Division of Rheumatology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), Av. Dr. Arnaldo 455, sala 3131, Sao Paulo, 01246-903, Brazil.
Adv Rheumatol. 2019 Dec 31;60(1):2. doi: 10.1186/s42358-019-0106-4.
The aims of this article were to assess the prevalence of nephrolithiasis and the factors associated with nephrolithiasis in Brazilian patients with primary gout.
One hundred twenty-three patients with primary gout were recruited from a tertiary referral hospital in São Paulo, Brazil. All patients underwent ultrasonography and had their clinical and laboratory characteristics assessed.
One hundred fifteen (93.5%) patients were male, with a mean age of 62.9 ± 9.4 years. Twenty-three (18.7%) patients had asymptomatic nephrolithiasis (detected only by ultrasonography), 7 (6.0%) had symptomatic nephrolithiasis (detected by ultrasonography and a positive clinical history), and 13 (10.0%) had a history of kidney stones, but ultrasonography at evaluation did not show nephrolithiasis. Therefore, 35.0% of the patients had nephrolithiasis (detected either by ultrasonography and/or a positive clinical history). Nephrolithiasis was associated with male gender (43 [100%] vs 72 [90%], p = 0.049), the use of potassium citrate (13 [30.2%] vs 0, p < 0.001) and the use of medications for diabetes (10 [23.3%] vs 8 [10%], p = 0.047) and dyslipidemia (15 [34.9%] vs 10 [12.5%], p = 0.003); benzbromarone had an inverse association with nephrolithiasis (21 [48.8%] vs 55 [68.8%], p = 0.030). In patients with and without nephrolithiasis, no differences were found in the laboratory and ultrasonography characteristics, including serum uric acid levels, urinary uric acid excretion and urine pH.
The prevalence of nephrolithiasis in primary gout was 35.0%, and 18.7% of the patients were asymptomatic. Nephrolithiasis was associated with male gender, diabetes and dyslipidemia. A positive history of nephrolithiasis probably biased the prescription of potassium citrate and benzbromarone.
本文旨在评估原发性痛风患者肾结石的患病率以及与肾结石相关的因素。
从巴西圣保罗的一家三级转诊医院招募了 123 名原发性痛风患者。所有患者均接受了超声检查，并评估了他们的临床和实验室特征。
115 名（93.5%）患者为男性，平均年龄 62.9±9.4 岁。23 名（18.7%）患者存在无症状肾结石（仅通过超声检查发现），7 名（6.0%）患者存在有症状肾结石（通过超声检查和阳性临床病史发现），13 名（10.0%）患者有肾结石病史，但在评估时超声检查未发现肾结石。因此，35.0%的患者患有肾结石（通过超声检查和/或阳性临床病史发现）。肾结石与男性（43 [100%] vs 72 [90%]，p=0.049）、枸橼酸钾的使用（13 [30.2%] vs 0，p<0.001）、糖尿病药物的使用（10 [23.3%] vs 8 [10%]，p=0.047）和血脂异常（15 [34.9%] vs 10 [12.5%]，p=0.003）相关；苯溴马隆与肾结石呈负相关（21 [48.8%] vs 55 [68.8%]，p=0.030）。肾结石组和无肾结石组的实验室和超声特征，包括血尿酸水平、尿尿酸排泄和尿 pH 值，均无差异。
原发性痛风患者肾结石的患病率为 35.0%，其中 18.7%的患者无症状。肾结石与男性、糖尿病和血脂异常有关。肾结石的阳性病史可能会影响枸橼酸钾和苯溴马隆的处方。
