Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea.
Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
Investig Clin Urol. 2023 Mar;64(2):161-167. doi: 10.4111/icu.20220271.
This study aimed to compare the characteristics of asymptomatic and symptomatic nephrolithiasis in patients who underwent surgical treatment for kidney stones.
Between 2015 and 2019, 245 patients who underwent percutaneous nephrolithotomy or retrograde intrarenal surgery for kidney stones were included. The patients were divided into asymptomatic (n=124) and symptomatic (n=121) groups. All patients underwent blood and urine tests, preoperative non-contrast computed tomography, and postoperative stone composition analysis. We retrospectively analyzed and compared the characteristics of the patients and stones, operation time, stone-free rate, and postoperative complications between the two groups.
In the asymptomatic group, mean body mass index (BMI) was significantly higher (25.7±3.8 kg/m² vs. 24.3±2.8 kg/m², p=0.002) and urine pH was significantly lower (5.6±0.9 vs. 5.9±0.9, p=0.013). The ratio of calcium oxalate dihydrate stones was significantly higher in the symptomatic group (5.3% vs. 15.5%, p=0.023). No significant differences were observed in stone characteristics, postoperative outcomes, or complications. In the multivariate logistic regression analysis for predicting variables for asymptomatic renal stones, BMI (odds ratio [OR], 1.144; 95% confidence interval [CI], 1.038-1.260; p=0.007), and urine pH (OR, 0.608; 95% CI, 0.407-0.910; p=0.016) were independent predictive variables for asymptomatic renal stones.
This study demonstrated that thorough medical check-ups are needed for the early detection of renal stones in individuals with a high BMI or low urine pH.
本研究旨在比较接受肾结石手术治疗的无症状和有症状肾结石患者的特征。
纳入了 2015 年至 2019 年间接受经皮肾镜碎石术或逆行肾内手术治疗肾结石的 245 例患者。将患者分为无症状（n=124）和有症状（n=121）两组。所有患者均接受血液和尿液检查、术前非增强计算机断层扫描和术后结石成分分析。我们回顾性分析并比较了两组患者和结石的特征、手术时间、结石清除率和术后并发症。
在无症状组中，平均体重指数（BMI）明显更高（25.7±3.8kg/m²比 24.3±2.8kg/m²，p=0.002），尿液 pH 值明显更低（5.6±0.9比 5.9±0.9，p=0.013）。有症状组二水草酸钙结石的比例明显更高（5.3%比 15.5%，p=0.023）。两组结石特征、术后结果或并发症无显著差异。在预测无症状肾结石的多变量逻辑回归分析中，BMI（比值比[OR]，1.144；95%置信区间[CI]，1.038-1.260；p=0.007）和尿液 pH（OR，0.608；95%CI，0.407-0.910；p=0.016）是无症状肾结石的独立预测变量。
本研究表明，对于 BMI 较高或尿液 pH 值较低的个体，需要进行彻底的体检以早期发现肾结石。
