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肾结石病患者后代的尿路结石风险因素。

Urinary stone risk factors in the descendants of patients with kidney stone disease.

机构信息

Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, 10150, Thailand.

Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand.

出版信息

Pediatr Nephrol. 2018 Jul;33(7):1173-1181. doi: 10.1007/s00467-018-3927-1. Epub 2018 Mar 28.

Abstract

BACKGROUND

Evidence has indicated that immediate family members of nephrolithiasis patients had high opportunity to develop stones. However, they are usually not regarded to be at risk, since it is unclear if there are any lithogenic abnormalities found in non-stone-forming nephrolithiasis relatives. Our aim was to investigate urinary metabolic abnormalities in the children of nephrolithiasis patients, compared with the general population.

METHODS

The 24-h urinary metabolic profile was studied for 28 calcium oxalate nephrolithiasis patients (NL) and 46 of their descendants (ND), as well as 40 non-stone-forming volunteers (V) and 34 of their descendants (VD).

RESULTS

There was no difference between age, gender, and serum creatinine between NL vs. V (parental groups) and ND vs. VD (descendant groups). High urinary oxalate in nephrolithiasis and urinary calcium in their descendants was detected. In addition, an elevated urinary excretion rate of calcium, phosphate, protein, and albumin, along with low citrate excretion and high urinary supersaturation was observed in both the nephrolithiasis patients and their descendants. Approximate 17.8-24.4% of the nephrolithiasis descendants had a urinary supersaturation higher than the nephrolithiasis level, but none was found in VD group. The level of urinary supersaturation index was correlated with urinary protein and albumin excretion in nephrolithiasis family.

CONCLUSION

It was demonstrated that nephrolithiasis offspring carried several urinary metabolic risks predisposing to stone formation which are similar to their parents, and about one in every five nephrolithiasis children had nephrolithiasis level urinary supersaturation.

摘要

背景

有证据表明,肾结石患者的直系亲属有很高的机会患上结石。然而,由于尚不清楚非结石形成的肾结石亲属是否存在结石形成异常,因此通常不认为他们有患病风险。我们的目的是研究肾结石患者的子女的尿代谢异常,并与普通人群进行比较。

方法

研究了 28 例草酸钙肾结石患者(NL)及其 46 名后代(ND)、40 名非结石形成志愿者(V)及其 34 名后代(VD)的 24 小时尿代谢谱。

结果

NL 与 V(父母组)和 ND 与 VD(后代组)之间在年龄、性别和血清肌酐方面没有差异。检测到肾结石患者及其后代的尿草酸和尿钙升高。此外,还观察到肾结石患者及其后代的尿钙、磷、蛋白质和白蛋白排泄率升高,柠檬酸排泄率降低,尿过饱和度升高。大约 17.8-24.4%的肾结石后代的尿过饱和度高于肾结石水平,但在 VD 组中未发现这种情况。尿过饱和度指数与肾结石家族的尿蛋白和白蛋白排泄有关。

结论

研究表明,肾结石患者的子女存在多种尿代谢风险,易发生结石形成,与父母相似,约五分之一的肾结石儿童的尿过饱和度达到肾结石水平。

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