects have been provided by means of the mechanism of after­ midday poster classes. This strategy authorized casual long discussions among these members specifically and the accountable investigator himself. moreover, casual staff discussions have been prepared in the course of the evenings on an advert hoc foundation. during this quantity, either the evaluation lectures and short summaries of the poster displays were accumulated. Interchange among ecu and American investigators was once completed via the direct participation of a giant delegation from North the USA. this massive attendance used to be made attainable by way of the beneficiant aid of the nationwide Institute for Arthritis, Metabolism and Digestive illness U.S. N.I.H.

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Net reabsorption of phosphate can be predominantely characterized by a marked phosphate outflux with very little if any phosphate influx or "secretion". Again, this general statement can serve as an introduction to the controversy which surrounds the possibility that there may indeed be a necessity to postulate phosphate secretion in some nephron segment. G . KNOX ET AL. 50 CALCIUM (MAGNESIUM) REABSORP ION (PHOSPHATE) ( URIC ACID) Figure 6. Mechanism of Reabsorption NEPHRON FUNCTION IN UROLITHIASIS 51 The fundamental question is whether the net phosphate reabsorptive process is predominante1y unidirectional or whether there is a significant secretory component.

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As far as fluctuations in inhibitory activity are concerned there is certainly a diurnal variation (Fig. 12) which is mainly attributable to changes in AMPS excretion and concentration coupled with changes in uric acid excretion. The factors controlling this diurnal variation in AMPS excretion are not known. Also it is not known whether there are any seasonal fluctuations in inhibitory activity or in AMPS excretion. There does, however, appear to be a seasonal variation in uric acid excretion (unpublished results) which would be anticipated to influence the level of inhibitory activity.

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