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坚持药物治疗对肾结石患者主要尿液代谢紊乱的影响。

Impact of the adherence to medical treatment on the main urinary metabolic disorders in patients with kidney stones.

作者信息

Manzo Braulio Omar, Cabrera Jose David, Emiliani Esteban, Sánchez Hector Manuel, Eisner Brian Howard, Torres Jose Ernesto

机构信息

Urology Department, Hospital Regional de Alta Especialidad del Bajío, Blvd. Milenio #130, Col. San Carlos la Roncha, León, Guanajuato, Mexico.

Urology Department, Fundación Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain.

出版信息

Asian J Urol. 2021 Jul;8(3):275-279. doi: 10.1016/j.ajur.2020.07.002. Epub 2020 Aug 6.

DOI:10.1016/j.ajur.2020.07.002
PMID:34401334
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8356059/
Abstract

OBJECTIVE

To assess the effect of the adherence to medical treatment on urinary parameters in the 24-h metabolic study of patients with kidney stones.

METHODS

A retrospective, longitudinal, descriptive, and observational study was carried out by reviewing the hospital electronic medical record from 2014 to 2018. The adherence to drug treatment was measured 6 months after its initiation, and the numerical values of the metabolic studies were compared. Wilcoxon tests were performed to compare the difference before and after treatment.

RESULTS

Ninety patients were evaluated, with 73.3% of adherence. The 180-day overall adherence rate was 61.2% in patients treated with a single drug and 85.4% in patients treated with multiple drugs. There is a statistically significant increase in citrate levels in patients with good adherence in comparison with non-adherent patients (=0.031 =0.528).

CONCLUSIONS

Medical treatment and dietary measures in patients with kidney stones have an initial impact at 6 months on the values of the main urinary metabolic alterations that predispose to calculi formation; the most significant is seen in those patients with adherence to medical treatment for hypocitraturia.

摘要

目的

在肾结石患者的24小时代谢研究中,评估坚持药物治疗对尿液参数的影响。

方法

通过回顾2014年至2018年的医院电子病历,开展了一项回顾性、纵向、描述性观察研究。在药物治疗开始6个月后测量药物治疗依从性,并比较代谢研究的数值。采用Wilcoxon检验比较治疗前后的差异。

结果

共评估了90例患者,依从率为73.3%。单药治疗患者的180天总体依从率为61.2%,多药治疗患者为85.4%。与未依从患者相比,依从性良好的患者枸橼酸盐水平有统计学意义的升高(=0.031 =0.528)。

结论

肾结石患者的药物治疗和饮食措施在6个月时对易导致结石形成的主要尿液代谢改变值有初步影响;在坚持治疗低枸橼酸尿症的患者中最为显著。

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本文引用的文献

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Compliance in patients with dietary hyperoxaluria: A cohort study and systematic review.饮食性高草酸尿症患者的依从性:一项队列研究和系统评价。
Asian J Urol. 2019 Apr;6(2):200-207. doi: 10.1016/j.ajur.2018.03.002. Epub 2018 Mar 29.
2
Primary nonadherence to chronic disease medications: a meta-analysis.慢性病药物治疗的原发性不依从性:一项荟萃分析。
Patient Prefer Adherence. 2018 May 7;12:721-731. doi: 10.2147/PPA.S161151. eCollection 2018.
3
Effectiveness of Treatment Modalities on Kidney Stone Recurrence.治疗方式对肾结石复发的影响。
Clin J Am Soc Nephrol. 2017 Oct 6;12(10):1699-1708. doi: 10.2215/CJN.11201016. Epub 2017 Aug 22.
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Factors Associated With Preventive Pharmacological Therapy Adherence Among Patients With Kidney Stones.肾结石患者预防性药物治疗依从性的相关因素
Urology. 2016 Jul;93:45-9. doi: 10.1016/j.urology.2016.03.030. Epub 2016 Mar 31.
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Medication Nonadherence and Effectiveness of Preventive Pharmacological Therapy for Kidney Stones.肾结石预防性药物治疗的药物不依从性与有效性
J Urol. 2016 Mar;195(3):648-52. doi: 10.1016/j.juro.2015.10.082. Epub 2015 Oct 17.
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The ROKS nomogram for predicting a second symptomatic stone episode.用于预测第二次有症状结石发作的韩国海军舰艇列线图。
J Am Soc Nephrol. 2014 Dec;25(12):2878-86. doi: 10.1681/ASN.2013091011. Epub 2014 Aug 7.
7
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J Endourol. 2015 Jan;29(1):70-4. doi: 10.1089/end.2014.0317.
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Pharmacologic treatment of kidney stone disease.肾结石病的药物治疗。
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