[Urinary exploration of metabolism: nutrition assessment, urolithiasis and tubulopathy.]

Exploration urinaire du métabolisme : bilan nutritionnel, lithiase urinaire et tubulopathie

Christelle Machon (1) , Anne-Sophie Bargnoux (2, 3) , Yann Barguil (4) , Stéphanie Baron (5) , Jean-Paul Cristol (2, 3) , Vincent Frochot (6)

1 HCL - Hospices Civils de Lyon
2 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
3 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
4 Centre hospitalier territorial Gaston-Bourret [Nouméa]
5 EA 4466 - Stress Cellulaire : Physiopathologie, Stratégies Nutritionnelles et Thérapeutiques Innovantes
6 CHU Tenon [AP-HP]

The SFBC working group aimed to deal with biological tests outside the french nomenclature that may be useful in the context of urinary exploration of metabolism. This section will be divides into three parts: 1) nutritional assessment using urinary urea; 2) metabolic assessment of urolithiasis; 3) exploration of tubulopathies. National and international recommendations support the evaluation of nutritional status from urea measurements in urine and dialysate with the following indications: primary metabolic evaluation of urolithiasis patients, monitoring of protein intake in chronic renal failure stage 3 or stage 5D with residual diuresis. For the management of the urolithiasis disease, biomedical tests recommended by the national and international guidelines are the measurement of the urinary density using refractometry in the primary metabolic evaluation as well as the determination of oxalemia in the diagnosis (patients with GFR< 30 mL/min/1.73 m2) and follow-up (patients with GFR< 60 mL/min/1.73 m2) of primary hyperoxaluria. The determination of the bicarbonaturia is retained for the in depth exploration of urolithiasis and tubular acidosis. The measure of chlore in urine is used to evaluate the volume status during metabolic alkalosis and to calculate the urinary anionic gap during metabolic acidosis.

Mots clés: Oxalemia; Recommendations; Urinary urea; Urinary density; Indications; Chlore in urine; Bicarbonaturia

Domaines: Sciences du Vivant [q-bio]

Christelle Machon, Anne-Sophie Bargnoux, Yann Barguil, Stéphanie Baron, Jean-Paul Cristol, et al.. [Urinary exploration of metabolism: nutrition assessment, urolithiasis and tubulopathy.]. Annales de Biologie Clinique, 2019, 77 (4), pp.381-389. ⟨10.1684/abc.2019.1458⟩. ⟨hal-02267016⟩