Emami-Naini Afsoon, Eshraghi Amid, Shahidi Shahrzad, Mortazavi Mojgan, Seyrafian Shiva, Roomizadeh Peyman, Abtahi Seyed-Hossein, Ghafoori Hamed-Basir
Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Nephrology, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2012;1:65. doi: 10.4103/2277-9175.100193. Epub 2012 Aug 28.
Nephrolithiasis is a major public health problem worldwide. In recent years, growing evidence suggest that this disease may originate from underlying metabolic disorders. This is the first study that reports the frequency of different metabolic abnormalities among patients with nephrolithiasis in Isfahan, a large central province of Iran.
From the time period between March 2009 and August 2010, 437 nephrolithiasis patients in Isfahan province enrolled in this study. Metabolic evaluation was performed by obtaining a 24-hours urine sample and fasting venous blood draw. We analyzed urine samples for volume, creatinine, calcium, citrate, oxalate, uric acid, sodium, and cystine. Fasting blood samples were assessed for serum calcium, phosphorus, sodium, potassium, uric acid, albumin, creatinine and blood urea nitrogen.
The mean age was 46 ± 13.8 years (rang: 18-87). Nearly 50% were first time stone formers. The most common metabolic abnormalities were hypocitraturia (40.5%) and hypernatriuria (31.8%) that was followed by hyperoxaluria (28.8%). Hypercalciuria was detected only in 9.2% of the cases.
Although, high calcium excretion was the most frequent metabolic derangement in several similar studies, in our province with considerably high prevalence of vitamin D deficiency, it is not frequent among nephrolithiasis patients. Instead, other metabolic risk factors were in higher frequencies.
肾结石是全球主要的公共卫生问题。近年来，越来越多的证据表明，这种疾病可能源于潜在的代谢紊乱。这是第一项报告伊朗中部大省伊斯法罕肾结石患者中不同代谢异常发生率的研究。
在2009年3月至2010年8月期间，伊斯法罕省的437例肾结石患者纳入本研究。通过采集24小时尿液样本和空腹静脉血进行代谢评估。我们分析了尿液样本的体积、肌酐、钙、柠檬酸盐、草酸盐、尿酸、钠和胱氨酸。对空腹血样本进行血清钙、磷、钠、钾、尿酸、白蛋白、肌酐和血尿素氮的评估。
平均年龄为46±13.8岁（范围：18 - 87岁）。近50%是首次形成结石者。最常见的代谢异常是低枸橼酸尿症（40.5%）和高钠尿症（31.8%），其次是高草酸尿症（28.8%）。高钙尿症仅在9.2%的病例中被检测到。
虽然在几项类似研究中，高钙排泄是最常见的代谢紊乱，但在我们这个维生素D缺乏患病率相当高的省份，高钙尿症在肾结石患者中并不常见。相反，其他代谢风险因素更为常见。
