Li Zhi, Fu Chong, Sun Chuangxin, Suo Yong, Li Kai, Qi Shiyong
Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.
Department of Urology, The 3(rd) Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.
Heliyon. 2024 May 13;10(10):e31180. doi: 10.1016/j.heliyon.2024.e31180. eCollection 2024 May 30.
Bilateral upper urinary tract stones are significantly related to renal function damage. However, few studies characterized the risk factors of bilateral upper urinary tract stones. We retrospectively enrolled 3905 patients with urinary tract stones from March 2019 to March 2022 at the Second Hospital of Tianjin Medical University. Patients were divided into two groups according to the location of the stones, and the related data were evaluated. In this study, 2485 unilateral and 1420 bilateral stone patients were included. Multivariate logistic regression analysis showed that BMI, gout, hyperparathyroidism, uric acid stone, urine PH, 24-h urinary calcium, blood uric acid, and metabolic syndrome (Mets) were independent risk factors for bilateral stone formation(P < 0.05). Based on these results, we construct a discrimination model. This model revealed good discrimination with an area under the receiver operating characteristic curves of 0.617, and the sensitivity and specificity were 0.592 and 0.586, respectively. Furthermore, the number of Mets components increased the risk of bilateral upper urinary tract stones. Hypertension, hyperglycemia, and low HDL level were strongly associated with bilateral upper urinary tract stones (P < 0.05). Patients with 5 components Mets had 1.89-fold higher risk of bilateral upper urinary tract stones than those with 1 component Mets (OR 3.381; 95 % CI 1.221-9.360; P = 0.013). Additionally, male patients with Mets had higher risk of bilateral upper urinary tract stones than female patients. Our analysis revealed that eight clinical factors were associated with the formation of bilateral upper urinary tract stones, namely BMI, gout, hyperparathyroidism, uric acid stone, urine PH, 24-h urinary calcium, blood uric acid, and Mets. This study could help clinicians adjust treatment strategies for high-risk patients with bilateral upper urinary tract stones.
双侧上尿路结石与肾功能损害显著相关。然而，很少有研究对双侧上尿路结石的危险因素进行特征描述。我们回顾性纳入了2019年3月至2022年3月在天津医科大学第二医院就诊的3905例尿路结石患者。根据结石部位将患者分为两组，并对相关数据进行评估。本研究纳入了2485例单侧结石患者和1420例双侧结石患者。多因素logistic回归分析显示，体重指数（BMI）、痛风、甲状旁腺功能亢进、尿酸结石、尿pH值、24小时尿钙、血尿酸和代谢综合征（Mets）是双侧结石形成的独立危险因素（P<0.05）。基于这些结果，我们构建了一个判别模型。该模型显示出良好的判别能力，受试者操作特征曲线下面积为0.617，敏感性和特异性分别为0.592和0.586。此外，Mets组分的数量增加了双侧上尿路结石的风险。高血压、高血糖和低高密度脂蛋白水平与双侧上尿路结石密切相关（P<0.05）。具有5个Mets组分的患者发生双侧上尿路结石的风险是具有1个Mets组分患者的1.89倍（比值比3.381；95%置信区间1.221-9.360；P=0.013）。此外，患有Mets的男性患者发生双侧上尿路结石的风险高于女性患者。我们的分析表明，八个临床因素与双侧上尿路结石的形成有关，即BMI、痛风甲状旁腺功能亢进、尿酸结石、尿pH值、24小时尿钙、血尿酸和Mets。本研究有助于临床医生调整双侧上尿路结石高危患者的治疗策略。
