Nemati Melissa R, Harris Peter C, Cogal Andrea G, Goldfarb David S
New York University, New York, NY.
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
Clin Nephrol Case Stud. 2021 May 7;9:54-58. doi: 10.5414/CNCS110496. eCollection 2021.
We recently encountered concern about the safety of bariatric surgery for a patient with cystinuria. Bariatric surgery procedures include those that cause malabsorption, like the Roux-en-Y gastric bypass procedure, and restrictive operations, such as the sleeve gastrectomy. These procedures produce beneficial effects on health and life expectancy, though whether kidney stones are prevented, as well as promoted, is not established. Although the importance of body weight to metabolic stone activity in patients with cystinuria is not established, the patient's physicians were concerned about whether any bariatric surgery procedure would affect her ability to drink sufficient quantities of water in order to reduce stone activity. Here we report the experience of a genetically defined patient with cystinuria who underwent a gastric sleeve procedure. In the months after the procedure, she lost 45 kg, though with time she regained 23 kg of that loss. She was able to maintain a urine volume of 4.0 L per day and has had no stone recurrence.
我们最近遇到了对一名胱氨酸尿症患者进行减肥手术安全性的担忧。减肥手术程序包括那些导致吸收不良的手术，如Roux-en-Y胃旁路手术，以及限制性手术，如袖状胃切除术。这些手术对健康和预期寿命产生有益影响，尽管肾结石是否会被预防或促进尚未确定。虽然体重对胱氨酸尿症患者代谢性结石活动的重要性尚未确定，但患者的医生担心任何减肥手术程序是否会影响她饮用足够量水以降低结石活动的能力。在此，我们报告一名接受袖状胃切除术的基因明确的胱氨酸尿症患者的经历。术后数月，她体重减轻了45公斤，但随着时间推移，又重新增加了23公斤的体重。她能够维持每天4.0升的尿量，并且没有结石复发。
