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I型糖尿病患者与II型糖尿病患者的肾结石:有差异吗?

Kidney Stones of Type I vs. Type II Diabetic Patients: Are There Any Differences?

作者信息

Pricop Cătălin, Ivănuță Marius, Nikolic Mihaela, Puia Dragoş

机构信息

"Grigore T. Popa", Faculty of Medicine, University of Medicine and Pharmacy, 700115 Iasi, Romania.

Department of Urology, "Dr. C.I. Parhon" Clinical Hospital, 700503 Iasi, Romania.

出版信息

J Clin Med. 2024 Oct 14;13(20):6110. doi: 10.3390/jcm13206110.

Abstract

: This study highlighted the differences between the biochemical compositions of urinary stones from patients with type 1 diabetes versus those with type 2 diabetes. : This study included patients diagnosed with kidney stones and diabetes who were referred to the Urological Clinic of the Dr. C. I. Parhon Hospital in Iasi from April 2017 to April 2024. We analyzed the spectroscopic stone composition from 128 lithiasis patients treated in our Clinic. In the current study, the distribution of the biochemical composition of stones varied significantly between diabetic patients with type 2 diabetes, who formed primarily mixed uric acid stones, and diabetic patients with type 1 diabetes, who mainly developed pure uric acid stones ( < 0.001). Patients with uric acid stones had significantly higher mean creatinine values than the other stone types ( < 0.001). Urinary pH levels were abnormal for all biochemical subtypes of stones, indicating acidic urine. However, patients with uric acid stones had lower pH values than the group average. From the Kaplan-Mayer analysis, patients with pure uric acid stones had a shorter time to stone recurrence compared to patients with other biochemical types identified. : These findings, which highlight the prevalence of pure uric acid stones in patients with type 1 diabetes and the impact of this on the strategy for dissolving pure stones, represent a significant advancement in understanding urinary lithiasis in diabetic patients.

摘要

本研究突出了1型糖尿病患者与2型糖尿病患者尿结石生化成分的差异。本研究纳入了2017年4月至2024年4月期间转诊至雅西C.I.帕尔洪医生医院泌尿外科诊所、被诊断患有肾结石和糖尿病的患者。我们分析了在我们诊所接受治疗的128例结石病患者结石的光谱成分。在当前研究中,2型糖尿病患者主要形成混合尿酸结石,1型糖尿病患者主要形成纯尿酸结石,两者之间结石的生化成分分布存在显著差异(<0.001)。尿酸结石患者的平均肌酐值显著高于其他结石类型(<0.001)。所有生化亚型结石的尿液pH值均异常,表明尿液呈酸性。然而,尿酸结石患者的pH值低于组平均水平。从卡普兰-迈耶分析来看,与其他已确定生化类型的患者相比,纯尿酸结石患者结石复发时间更短。这些发现突出了1型糖尿病患者中纯尿酸结石的患病率及其对纯结石溶解策略的影响,代表了在理解糖尿病患者尿路结石方面的重大进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1453/11508552/955c31a9dcdb/jcm-13-06110-g001.jpg

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