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肾移植受者肾结石的发病率:一项系统评价和荟萃分析。

Incidence of kidney stones in kidney transplant recipients: A systematic review and meta-analysis.

作者信息

Cheungpasitporn Wisit, Thongprayoon Charat, Mao Michael A, Kittanamongkolchai Wonngarm, Jaffer Sathick Insara J, Dhondup Tsering, Erickson Stephen B

机构信息

Wisit Cheungpasitporn, Charat Thongprayoon, Michael A Mao, Wonngarm Kittanamongkolchai, Insara J Jaffer Sathick, Tsering Dhondup, Stephen B Erickson, Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States.

出版信息

World J Transplant. 2016 Dec 24;6(4):790-797. doi: 10.5500/wjt.v6.i4.790.

Abstract

AIM

To evaluate the incidence and characteristics of kidney stones in kidney transplant recipients.

METHODS

A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from the inception of the databases through March 2016. Studies assessing the incidence of kidney stones in kidney transplant recipients were included. We applied a random-effects model to estimate the incidence of kidney stones.

RESULTS

Twenty one studies with 64416 kidney transplant patients were included in the analyses to assess the incidence of kidney stones after kidney transplantation. The estimated incidence of kidney stones was 1.0% (95%CI: 0.6%-1.4%). The mean duration to diagnosis of kidney stones after kidney transplantation was 28 ± 22 mo. The mean age of patients with kidney stones was 42 ± 7 years. Within reported studies, approximately 50% of kidney transplant recipients with kidney stones were males. 67% of kidney stones were calcium-based stones (30% mixed CaOx/CaP, 27%CaOx and 10%CaP), followed by struvite stones (20%) and uric acid stones (13%).

CONCLUSION

The estimated incidence of kidney stones in patients after kidney transplantation is 1.0%. Although calcium based stones are the most common kidney stones after transplantation, struvite stones (also known as "infection stones") are not uncommon in kidney transplant recipients. These findings may impact the prevention and clinical management of kidney stones after kidney transplantation.

摘要

目的

评估肾移植受者肾结石的发病率及特征。

方法

通过检索MEDLINE、EMBASE以及Cochrane系统评价数据库,纳入自建库起至2016年3月间评估肾移植受者肾结石发病率的研究,运用随机效应模型估算肾结石发病率。

结果

纳入21项研究,共64416例肾移植患者,以分析肾移植后肾结石的发病率。估算肾结石发病率为1.0%(95%CI:0.6%-1.4%)。肾移植后诊断出肾结石的平均时间为28±22个月。肾结石患者的平均年龄为42±7岁。在已报道的研究中,肾结石肾移植受者约50%为男性。67%的肾结石为钙基结石(30%为草酸钙/磷酸钙混合结石,27%为草酸钙结石,10%为磷酸钙结石),其次是鸟粪石结石(20%)和尿酸结石(13%)。

结论

肾移植患者肾结石的估算发病率为1.0%。虽然钙基结石是移植后最常见的肾结石,但鸟粪石结石(又称“感染性结石”)在肾移植受者中也并不少见。这些发现可能会影响肾移植后肾结石的预防和临床管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002e/5175239/ea09701556e1/WJT-6-790-g001.jpg

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