Kartha Ganesh K, Li Ina, Comhair Suzy, Erzurum Serpil C, Monga Manoj
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, United States of America.
Respiratory Institute and Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America.
PLoS One. 2017 Jan 12;12(1):e0168813. doi: 10.1371/journal.pone.0168813. eCollection 2017.
It has been proposed that epithelial dysfunction and inflammation may predispose patients to kidney stone formation. Asthma is another chronic condition related to epithelial dysfunction and inflammation. We hypothesized that pediatric patients with asthma would have an increased prevalence of nephrolithiasis. Furthermore, we investigated if asthma patients with nephrolithiasis have clinical characteristics and urine profiles that point to mechanisms of stone formation. We evaluated 865 pediatric patients who had a diagnosis of nephrolithiasis. Clinical/demographic data and 24 hour urine samples were compared between asthma + stone (n = 142) and stone only patients. Data from asthmatics without stone were also available for evaluation of medication differences among asthma + stone and asthma only patients. The prevalence of nephrolithiasis in the pediatric population at our institution was 0.08% vs. 0.31% in our pediatric asthmatic population. The prevalence of asthma in our pediatric population was 6.8% vs. 26.7% in our pediatric stone patients. Asthma + stone patients were more likely to be on a combination inhaled corticosteroid + long acting beta agonist inhaler as compared to age/gender/BMI matched asthma patients without stone (29.7% vs. 13.7%, p = 0.0012). 259 kidney stone patients had 24 hour urine samples for comparison. There was no difference in 24 hour urine profiles between asthma + stone and stone only patients. Children with asthma have a 4-fold greater prevalence of kidney stones than the general pediatric population. Similarly, children with kidney stones have a 4-fold greater prevalence of asthma. This correlation may suggest a mechanistic link between asthma and nephrolithiasis. Further investigation is needed to elucidate the pathophysiologic origin of this relationship.
有人提出,上皮功能障碍和炎症可能使患者易患肾结石。哮喘是另一种与上皮功能障碍和炎症相关的慢性疾病。我们假设患有哮喘的儿科患者肾结石患病率会增加。此外,我们研究了患有肾结石的哮喘患者是否具有指向结石形成机制的临床特征和尿液特征。我们评估了865例诊断为肾结石的儿科患者。比较了哮喘合并结石患者(n = 142)和单纯结石患者的临床/人口统计学数据及24小时尿液样本。还可获得无结石哮喘患者的数据,以评估哮喘合并结石患者与单纯哮喘患者之间的药物差异。我们机构儿科人群中肾结石的患病率为0.08%,而儿科哮喘人群中为0.31%。我们儿科人群中哮喘的患病率为6.8%,而儿科结石患者中为26.7%。与年龄/性别/体重指数匹配的无结石哮喘患者相比,哮喘合并结石患者更有可能使用吸入性糖皮质激素+长效β受体激动剂联合吸入器(29.7%对13.7%,p = 0.0012)。259例肾结石患者有24小时尿液样本用于比较。哮喘合并结石患者和单纯结石患者的24小时尿液特征没有差异。患有哮喘的儿童肾结石患病率比普通儿科人群高4倍。同样,患有肾结石的儿童哮喘患病率高4倍。这种相关性可能表明哮喘与肾结石之间存在机制上的联系。需要进一步研究以阐明这种关系的病理生理起源。