Table Of ContentAdvances in
Nephrourology
ETTORE MAJORANA INTERNATIONAL SCIENCE SERIES
Series Editor:
Antonino Zichichi
European Physical Society
Geneva, Switzerland
(LIFE SCIENCES)
Volume 1 BLADDER TUMORS AND OTHER TOPICS IN UROLOGICAL
ONCOLOGY
Edited by M. Pavone-Macaluso, P. H. Smith, and F. Edsmyr
Volume 2 ADVANCES IN RADIATION PROTECTION AND DOSIMETRY
IN MEDICINE
Edited by Ralph H. Thomas and Victor Pel'ez-Mendez
Volume 3 PULMONARY CIRCULATION IN HEALTH AND DISEASE
Edited by G. Cumming and G. Bonsignore
Volume 4 SELECTED TOPICS IN EXERCISE CARDIOLOGY
AND REHABILITATION
Edited by A. Raineri, J. J. Kellermann, and V. Rulli
Volume 5 THE AGING BRAIN: Neurological and Mental Disturbances
Edited by G. Barbagallo-Sangiorgi and A. N. Exton-Smith
Volume 6 THE LUNG IN ITS ENVIRONMENT
Edited by G. Cumming and G. Bonsignore
Volume 7 INVESTIGATION OF BRAIN FUNCTION
Edited by A. W. Wilkinson
Volume 8 THE IMMUNOLOGY OF INFANT FEEDING
Edited by A. W. Wilkinson
Volume 9 ADVANCES IN NEPHROUROLOGY
Edited by M. Pavone-Macaluso and P. H. Smith
Advances in
Nephrourology
Edited by
Michele Pavone-Macaluso
University Polyclinic Hospital
Palermo, Italy
and
Philip H. Smith
St. James's University Hospital
Leeds, England
Associate Editors.
Antonio Vercellone
University of Turin
Turin, Italy
Rosario Maiorca
United Hospitals
Brescia, Italy
Ugo Rotolo
University Polyclinic Hospital
Palermo, Italy
Plenum Press . New York and .L ondon
Library of Congress Cataloging in Publication Data
International Nephrourological Course (3rd: 1980: Erice, Italy)
Advances in nephrourology.
(Ettore Majorana international science series. Life sciences; v. 9)
"Proceedings of the Third International Nephrourological Course, held May 12-
18, 1 980, in Erice, Sicily" - T .p. verso.
Bibliography: p.
Includes index.
1. Kidneys-Calculi-Congresses. 2. Kidneys-Diseases-Immunological aspects
Congresses. I. Pavone-Macaluso, M. II. Smith, Philip Henry. III. Title. IV. Series.
[DNLM: 1. Kidney diseases-Immunology-Congresses. 2. Kidney calculi
Congresses. W1 ET71 2M v. 9/WJ 300 1598 1980a]
RC916.1561980 616.6'1 81-13934
ISBN 978-1-4684-8946-0 ISBN 978-1-4684-8944-6 (eBook) AACR2
DOl 10.1007/978-1-4684-8944-6
Proceedings of the Third International Nephrourological Course, held May 12-18,
1980, in Erice, Sicily
© 1981 Plenum Press, New York
Softcover reprint of the hardcover 1s t edition 1 981
A Division of Plenum Publishing Corporation
233 Spring Street, New York, N.Y. 10013
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted,
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the publisher
PREFACE
This volume is a report of the proceedings of the Third
International Nephro-Lrological Course held in the Ettore Majorana
Centre for Scientific Culture, Erice, Sicily, from 12th to 18th
May 1980.
Contributions were accepted on the understanding that the
editors could make certain changes leading towards a uniformity of
style but accepting as a Driority the importance of early publi
cation, if necessary at the expense of stylistic perfection.
The meeting, directed by A. Vercellone (Torino), R. Maiorca
(Brescia) and M. Pavone-Macaluso (Palermo), was sponsored by: the
Italian Associations of Nephrology, Immunology and Urology; the
Ministries of Scientific Research and Public Education of the
Republic of Italy; the Sicilian Regional Government; the National
Research Council and the University of Palermo.
