Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota 55905, USA.
Curr Opin Nephrol Hypertens. 2013 Jul;22(4):390-6. doi: 10.1097/MNH.0b013e32836214b9.
The prevalence of nephrolithiasis has been on the rise over recent decades. There have also been extensive efforts to identify risk factors for chronic kidney disease (CKD). The purpose of this review is to highlight recent evidence on the association of nephrolithiasis with the development of CKD and end-stage renal disease (ESRD).
Several epidemiologic studies over the past decade assessed the relationship between history of nephrolithiasis and CKD. Across several studies, patients with nephrolithiasis had about a two-fold higher risk for decreased renal function or need for renal replacement therapy. This risk appears to be independent of risk factors for CKD that are common in stone formers such as hypertension and diabetes mellitus. Specific risk factors for CKD in stone formers include recurrent urinary tract infections, struvite and possibly uric acid stone composition, symptomatic stones, solitary kidney, ileal conduit, neurogenic bladder, and hydronephrosis.
Recent evidence has shown a consistent relationship between nephrolithiasis history and an increased risk of CKD and ESRD. Understanding the characteristics that predispose to CKD may better inform how to optimally manage patients with nephrolithiasis and prevent this complication.
近几十年来，肾结石的患病率一直在上升。人们也一直在努力寻找慢性肾脏病（CKD）的危险因素。本文旨在强调肾结石与 CKD 和终末期肾病（ESRD）发展之间关联的最新证据。
过去十年的几项流行病学研究评估了肾结石病史与 CKD 之间的关系。多项研究表明，肾结石患者的肾功能下降或需要肾脏替代治疗的风险增加约两倍。这种风险似乎独立于结石形成者中常见的 CKD 危险因素，如高血压和糖尿病。结石形成者中 CKD 的具体危险因素包括复发性尿路感染、鸟粪石和可能的尿酸结石成分、有症状的结石、孤立肾、回肠导管、神经性膀胱和肾积水。
最近的证据表明肾结石病史与 CKD 和 ESRD 的风险增加之间存在一致的关系。了解导致 CKD 的特征可能有助于更好地指导如何优化肾结石患者的管理并预防这种并发症。
