Xu Li Hao Richie, Adams-Huet Beverley, Poindexter John R, Maalouf Naim M, Moe Orson W, Sakhaee Khashayar
Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas; Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas.
J Urol. 2017 Jun;197(6):1465-1471. doi: 10.1016/j.juro.2017.01.057. Epub 2017 Jan 20.
The prevalence of kidney stones has increased globally in recent decades. However, studies investigating the association between temporal changes in the risk of stone formation and stone types are scarce. We investigated temporal changes in stone composition, and demographic, serum and urinary parameters of kidney stone formers from 1980 to 2015.
We retrospectively analyzed the records of 1,516 patients diagnosed with either calcium or uric acid stones at an initial visit to a university kidney stone clinic from 1980 to 2015.
From 1980 to 2015, the proportion of uric acid stones in all stone formers increased from 7% to 14%. While age and body mass index increased with time in both uric acid and calcium stone formers, uric acid stone formers were consistently older and had a higher body mass index and lower urinary pH than calcium stone formers. The proportion of females with stones has increased over time but the increase in female gender was more prominent among calcium stone formers. Urinary pH, phosphorus, oxalate and sodium increased with time in calcium stone formers but remained unchanged in uric acid stone formers. After accounting for various parameters of stone risk, the strongest clinical discriminant of uric acid vs calcium stones was urinary pH. Limitations of this study include the retrospective single center design and the available number of patients with stone analysis.
From 1980 to 2015, the proportion of uric acid stones increased significantly. With time, there were proportionately more female calcium stone formers but not uric acid stone formers. Urinary pH is the most prominent factor distinguishing uric acid from calcium stones.
近几十年来，肾结石的患病率在全球范围内有所上升。然而，关于结石形成风险的时间变化与结石类型之间关联的研究却很少。我们调查了1980年至2015年期间肾结石患者的结石成分、人口统计学特征、血清和尿液参数的时间变化。
我们回顾性分析了1980年至2015年期间首次就诊于某大学肾结石诊所的1516例被诊断为钙结石或尿酸结石患者的记录。
从1980年到2015年，所有结石患者中尿酸结石的比例从7%增加到了14%。虽然尿酸结石患者和钙结石患者的年龄和体重指数均随时间增加，但尿酸结石患者始终比钙结石患者年龄更大、体重指数更高且尿液pH值更低。结石女性患者的比例随时间增加，但女性比例的增加在钙结石患者中更为显著。钙结石患者的尿液pH值、磷、草酸盐和钠随时间增加，而尿酸结石患者则保持不变。在考虑了结石风险的各种参数后，尿酸结石与钙结石最强的临床判别因素是尿液pH值。本研究的局限性包括回顾性单中心设计以及可用于结石分析的患者数量。
从1980年到2015年，尿酸结石的比例显著增加。随着时间的推移，钙结石女性患者的比例相应增加，但尿酸结石女性患者并非如此。尿液pH值是区分尿酸结石和钙结石的最突出因素。
