Pak Charles Y C
Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Tex 75390-8571, USA.
Nephron Clin Pract. 2004;98(2):c49-53. doi: 10.1159/000080252.
A variety of dietary and metabolic factors may contribute or cause stone formation in idiopathic calcium oxalate nephrolithiasis. Dietary factors include a high intake of animal proteins, oxalate and sodium, and a low intake of fluids and potassium-containing citrus products. Some of the metabolic causes of stones are hypercalciuria, hypocitraturia, gouty diathesis, hyperoxaluria, and hyperuricosuria. Dietary modification, to be applied in all patients with stones includes a high fluid intake, restriction of oxalate and sodium, and balanced diet with animal proteins complemented by adequate intake of fruits and vegetables. When dietary modification is ineffective in controlling stone formation or in the presence of severe metabolic derangements, a pharmacologic intervention may be necessary. In a simple approach, thiazide or indapamide with potassium citrate is recommended for patients with hypercalciuria, and potassium citrate alone for the remaining normocalciuric subjects.
多种饮食和代谢因素可能促成或导致特发性草酸钙肾结石的形成。饮食因素包括大量摄入动物蛋白、草酸盐和钠，以及液体和含钾柑橘类产品摄入不足。结石的一些代谢原因是高钙尿症、低枸橼酸尿症、痛风素质、高草酸尿症和高尿酸尿症。适用于所有结石患者的饮食调整包括大量摄入液体、限制草酸盐和钠的摄入，以及均衡饮食，摄入动物蛋白并辅以充足的水果和蔬菜。当饮食调整在控制结石形成方面无效或存在严重代谢紊乱时，可能需要进行药物干预。一种简单的方法是，对于高钙尿症患者，推荐使用噻嗪类药物或吲达帕胺加枸橼酸钾，对于其余正常钙尿症患者，单独使用枸橼酸钾。
