尿石症：非肾肿瘤患者中最易导致肾切除术的疾病。

Urolithiasis: the most risk for nephrectomy in nonrenal tumor patients.

机构信息

Department of Urology, Huashan Hospital, Fudan University, No.12 Middle Wulumuqi Road, Shanghai, P.R. China.

出版信息

J Endourol. 2012 Oct;26(10):1356-60. doi: 10.1089/end.2012.0080. Epub 2012 Jul 18.

DOI:10.1089/end.2012.0080

PMID:22809053

Abstract

BACKGROUND AND PURPOSE

The existence of upper urinary tract calculus may cause complete loss of renal function, which eventually results in nephrectomy. Our purpose was to describe the prevalence and clinical characteristics of upper urinary tract calculus cases among a series of patients undergoing nephrectomy during a 10-year period.

PATIENTS AND METHODS

The data of 1059 patients undergoing nephrectomy between January 2001 and December 2010 in our center were reviewed. The prevalence and clinical characteristics of upper urinary tract calculi-derived nonfunctioning kidney were analyzed.

RESULTS

Among 1059 patients, 177 (16.7%) had nonfunctioning kidneys, which were second in number to renal tumor cases (801, 75.6%). Upper urinary tract calculi accounted for the greatest cause (101, 57.1%) in these nonfunctioning kidney cases. These patients were mainly screened by ultrasonography and the diagnosis confirmed by CT, intravenous urography, and nuclear renography. There were 44 (43.6%) patients with a single renal stone in the ureteropelvic junction, 36 (35.6%) with a single ureteral stone, and 21 (20.8%) with multiple unilateral renal and ureteral stones. The average size of the renal stones and ureteral stones were 15.6±8.8 mm (4-50 mm) and 13.4±4.0 mm (4-21mm) in diameter, respectively. Prevalence of urolithiasis derived nonfunctioning kidney had not changed significantly over 10 years and even showed a slight increase. Most of the stones were more than 10 mm in diameter. A nonfunctioning kidney was more likely to develop in females or patients with a low living standard.

CONCLUSIONS

Upper urinary tract calculus (>10 mm) and loss to follow-up are the greatest risk factors for a nonfunctioning kidney. A nonfunctioning kidney develops more easily in females or patients with a low living standard. A regular urinary system health examination is recommended. Routine follow-up of urolithiasis is also recommended for patients with a stone history to prevent renal dysfunction.

摘要

背景与目的

上尿路结石的存在可能导致肾功能完全丧失，最终导致肾切除。我们的目的是描述在 10 年期间接受肾切除术的一系列患者中上尿路结石病例的患病率和临床特征。

患者与方法

回顾了 2001 年 1 月至 2010 年 12 月期间在我们中心接受肾切除术的 1059 名患者的数据。分析了上尿路结石导致的无功能肾的患病率和临床特征。

结果

在 1059 名患者中，177 名（16.7%）患有无功能肾，仅次于肾肿瘤病例（801 例，75.6%）。上尿路结石是这些无功能肾脏病例的最大原因（101 例，57.1%）。这些患者主要通过超声检查进行筛查，并通过 CT、静脉尿路造影和核肾图进行诊断。有 44 例（43.6%）患者在肾盂输尿管连接处有单个肾结石，36 例（35.6%）患者有单个输尿管结石，21 例（20.8%）患者有单侧多个肾和输尿管结石。肾结石和输尿管结石的平均直径分别为 15.6±8.8mm（4-50mm）和 13.4±4.0mm（4-21mm）。10 年来，上尿路结石引起的无功能肾病的患病率没有明显变化，甚至略有增加。大多数结石直径超过 10mm。女性或生活水平较低的患者更有可能发生无功能肾。