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尿酸肾结石

Uric Acid Nephrolithiasis

作者信息

KC Manish, Leslie Stephen W.

机构信息

Creighton University School of Medicine

Abstract

Uric acid nephrolithiasis, a form of kidney stone disease, results from the accumulation of uric acid crystals in the kidneys. These crystals can aggregate into stones, leading to painful and potentially recurrent urinary tract obstructions. This condition often correlates with elevated uric acid levels in the bloodstream, known as hyperuricemia. Almost two-thirds of all uric acid kidney stones can be dissolved by increasing urinary pH and volume and decreasing hyperuricosuria. Nephrolithiasis is a frequent health problem in developed nations, with an estimated 2 to 5% of people affected at least once in their lifetimes worldwide. Numerous conditions increase susceptibility to nephrolithiasis, including genetic disorders, underlying metabolic processes, and dietary and environmental factors. Medical conditions, such as metabolic syndrome, obesity, diabetes mellitus, gout, hypertension, and chronic renal failure, can be associated with uric acid nephrolithiasis.  Swedish pharmacist C. Scheele first identified what we now call "uric acid" as the primary acidic component of bladder stones in 1776. Renal and, specifically, bladder stones made of uric acid have historically inflicted immense pain and suffering. In the absence of modern interventions, the sole available treatment was high-risk surgery with significant mortality rates. Sir Isaac Newton and Michelangelo are 2 of many prominent historical figures who had recurrent uric acid kidney stones.

摘要

尿酸肾结石是肾结石疾病的一种形式,由尿酸晶体在肾脏中积聚所致。这些晶体会聚集成结石,导致疼痛且可能反复出现的尿路梗阻。这种情况通常与血液中尿酸水平升高有关,即高尿酸血症。通过提高尿液pH值和增加尿量以及减少高尿酸尿症,几乎三分之二的尿酸肾结石都可以溶解。肾结石在发达国家是一个常见的健康问题,据估计全球有2%至5%的人一生中至少患过一次。许多情况会增加患肾结石的易感性,包括遗传疾病、潜在的代谢过程以及饮食和环境因素。一些疾病,如代谢综合征、肥胖症、糖尿病、痛风、高血压和慢性肾衰竭,可能与尿酸肾结石有关。1776年,瑞典药剂师C. 舍勒首次确定了我们现在所说的“尿酸”是膀胱结石的主要酸性成分。由尿酸构成的肾结石,尤其是膀胱结石,在历史上曾带来巨大的痛苦。在缺乏现代干预措施的情况下,唯一可用的治疗方法是高风险手术,死亡率很高。艾萨克·牛顿爵士和米开朗基罗是众多患有复发性尿酸肾结石的著名历史人物中的两位。

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