Department of Rheumatology, The First Affiliated Hospital, Jinan University, No. 613 West Huangpu Ave, Tianhe District, Guangzhou, 510630, China.
Department of Orthopedics, The First Affiliated Hospital, Jinan University, NO.613 West Huangpu Ave,Tianhe District, Guangzhou, 510630, China.
BMC Nephrol. 2019 Jul 19;20(1):273. doi: 10.1186/s12882-019-1441-8.
A study to evaluate the prevalence of uric acid (UA) nephrolithiasis with dual-energy CT (DECT) and explore the risk factors for kidney stones in primary gout patients.
Eighty-four consecutive gout patients underwent urinary tract ultrasonography or DECT to confirm the existence of kidney stones. Urine and blood samples were also taken for laboratory analysis.
Forty-one subjects (48.8%) had nephrolithiasis diagnosed; 38 had a kidney stone. Thirty-two of the 38 patients underwent a DECT scan, and 27 patients had nephrolithiasis in DECT. Among them, 63.0% (17/27) and 14.8% (4/21) of the patients had pure UA and UA-based mixed stone, respectively, and 22.2% (6/27) had a non-UA stone. Those with nephrolithiasis suffered from more frequent acute attacks and had longer disease durations of gout. At least one urine biochemical abnormality was found in 81% of patients. Forty-four (55.0%) patients presented hypomagnesuria. Forty-three (51.8%) patients had low urine volume. Unduly acidic urine (UAU) was present in 36 patients (44.4%). Hyperuricosuria was only found in ten (12.2%) patients. In comparison to the non-lithiasic group, the lithiasic group was more likely to have a UAU. Binary logistic regression showed that female gender was a protective factor, while disease duration of gout and low urine pH were risk factors for nephrolithiasis.
Our results indicated that nephrolithiasis, especially UA stones, were more common than previous reports in gout patients indicated, and that disease duration of gout, and low urine pH, were risk factors for nephrolithiasis.
本研究旨在应用双能 CT（DECT）评估尿酸盐肾病结石的患病率，并探讨原发性痛风患者肾结石形成的危险因素。
84 例连续的痛风患者接受了尿路超声或 DECT 检查以确认肾结石的存在。还采集了尿液和血液样本进行实验室分析。
41 例（48.8%）患者诊断为肾结石；38 例患者存在肾结石。38 例患者中有 32 例行 DECT 扫描，27 例 DECT 检查发现肾结石。其中，27 例患者中 63.0%（17/27）和 14.8%（4/21）分别为单纯尿酸盐和尿酸盐混合结石，22.2%（6/27）为非尿酸盐结石。患有肾结石的患者痛风急性发作更频繁，痛风病程更长。81%的患者至少有一种尿液生化异常。44 例（55.0%）患者存在低镁尿。43 例（51.8%）患者存在少尿。36 例（44.4%）患者存在尿液过度酸化（UAU）。高尿酸尿症仅在 10 例（12.2%）患者中发现。与非结石组相比，结石组更有可能出现 UAU。二项逻辑回归显示，女性是保护因素，而痛风病程和低尿 pH 是肾结石形成的危险因素。
我们的研究结果表明，与以往报告相比，痛风患者中肾结石，尤其是尿酸盐结石更为常见，且痛风病程和低尿 pH 是肾结石形成的危险因素。