Immunologic problems in renal disease Rnd metabolic and medical
aspects of urolithiasis were the two subjects of the Congress,
which was attended by numerous invi~ed speakers and participants.
The first part was introduced by A. Vercellone (Torino), who
discussed the major steps in the development and the present per
spectives of nephrology, a relatively newly born science, recognized
as such only in 1960. He called attention to the great significance
of our present knowledge of the immunologic mechanisms (circulating
immune complexes or in situ mounting, cellular immunity, activation
of complement) which are involved in the pathogenesis of glomerulo
nephritis.The routine use of assays capable of elucidating the
abnormalities of such mechanisms will ir,crease the accuracy of our
diagnostic assessment and allow new rational approaches and treat
ments in the fields of glomerulonephritis and kidney transplantation.
v
vi PREFACE
The second part, devoted to medical and metabolic aspects of
urolithiasis, was introduced by S. Maiorca (Brescia). It was pointed
out that stone disease is very frequent in the Mediterranean area,
especially in the southern regions of the Italian peninsula. The in
creased incidence of calcium-phosphate and oxalate stones may depend
on the high calorie content and protein intake of the Western
industrialized countries. A decrease of uric acid lithiasis can
be observed, particularly in Europe, although it is still endemic
in some parts of Asia. A more detailed investigation of certain
high-risk groups will undoubtedly elucidate some obscure points in
the genesis of urolithiasis.
Another important point of interest, which led to a stimulating
discussion, was the problem of the pathophysiology and diagnosis of
calcium nephrolithiasis. The pathogenesis of absorptive hyper
calciuria seems to be due to enhanced renal synthesis and ~:o high
serum levels of 1-25 (OH)2D3. However, some patients with absorptive
hypercalciuria show a vitamin-D independent calcium hyperabsorption.
The concept of a primary renal disease, the so called "renal
calcium leak theory", as responsible for idiopathic hypercalciuria,
was an important and much debated issue of discussion.
A significant step forward is the prognostic value of crystal~
luria in the follow-up of stone patients. By this easy, quick and
simple method it is possible to observe microscopically the type,
the number, the size and also the aggregation of crystals in the
urinary sediment. Another development of great potential is the
concept of the treatment of urinary trAct infection by urease in
hibitors.
We would like to thank Miss Francesca Montano for collating
the material and typing the manuscript and gratefully acknowledge
the cooperation and the generous help provided by Ente Fiuggi, Rome,
for the section devoted to urolithiasis.
The next Course of the International School of Urology and
Nephrology will deal with tumours of the kidney and of the prostate.
It will be held in Erice, 2-12 June 1981.
CONTENTS
PART 1
IMMUNOLOGY OF RENAL DISEASE
Immunological Problems in Kidney Disease-
An Introduction . . . . . . . . . 3
A. Vercellone
Pathophysiology of Inflammation . . . . . . . . . . . 7
G. Camussi, C. Tetta, F. Bussolino, C. Masera and
A. Vercellone
The Abnormalities of the Complement System in Human
Glomerulonephritis 25
F.C. Berthoux, B. Laurent, C. Genin and
J.C. Sabatier
The Significance of the Detection of Circulating Immune
Complexes in Human Glomerulonephritis .. 35
R. Coppo, D. Roccatello, C. Rollino, G. Martina,
A. Aprato, G. Camussi, M. Messina and G. Piccoli
