Worcester Elaine M, Parks Joan H, Evan Andrew P, Coe Fredric L
Nephrology Section, University of Chicago, Illinois, USA.
J Urol. 2006 Aug;176(2):600-3; discussion 603. doi: 10.1016/j.juro.2006.03.095.
We describe kidney function, as measured by creatinine clearance in stone formers, and classified by type of stone formed and systemic etiologies of stone formation.
The mean of 3 pretreatment 24-hour creatinine clearance measurements in each of 1,856 stone formers and creatinine clearance in 153 normal individuals were used. Clearance was adjusted for patient sex, age and body weight using general linear modeling.
As a group, all stone formers had decreased clearance adjusted for age, sex and body weight compared to that in normal individuals. Although clearance was particularly low in cystine and struvite stone formers, they were below normal in even common CaOx stone formers.
As a rule, patients with kidney stones do not have normal kidney function. In clinical management all efforts must be made to minimize renal injury, balancing the risks of obstruction from stones against those of urological procedures.
我们描述了通过肌酐清除率测定的结石形成者的肾功能,并根据所形成结石的类型和结石形成的全身病因进行分类。
采用1856名结石形成者每人3次治疗前24小时肌酐清除率测量值的平均值以及153名正常个体的肌酐清除率。使用一般线性模型根据患者的性别、年龄和体重对清除率进行校正。
总体而言,与正常个体相比,所有结石形成者经年龄、性别和体重校正后的清除率均降低。尽管胱氨酸结石和鸟粪石结石形成者的清除率特别低,但即使是常见的草酸钙结石形成者,其清除率也低于正常水平。
通常,肾结石患者的肾功能不正常。在临床管理中,必须尽一切努力将肾损伤降至最低,平衡结石梗阻风险与泌尿外科手术风险。