Department of Clinical and Experimental Medicine, Federico II University Medical School, Naples, Italy.
Nephrol Dial Transplant. 2013 Nov;28 Suppl 4:iv146-51. doi: 10.1093/ndt/gft076. Epub 2013 Apr 17.
Epidemiological data indicate an increasing incidence and prevalence of nephrolithiasis (NL) worldwide in the last few decades.
The aim of this study was to compare the clinical and biochemical profiles of recurrent stone formers referred to a Kidney Stone Centre from March 1983 to June 1986 with the one featured by patients seen 25 years later in the same geographical area, Campania, southern Italy.
Idiopathic calcium stone formers made up the large majority of the patient population in both series. Those examined in 2008-11 showed higher age at the onset of NL, higher prevalence of overweight/obesity and higher urinary excretion of oxalate and phosphate compared with those seen in 1983-86. The differences in the urinary biochemical variables remained significant upon accounting for age, gender, creatinine clearance and body mass index (BMI), and were not observed in patients with primary hyperparathyroidism enrolled in the same periods. A greater prevalence of uric acid stone formers was also observed in the 2008-11 population.
The massive epidemics of overweight/obesity and the substantial modifications of dietary habits over the last few decades in most Western countries may be the factors underlying the changing clinical and biochemical profiles of patients with recurrent NL.
流行病学数据表明，在过去几十年中，全球范围内肾结石（NL）的发病率和患病率呈上升趋势。
本研究的目的是比较 1983 年 3 月至 1986 年期间向肾结石中心就诊的复发性结石患者的临床和生化特征与 25 年后同一地理区域（意大利南部坎帕尼亚地区）就诊的患者的特征。
在两个系列中，特发性钙结石患者构成了患者群体的绝大多数。与 1983-86 年相比，2008-11 年就诊的患者 NL 发病年龄更高，超重/肥胖患病率更高，尿草酸盐和磷酸盐排泄量更高。在考虑年龄、性别、肌酐清除率和体重指数（BMI）后，这些尿生化变量的差异仍然显著，而在同期纳入的原发性甲状旁腺功能亢进症患者中则没有观察到这些差异。2008-11 年就诊的患者中尿酸结石患者的患病率也更高。
在过去几十年中，超重/肥胖的大规模流行以及大多数西方国家饮食习惯的实质性改变，可能是复发性 NL 患者临床和生化特征发生变化的原因。
