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枸橼酸钾给药是否会改变双 J 支架上结石与原发性结石相比的类型和组成?

Does potassium citrate administration change the type and composition of encrusted material on Double-J stent compared to primary stone?

机构信息

Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Science, Tehran, Iran.

出版信息

Int Urol Nephrol. 2021 Sep;53(9):1797-1803. doi: 10.1007/s11255-021-02891-x. Epub 2021 May 29.

DOI:10.1007/s11255-021-02891-x
PMID:34050877
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8164059/
Abstract

PURPOSE

To evaluate the effect of potassium citrate administration on the composition of encrusted material on the ureteral stent after Double-J insertion.

METHODS

We designed a randomized clinical trial for our study; 65 patients that underwent transurethral lithotripsy and Double-J stent insertion were included in the study after informed consent and divided into two groups. In the first group (33 patients) potassium citrate was prescribed after surgery till stent removal and the second group (32 patients) followed without prescribing this medication. After stent removal, encrusted materials on removed stents were analyzed then the type and composition of encrusted material compared with the primary stone that was removed.

RESULTS

Our results revealed that the type and composition of primary stone and encrusted stone were similar in patients that do not receive potassium citrate (p-value of 0.073, 0.251 and 0.944 for calcium oxalate, uric acid, and calcium phosphate respectively). In patients that taking potassium citrate rate of calcium oxalate (p-value < 0.001) and uric acid (p-value < 0.001) material on encrusted stent significantly decreased compared with the non-intervention group.

CONCLUSION

Results of this study revealed that taking of potassium citrate after ureteral stent insertion significantly decreases the formation of calcium oxalate and uric acid encrusted material on Double-J stent so it could be recommended for prevention of stent encrustation in patients that primary stone analysis are calcium oxalate and uric acid stone.

摘要

目的

评估枸橼酸钾给药对双 J 管置入后输尿管支架上包裹物成分的影响。

方法

我们设计了一项随机临床试验,纳入了 65 例接受经尿道碎石术和双 J 管置入术的患者,在知情同意后将其分为两组。在第一组(33 例)中,手术后给予枸橼酸钾直至支架取出,第二组(32 例)未给予该药物。支架取出后,分析取出支架上的包裹物,并将包裹物的类型和成分与取出的原发结石进行比较。

结果

我们的结果表明,未接受枸橼酸钾治疗的患者的原发结石和包裹结石的类型和成分相似(对于草酸钙、尿酸和磷酸钙,p 值分别为 0.073、0.251 和 0.944)。在服用枸橼酸钾的患者中,包裹支架上草酸钙(p 值 < 0.001)和尿酸(p 值 < 0.001)物质的含量明显低于未干预组。

结论

本研究结果表明,输尿管支架置入后服用枸橼酸钾可显著减少双 J 管上草酸钙和尿酸包裹物的形成,因此对于原发性结石分析为草酸钙和尿酸结石的患者,可推荐使用枸橼酸钾预防支架包裹。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/8164059/92b354dffae9/11255_2021_2891_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/8164059/92b354dffae9/11255_2021_2891_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/8164059/92b354dffae9/11255_2021_2891_Fig1_HTML.jpg

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Double JJ Ureteral Stenting: Encrustation and Tolerability.双 J 输尿管支架置管:结石形成与耐受性。
Eur Urol Focus. 2021 Jan;7(1):7-8. doi: 10.1016/j.euf.2020.08.014. Epub 2020 Sep 9.
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Double Loop Ureteral Stent Encrustation According to Indwelling Time: Results of a European Multicentric Study.双 J 管结石形成与留置时间的关系:一项欧洲多中心研究的结果。
J Endourol. 2021 Jan;35(1):84-90. doi: 10.1089/end.2020.0254. Epub 2020 Nov 6.
3
Latest advancements in ureteral stent technology.输尿管支架技术的最新进展。
维生素 D 受体、紧密连接蛋白和钙敏感受体基因启动子高甲基化与结石复发的相关性。
BMC Med Genomics. 2022 May 11;15(1):109. doi: 10.1186/s12920-022-01265-1.
Transl Androl Urol. 2019 Sep;8(Suppl 4):S436-S441. doi: 10.21037/tau.2019.08.16.
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Innovations in Ureteral Stent Technology.输尿管支架技术的创新
Urol Clin North Am. 2019 May;46(2):245-255. doi: 10.1016/j.ucl.2018.12.013. Epub 2019 Mar 4.
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6
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Biofouling. 2019 Jan;35(1):117-127. doi: 10.1080/08927014.2018.1562549. Epub 2019 Feb 8.
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[The impact of ureteral stent surface on encrustation and biofilm formation].[输尿管支架表面对结石形成和生物膜形成的影响]
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