Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Front Endocrinol (Lausanne). 2022 Feb 9;13:828839. doi: 10.3389/fendo.2022.828839. eCollection 2022.
The association between primary aldosteronism (PA) and nephrolithiasis is still unclear. The hypercalciuria and hypocitraturia of PA patients might be the reason leading to recurrent calcium nephrolithiasis. This study aimed to evaluate the relationship between PA and renal stones, including stone size and density.
From February 2010 to March 2021, we retrospectively collected 610 patients who presented to our medical center with hypertension history, and all these patients, suspicious of PA, had PA data survey. In total, 147 patients had kidney stone and were divided into 44 patients with essential hypertension as group 1 and 103 patients with PA as group 2. Pearson χ test and independent Student's t-test were performed to examine the differences among variables.
The mean age was 54.4 ± 12.0 years in group 1 and 53.0 ± 11.1 years in group 2. The incidence rate of renal stones in the PA group was around 24%. No significant differences between the two groups were found for gender, systolic/diastolic blood pressure, duration of hypertension, diabetes mellitus history, and laterality of kidney stone; however, mean stone size was 4.0 ± 3.3 mm in group 1 and 6.5 ± 7.2 mm in group 2, with a significantly larger renal stone size noted in the PA group than that in the essential hypertension group (p = 0.004). Hounsfield unit (HU) density was higher in the PA group the essential hypertension cohort, although this did not reach a significant difference (p = 0.204).
Our study revealed that PA patients had a higher incidence rate of renal stones compared to that of the general population. Besides, the PA-related renal stones also presented as larger and harder than those of the essential hypertension group. Further investigation concerning the association between PA and renal stones is warranted.
原发性醛固酮增多症(PA)与肾结石的关系尚不清楚。PA 患者的高钙尿和低枸橼酸盐可能是导致复发性钙肾结石的原因。本研究旨在评估 PA 与肾结石之间的关系,包括结石大小和密度。
从 2010 年 2 月至 2021 年 3 月,我们回顾性收集了 610 名因高血压就诊于我院的患者,所有这些疑似 PA 的患者均进行了 PA 数据调查。共有 147 例患者患有肾结石,分为原发性高血压组 44 例(组 1)和 PA 组 103 例(组 2)。采用 Pearson χ 检验和独立样本 t 检验比较变量之间的差异。
组 1 的平均年龄为 54.4 ± 12.0 岁,组 2 为 53.0 ± 11.1 岁。PA 组肾结石的发生率约为 24%。两组在性别、收缩压/舒张压、高血压病程、糖尿病史和肾结石侧位等方面无显著性差异;然而,组 1 的平均结石大小为 4.0 ± 3.3mm,组 2 为 6.5 ± 7.2mm,PA 组的肾结石明显大于原发性高血压组(p = 0.004)。PA 组的结石 CT 值(Hounsfield unit,HU)密度高于原发性高血压组,但差异无统计学意义(p = 0.204)。
本研究表明,PA 患者肾结石的发生率高于一般人群。此外,PA 相关肾结石也比原发性高血压组的肾结石更大、更硬。需要进一步研究 PA 与肾结石之间的关系。