Kang Ho Won, Seo Sung Pil, Kim Won Tae, Kim Yong-June, Yun Seok-Joong, Kim Wun-Jae, Lee Sang-Cheol
1 Department of Urology, College of Medicine, Chungbuk National University , Cheongju, South Korea .
2 Department of Urology, Chungbuk National University Hospital , Cheongju, South Korea .
J Endourol. 2017 Aug;31(8):806-811. doi: 10.1089/end.2017.0210.
The aim of this study was to assess the metabolic characteristics and risks of stone recurrence in young adult stone patients in Korea.
The medical records of 1532 patients presenting with renal or ureteric stones at our stone clinic between 1994 and 2015 were retrospectively reviewed. Patients were grouped according to age (young adult, 18-29 years; intermediate onset, 30-59 years; old age, ≥60 years) at first presentation, and measurements of clinicometabolic characteristics and risks of stone recurrence were compared.
Overall, excretion of urinary stone-forming substances was highest in the intermediate onset group, followed by the young adult and old age groups. Importantly, excretion of urinary citrate was lowest in the young adult group. Kaplan-Meier analyses identified a significant difference between the three age groups in terms of stone recurrence (log rank test, p < 0.001). Multivariate Cox regression analyses revealed that age at first stone presentation was an independent risk factor for stone recurrence. Urinary citrate excretion was an independent risk factor for stone recurrence in young adult stone patients.
Younger age (18-29 years) at first stone presentation was a significant risk factor for stone recurrence, and urinary citrate excretion was an independent risk factor affecting recurrence in this group. Metabolic evaluation and potassium citrate therapy should be considered for young adult stone patients to prevent recurrence.
本研究旨在评估韩国年轻成年结石患者的代谢特征及结石复发风险。
回顾性分析了1994年至2015年间在我院结石门诊就诊的1532例肾或输尿管结石患者的病历。根据首次就诊时的年龄（年轻成年组，18 - 29岁；中年发病组，30 - 59岁；老年组，≥60岁）对患者进行分组，并比较临床代谢特征及结石复发风险的测量结果。
总体而言，尿结石形成物质的排泄量在中年发病组最高，其次是年轻成年组和老年组。重要的是，年轻成年组的尿枸橼酸盐排泄量最低。Kaplan - Meier分析显示，三个年龄组在结石复发方面存在显著差异（对数秩检验，p < 0.001）。多因素Cox回归分析表明，首次结石发作时的年龄是结石复发的独立危险因素。尿枸橼酸盐排泄是年轻成年结石患者结石复发的独立危险因素。
首次结石发作时年龄较小（18 - 29岁）是结石复发的重要危险因素，尿枸橼酸盐排泄是影响该组复发的独立危险因素。对于年轻成年结石患者，应考虑进行代谢评估及枸橼酸钾治疗以预防复发。
