Department of Urology, Loyola University Medical Center, Maywood, IL, USA.
Urology. 2011 Oct;78(4):744-7. doi: 10.1016/j.urology.2011.04.007. Epub 2011 Jun 12.
To determine the effect of renal function on urinary mineral stone excretion and composition of kidney stones in patients undergoing urologic intervention for nephrolithiasis.
We performed a retrospective analysis of 158 patients with 193 kidney stones who underwent endourologic intervention for nephrolithiasis. The patients were grouped by the estimated glomerular filtration rate (eGFR). The kidney stone composition and results of the 24-hour urinalysis were reported for each group. Statistical analysis was performed using the chi-square test, Kruskal-Wallis test, and analysis of variance.
The kidney stone composition profile differed significantly between the groups, with uric acid stones associated with a lower eGFR and calcium phosphate stones associated with a greater eGFR. A lower eGFR correlated with lower urine pH, lower calcium excretion, and greater oxalate excretion. Excretion of uric acid and the body mass index did not differ between groups.
Different degrees of renal function correlated with certain types of kidney stones. The urine pH was lower in patients with impaired renal function. Renal function might be an underappreciated factor that affects kidney stone composition and urinary mineral excretion.
探讨肾功能对接受泌尿外科干预的肾结石患者尿矿物结石排泄和结石成分的影响。
我们对 158 例因肾结石接受腔内泌尿外科干预的 193 例肾结石患者进行了回顾性分析。根据估算肾小球滤过率（eGFR）对患者进行分组。报告了每组的结石成分和 24 小时尿液分析结果。采用卡方检验、Kruskal-Wallis 检验和方差分析进行统计学分析。
结石成分谱在各组之间有显著差异，尿酸结石与较低的 eGFR 相关，而磷酸钙结石与较高的 eGFR 相关。较低的 eGFR 与较低的尿 pH 值、较低的钙排泄量和较高的草酸盐排泄量相关。尿酸排泄量和体重指数在各组之间无差异。
不同程度的肾功能与某些类型的肾结石相关。肾功能受损的患者尿 pH 值较低。肾功能可能是影响结石成分和尿矿物排泄的一个被低估的因素。
