Shekarriz B, Lu H F, Stoller M L
Department of Urology, University of California, San Francisco, San Francisco, California 94143-0738, USA.
J Urol. 2001 Apr;165(4):1085-7.
Recurrent stone formers commonly present with calculi on the same side and the etiology of recurrent unilateral urolithiasis is unclear. Despite comprehensive metabolic evaluations, many patients will not be readily categorized into a treatable group. Data from the literature support that sleep posture may result in alterations of renal hemodynamics. We investigate the correlation of sleep posture with unilateral urinary stone formation.
A prospective study of 110 patients with recurrent unilateral nephrolithiasis was conducted. A questionnaire was used to evaluate patient sleep posture. Right or left side down and rotisserie-like sleep postures were defined. The side of stone formation was correlated with sleep posture using chi-square test.
Of the patients 93 slept consistently with 1 side in a dependent position and the side of stone was identical to the dependent sleep side in 76% (p = 0.008). The positive predictive values of right and left side down sleep posture for formation of ipsilateral calculi were 82% and 70%, respectively.
Although the exact pathophysiology of the association between sleep posture and recurrent unilateral stone disease remains to be elucidated, sleep posture may alter renal hemodynamics during sleep and promote stone formation. This observation needs further investigation and should be factored into the evaluation and prevention of unilateral urinary stone disease.
复发性结石形成者通常在同一侧出现结石，而复发性单侧尿路结石的病因尚不清楚。尽管进行了全面的代谢评估，但许多患者仍难以被归为可治疗组。文献数据支持睡眠姿势可能导致肾血流动力学改变。我们研究睡眠姿势与单侧尿路结石形成之间的相关性。
对110例复发性单侧肾结石患者进行了一项前瞻性研究。使用问卷评估患者的睡眠姿势。定义右侧或左侧朝下以及旋转烤肉架样的睡眠姿势。使用卡方检验将结石形成的一侧与睡眠姿势相关联。
在这些患者中，93例始终以一侧处于依赖位置的方式睡眠，结石所在侧与依赖睡眠侧相同的比例为76%（p = 0.008）。右侧和左侧朝下睡眠姿势对同侧结石形成的阳性预测值分别为82%和70%。
尽管睡眠姿势与复发性单侧结石疾病之间关联的确切病理生理学仍有待阐明，但睡眠姿势可能在睡眠期间改变肾血流动力学并促进结石形成。这一观察结果需要进一步研究，并且应纳入单侧尿路结石疾病的评估和预防中。
