EARLY DETECTION OF RESPIRATORY OXALOSIS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND COMORBID UROLITHIASIS WITH PYELONEPHRITIS
DOI:
https://doi.org/10.11603/1811-2471.2017.v0.i2.7702Keywords:
pyelonephritis, chronic obstructive pulmonary disease, oxalosis, urolithiasis, hyperoxaluria.Abstract
SUMMARY. Introduction. According to the European respiratory society guidelines, comorbidity of chronic obstructive pulmonary disease (COPD) and chronic pyelonephritis can be defined as respiratory oxalosis. Such pathologic state needs special therapeutic approach that is different from standard therapy, therefore convenient diagnostic methods should be developed.
The aim of the study – to check the suitability of spectroscopy as a method for early diagnosis of respiratory oxalosis.
Materials and Methods. 60 patients were examined and divided in 4 study groups. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2016 were used to diagnose COPD along with clinical guidelines of The European Association of Urology (EAU). IBM SPSS Statistics 20 software was used for statistical analysis.
Results. In patients with comorbid COPD (GOLD 2B, 3C), oxalic urolithiasis and pyelonephritis during spirometry forced expiratory volume in 1 second (FEV1), after salbutamol spray was increased by 4.7±1.2 %, that is 23.3 % less than in patients with COPD without renal pathology (р<0.05). Such low reversibility is a characteristic feature of respiratory oxalosis. Spectroscopy of urine and sputum of patients of the group with COPD, urolithiasis and chronic pyelonephritis in 230–250 nm high viscosity of sputum due to calcium oxalate crystals was diagnosed. Such clinical sign is a marker of respiratory oxalosis with severe therapy-resistant bronchial obstruction. ROC-curve analysis showed high diagnostic value of spectroscopy of the sputum in 230–2350 nm for patients with respiratory oxalosis (AUROC 0.993 (95 % CI 0.954- 0.999; р<0.001).
Conclusions. Spectroscopy can detect level of calcium oxalate crystals in urine and sputum in wave lengths 230– 250 nm therefore can be used for early diagnostic method of respiratory oxalosis.
References
Khukhlіna, O.S., Dudka, T.V., Dudka, І.V. (2013). Zmіni morfo-funkcіonal'nih vlastivostej eritrocitіv ta їh rol' v patogenezі vzaєmoobtyazhennya bronhіal'noї astmi ta hronіchnogo holecistitu [Changes of morpho-functional state of erythrocytes and their role in pathogenesis of mutual burdening of bronchial asthma and chronic cholecystitis]. Vіsnik “Ukrainskoi mededychnoi stomatologichnoi akademіi” . [Heral of “ Ukrainian Dental Academy”], 13, 2 (42), 95-98. [in Ukrainian].
Khukhlіna, O.S., Vіlіgorska, K.V. (2014). Dismetabolіchnі porushennya obmіnu shchavelevoї kisloti yak provokacіjnij faktor rozvitku hronіchnogo obstruktivnogo zahvoryuvannya legen [Dysmetabolic disturbances of oxalic acid exchange as a provocative factor of development of chronic obstructive pulmonary disease]. Zdobutki klіnіchnoї ta eksperimental'noї medicini.[Achievements of clinical and experimental medicine], 1(20), 26-29 [in Ukrainian].
Decramer, M., Casaburi, R., Barreiro, E., Maltais, F. (2014). An official American thoracic society/Еuropean respiratory society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med, 189, 15–62.
Khukhlіna, O.S. ,Viligorska, K.V. (2013). Stan sistemi krovotvorennya u hvorih na hronіchne obstruktivne zahvoryuvannya legen' ta sechokam’yanu hvorobu [State of the blood-formation system in patients with chronic obstructive pulmonary disease and urolithiasis] Materіaly naukovo-praktichnoi konferencіi «Komorbіdnіst u klіnіcі vnutrіshn'oi medicini: faktori riziku, mekhanіzmi rozvitku ta vzayemoobtyazhennya, osoblivostі farmakoterapіi» [Materials of scientific and practical conference “Comorbidity in internal medicine: risk factors, mechanism of development and mutual burdening, peculiarities of pharmacotherapy”], 14-15. [in Ukrainian].
Franceschi, С., Campisi, J. (2014). Chronic Inflammation (Inflammaging) and Its Potential contribution to Age-associated Diseases.Advances in Geroscience: Impact on Healthspan and Chronic Disease Perspective, 69, 4-6.
Khukhlina, O.S., Viligorska, K.V., Antoniv, A.A. (2014). Metabolic oxalic acid disorderas a provocative marker in the pathogenesis of chronic obstructive pulmonary disease. Вook of abstracts ISCOMS 2014: Рulmonary medicine and medical physiology. Groningen, 546.
Khukhlina, O.S., Viligorska, K.V., Motrich, A.V. (2014). Risk factors for pulmonary oxalosis and oxalate nephropathy. Abstract book of the 25th European students’ conference «Rethinking Medical Research». Berlin, 502.
Khukhlina, O.S., Viligorska, K.V., Antoniv, A.A. (2013). The state of hematopoiesis in patients with comorbid course of chronic obstructive pulmonary disease and urolithiasis with anemic syndrome. Abstract book of the 24thЕuropean students’ conference «Exploring the Unknown». Berlin, 395.
Lin, L., Peng, K., Du, R., Huang, X., Lu, J., Xu, Y. Et al. (2017). Metabolically healthy obesity and incident chronic kidney disease: The role of systemic inflammation in a prospective study. Obesity.doi:10.1002/oby.21768.
Rosner, B. (2005). Fundamentals of biostatistics (6-th ed.). Belmont: Duxbury Press, 68.
