Department of Internal Medicine, Kang Dong Dr. Han medical clinic, 156, Seongan-ro, Gangdong-gu, Seoul, 05355, Korea.
Department of Internal Medicine, College of Medicine, Hallym University, Kandong Sacred Heart Hospital, 150, Seongan-ro, Gangdong-gu, Seoul, 05355, Korea.
Sci Rep. 2019 Feb 13;9(1):1929. doi: 10.1038/s41598-018-38191-1.
Osteoporotic fracture associated with calcium dysregulation is more common in patients with kidney stones. However, little is known about the association of kidney stones and bone health status in patients with chronic kidney disease (CKD). This retrospective medical record-based study included 2282 patients with stable stage 3-4 CKD between 2007 and 2017. Of these, 113 patients were diagnosed with kidney stones. Propensity score matching for 226 patients with and without kidney stones showed that osteoporotic fracture occurred more often in patients with kidney stones (33, 29.2%) than in patients without kidney stones (16, 14.2%), resulting in rates of 5.56 and 2.63/100 patient-years, respectively (p < 0.01). In particular, Cox proportional hazard analysis revealed that kidney stones were significantly associated with osteoporotic fracture, even after adjusting for age, sex, body mass index, kidney stones, estimated glomerular filtration rate, excessive alcohol consumption, current smoking, and steroid use in patients with CKD stage 3-4 (hazard ratio, 2.32, 95% CI 1.24-4.34, p = 0.01). This study showed that the presence of kidney stones was a significant predictor for osteoporotic fracture in patients with CKD, suggesting that it should be considered as a clinical risk factor for osteoporotic fracture in them.
与钙调节异常相关的骨质疏松性骨折在肾结石患者中更为常见。然而，对于慢性肾脏病（CKD）患者肾结石与骨骼健康状况之间的关系知之甚少。本回顾性病历研究纳入了 2007 年至 2017 年间 2282 例稳定期 3-4 期 CKD 患者。其中，113 例患者被诊断为肾结石。对有肾结石和无肾结石的 226 例患者进行倾向评分匹配，结果显示肾结石患者发生骨质疏松性骨折的频率更高（33 例，29.2%），而无肾结石患者为 16 例（14.2%），发生率分别为 5.56 和 2.63/100 患者年（p<0.01）。特别是 Cox 比例风险分析显示，即使在校正了年龄、性别、体重指数、肾结石、估算肾小球滤过率、过量饮酒、当前吸烟和 CKD 3-4 期患者使用类固醇等因素后，肾结石与骨质疏松性骨折仍显著相关（风险比 2.32，95%CI 1.24-4.34，p=0.01）。本研究表明，肾结石的存在是 CKD 患者发生骨质疏松性骨折的一个显著预测因素，提示其应被视为此类患者骨质疏松性骨折的临床危险因素。
