Department of Urology, Loyola University Medical Center, Maywood, IL.
Department of Urology, Loyola University Medical Center, Maywood, IL.
Urology. 2020 Jul;141:45-49. doi: 10.1016/j.urology.2020.03.023. Epub 2020 Apr 12.
To investigate the effect of kidney function on stone composition and urinary mineral excretion in patients undergoing surgical intervention for nephrolithiasis.
Using our institutional kidney stone database, we performed a retrospective review of stone patients who underwent surgical intervention between 2004 and 2015. Patients' demographic information, 24-hour urinary mineral excretion, and stone characteristics were reported. The patients' estimated glomerular filtration rates (eGFR) were compared with their stone compositions and 24-hour urine mineral excretions.
A statistically significant difference was noted between the groups, with uric acid stones being associated with lower eGFR and calcium phosphate stones associated with higher eGFR. No relationship could be demonstrated between eGFR and calcium oxalate or struvite stones. Patients with lower eGFR also demonstrated a statistically significant association with lower urinary pH as well as lower urinary excretion of calcium and citrate.
While various factors have been found to play significant roles in kidney stone formation and composition, our findings demonstrate a definite relationship between these and renal function. This paper highlights the fact that renal function evaluation should be considered an important component in the evaluation, counseling, and management of patients with nephrolithiasis.
探讨肾功能对肾结石患者结石成分和尿矿物排泄的影响。
我们使用机构肾结石数据库，对 2004 年至 2015 年间接受手术干预的肾结石患者进行回顾性研究。报告患者的人口统计学信息、24 小时尿矿物排泄量和结石特征。比较患者的估算肾小球滤过率（eGFR）与其结石成分和 24 小时尿矿物排泄量。
组间有统计学显著差异，尿酸结石与较低的 eGFR 相关，而磷酸钙结石与较高的 eGFR 相关。eGFR 与草酸钙或鸟粪石结石之间无相关性。eGFR 较低的患者尿液 pH 值也明显较低，尿钙和柠檬酸排泄量也较低。
尽管已经发现许多因素在肾结石形成和成分中起重要作用，但我们的研究结果表明，这些因素与肾功能之间存在明确的关系。本文强调了肾功能评估应作为肾结石患者评估、咨询和管理的重要组成部分。
