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KMID : 0351619670080010015
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Kyungpook Medical Journal
1967 Volume.8 No. 1 p.15 ~ p.39
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Studies on the Influence of Corticosteroids in Urinary Calculogenesis
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Abstract
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The etio1ogy of urinary stone remains unsolved despite a vast amount of clinical observation and experimental research. Among the numerous etiologic factors the relationship between corticosteroids and urinary stone has received considerable attention in recent years since A. G. Butt (1956) has pointed out that cortisone had a certain influence on urinary calculogenesis.
There was a few reports that cortisone and ACTH had an enhancing or promoting influence on urinary stone formation, but the corticosteroids, newer synthetic and more potent than cortisone, have not been extensively investigated in regard to calculogenesis.
From this point of view, in order to investigate the effects of hydrocortisone, prednisolone and dexamethasone and even cortisone on urinary calculogenesis under varying conditions, the author made an experimental study on 105 white rats. In this study a piece of zinc ball was inserted into the each bladder to form stones and corticosteroids were given, observing the weight, chemical componets and electron microscopic appearance of stones which formed in the bladder, and also observing the pathological findings of the kidneys.
The results are as follows :
1. There was a tendency to an increase in the weight of stones in the groups administered cortisone acetate suspension (CAS), hydrocortisone acetate suspension (HAS), prednisolone suspension (PDS) and dexamethasone suspension (DMS) than in that of control.
2. There was no proportionate difference in the tendency of stone formation whether the administered dose of CAS, HAS, PDS and DMS was a larger dose or a usual dose.
3. Comparing the effects cf each corticosteroid on calculogenesis, DMS sholwed the greatest increase, followed by PDS and HAS showing a similar but smaller increase and CAS showed the least increase in stone weight, there was a marked difference between the groups given DMS and CAS.
4. In orchiectomized rats the group given CAS caused the weight of stones to be approximately twice that, and those given DMS 5.6 times that in the control group.
5. In oophorectomized rats the group given DMS showed a marked increase in the stone weight compared with those given CAS and those in the control group.
6. In orchiectomized rats the weight of stones was twice that in the oophorectomized rats.
7. In adrenalectomized rats the weight of stones was 15 times less that of the non-adrenalectomized group. However, the adrenalectomized rats given DMS, PDS and CAS showed a slight increase in the weight of stone. compared with those not given corticosteroids.
8. Chemical composition of stones in the group given corticosteroids showed a decrease in magnesium and an increase in calcium and phosphate. The group administered the larger doses of corticosteroids showed a larger increase in calcium and phosphate than the group administered the usual doses.
9. Stereomicroscopic and electron microscopic appearance showed no correlation with the corticosteroids given.
10. Histopathological findings of the kidneys showed no difference in each group except moderate degree of calcification in the medulla and cortex of the group given CAS.
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