Immunological Aspects of Renal Vascular Involvement 57
J. Egido, M. Sanchez Crespo and L. Hernando
The Immunology of Glomerular Nephropathies 77
B. Van Damme and V.J. Desmet
Immunopathology of Tubulo-Interstitial Nephritis in
Man and in Experimental Animals 91
T. Sugisaki and G. Andres
vii
viii CONTENTS
Monitoring the Allotransplant Recipient. . . . . . . . . .• 119
H. Kreis and J. Crosnier
The Selection and Investigation of Candidates for
Renal Transplantation 137
V. Bonomini and A. Vangelista
The Immunological Basis of the Treatment of
Glomerulonephritis 147
J.F. Bach and~. Chatenoud
Treatment of Glomerulonephritis with non Steroidal
Antiinflammatory Drugs 153
P. Michielsen
Corticosteroid Therapy in Idiopathic Glomerulonephritis 159
G. Piccoli, R. Coppo, P. Stratta, M. Messina,
D. Roccatello, G.M. Bosticardo, F. Quarello and
S. Alloatti
Plasmapheresis and Cryopheresis . . . . . . . . . . . . . 183
Q. Maggiore, A. L'Abbate, F. Bartolomeo, V. Misefari,
A. Caccamo and C. Martorano
New Therapeutic Approach to IgA Mesangial
Glomerulonephritis (Berger's Disease) 195
J. Egido, J. Sancho, M. Lopez Trascasa,
M. Sanchez Crespo, F. Rivera, V. Alvarez, A. Barat
and L. Hernando
PART 2
MEDICAL AND METABOLIC ASPECTS OF UROLITHIASIS
Metabolic and Medical Aspects of Urolithiasis--
Introduction 207
R. Maiorca
CONTENTS ix
Epidemiology of Uroli~hiasis 213
M. Pavone-Macaluso, U. Rotolo, G. Caramia and
D. Melloni
Crystallography: An Introduction . . • • . • • • . • • . • . 235
L. Riva di Sanseverino
Crystallographic Contributions to the Pathogenesis
of Renal Lithiasis 241
R. Mongiorgi
Crystalluria: A Valuable Parameter in the Study of
Urolithiasis .••• 251
A. Martelli, V. Pulini and P. Buli
Urodynamic Investigations in Nephrolithiasis 261
J. Hannappel
Inhibitors and Promoters of "Stone Formation. • . . • . . • • 275
H. Fleisch
Renal Stone Inhibitors 301
F. Corrado, M. Fini and A. Ligabue
Physiopathology and Diagnosis of Hyperparathyroidism 313
L. Giuliani
Controversies in the Pathophysiology of Calcium
Nephrolithiasis ..•..••••.. 327
G. Maschio, N. Tessitore, A. D'Angelo, E. Bonucci,
C. Lo Schiavo, E. Valvo, A. Lupo, A. Fabris,
L. Oldrizzi and G. Previato
Definition, Types and Management of Normocalcaemic
Hypercalciuria in Renal Lithiasis ..•• 337
B. Pinto, F.J. Ruiz-Marcellan and J. Bernshtam
Oxalic Acid Lithiasis and the Hyperoxaluric Syndromes 345
M. Marangella, M. Bruno, B. Fruttero and F. Linari
x CONTENTS
Uric Acid Nephrolithiasis - Prevalence, Pathogenesis
and Results of Conservative Treatment • 357
L. Miano, S. Petta, M. Gallucci and S. Goldoni
Clinical Features and Management of Cystine
Nephrolithiasis •• 375
L. Miano, I. Antonozzi, M. Gallucci, S. Morano
and S. Petta
Urinary Lithiasis in Children - A Review of 100 Cases. • •. 389
M. Broyer, M.F. Gagnadoux and D. Beurton
Soft renal Calculi (Matrix Stones) 403
M. Carney and A. Le Duc
Struvite Staghorn Lithiasis 411
A. Rousaud
Indications for Surgery and Surgical Techniques in
Staghorn Calculi ......... . 423
M. Carney and A. Le Duc
Urease Inhibitor Therapy in Infected Renal Stones. . . . • . 431
A. Martelli, P. Buli and V. Cortecchia
Prophylaxis and Metaphylaxis of Urolithiasis 441
W. Lutzeyer, F. Hering and J. Hannappel
Long-Term Treatment with Thiazide in the Prevention
of Calcium Nephrolithiasis •.••••. 449
N. Tessitore, A. D'Angelo, F. Pagano, C. Lo Schiavo,
A. Corgnati, A. Fabris, A. Lupo, E. Valvo, A. Tasca,
L. Oldrizzi, G. Previato, G. Maschio
Litholysis: In Situ Dissolution of Kidney Stones· 455
E. Dormia
Speakers 469
Index . • . . . . . • • • • • • • . • • • • . • • • • • • • • 471
