New York University School of Medicine, New York, USA.
Kidney Int. 2011 Jun;79(11):1178-85. doi: 10.1038/ki.2011.76. Epub 2011 Mar 30.
Nephrolithiasis is a common disease across the world that is becoming more prevalent. Although the underlying cause for most stones is not known, a body of literature suggests a role of heat and climate as significant risk factors for lithogenesis. Recently, estimates from computer models predicted up to a 10% increase in the prevalence rate in the next half century secondary to the effects of global warming, with a coinciding 25% increase in health-care expenditures. Our aim here is to critically review the medical literature relating stones to ambient temperature. We have categorized the body of evidence by methodology, consisting of comparisons between geographic regions, comparisons over time, and comparisons between people in specialized environments. Although most studies are confounded by other factors like sunlight exposure and regional variation in diet that share some contribution, it appears that heat does play a role in pathogenesis in certain populations. Notably, the role of heat is much greater in men than in women. We also hypothesize that the role of a significant human migration (from rural areas to warmer, urban locales beginning in the last century and projected to continue) may have a greater impact than global warming on the observed worldwide increasing prevalence rate of nephrolithiasis. At this time the limited data available cannot substantiate this proposed mechanism but further studies to investigate this effect are warranted.
肾结石是一种在全球范围内普遍存在且日益普遍的疾病。尽管大多数结石的根本原因尚不清楚，但大量文献表明，热和气候是结石形成的重要危险因素。最近，计算机模型的估计预测，由于全球变暖的影响，未来半个世纪结石的患病率将增加 10%，医疗保健支出也将相应增加 25%。我们的目的是批判性地回顾与环境温度有关的结石医学文献。我们按照方法对证据进行了分类，包括地理区域之间的比较、随时间的比较以及专门环境中的人群之间的比较。尽管大多数研究受到其他因素的干扰，如阳光照射和饮食在区域上的差异，这些因素也有一定的影响，但热似乎确实在某些人群的发病机制中发挥了作用。值得注意的是，热的作用在男性中比在女性中更为显著。我们还假设，从上个世纪开始并预计将持续下去的重大人类迁徙（从农村地区向更温暖的城市地区），对观察到的全球肾结石患病率的上升的影响可能比全球变暖更大。目前，现有数据还无法证实这一推测机制，但需要进一步研究以调查这一影响。
