Division of Nephrology, Humanitas Clinical and Research Center, via Manzoni 56, 20089, Rozzano, MI, Italy.
Division of Paediatric Nephrology, Ospedale "G. Di Cristina", Piazza Porta Montalto 2, 90134, Palermo, PA, Italy.
Urolithiasis. 2017 Oct;45(5):457-460. doi: 10.1007/s00240-016-0956-8. Epub 2016 Dec 5.
Diabetes and obesity are already recognized as potential risk factors for nephrolithiasis, especially for uric acid stones. Insulin resistance and hyperinsulinemia actively contribute to impaired ability to excrete an acid load and altered ammonium production, leading to a lower urinary pH compared to non-diabetic controls. All these electrolytic disorders play an important role in stone formation and aggregation, especially in uric acid stones. There are still missing points in scientific evidence if the increased risk in stone formation is already existing even in the prediabetic statuses (isolated impaired glucose tolerance, isolated impaired fasting glucose, and associated impaired glucose tolerance/impaired fasting glucose) as well as it is worth to consider the same level of risk. Urolithiasis is the most frequent urological cause of hospitalization in diabetic patients and its cost is usually higher compared to non-diabetic patients, but less is known in others altered glycaemic diseases. The aim of this review article is to focus on the association between stone formation and altered glycaemic statuses, beyond the already known link between nephrolithiasis and diabetes mellitus.
糖尿病和肥胖症已被认为是肾结石的潜在危险因素，尤其是尿酸结石。胰岛素抵抗和高胰岛素血症积极导致酸负荷排泄能力受损和铵生成改变，导致与非糖尿病对照组相比尿 pH 值较低。所有这些电解质紊乱在结石形成和聚集中起重要作用，尤其是尿酸结石。如果在糖尿病前期状态（孤立性糖耐量受损、孤立性空腹血糖受损以及相关的糖耐量受损/空腹血糖受损）中已经存在结石形成风险增加，以及是否值得考虑相同水平的风险，这在科学证据中仍然存在空白。在糖尿病患者中，尿石症是最常见的住院泌尿外科病因，其费用通常高于非糖尿病患者，但在其他糖代谢异常疾病中知之甚少。本文综述的目的是关注结石形成与糖代谢状态改变之间的关系，而不仅仅是肾结石与糖尿病之间已有的联系。
