Zheng Zhibin, Hu Weiguo, Ji Chaoyue, Zhang Xuming, Ding Xijie, Zhou Shaobo, Li Jianxing, Chen Guojun
Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China.
Department of Urology, Qinghai University Affiliated Hospital, Xining, 810000, China.
Sci Rep. 2024 Dec 3;14(1):30154. doi: 10.1038/s41598-024-81454-3.
Bilateral upper urinary tract stones are more likely to lead to impairment of renal function, but few biochemical metabolic studies of bilateral upper urinary tract stones have been reported. We collected clinical data from 555 patients with upper urinary tract stones admitted to Beijing Tsinghua Changgung Hospital from June 2020 to June 2024, and divided them into unilateral and bilateral stone groups by CT scans, analysed the metabolic differences between unilateral and bilateral stone groups by statistical methods, and used multifactorial logistic regression analysis to explore the risk factors that might affect the formation of bilateral stones. A total of 281 cases of unilateral and 274 cases of bilateral stones were identified. The proportion of male patients in the bilateral group was higher than that in the unilateral group (P < 0.05). The most prevalent major stone component was calcium oxalate monohydrate (48.1%), with a significantly higher prevalence of cystine stones observed in the bilateral stone group (1.8%) compared to the unilateral stone group (0.4%) (P < 0.05). Blood uric acid, blood BUN, blood creatinine, urine pH, and 24-hour urine output were higher in the bilateral stone group than in the unilateral group (P < 0.05). The most prevalent metabolic abnormality was low urine volume (45.7%). Bilateral stone group had higher proportion of patients with hyperuricemia (P < 0.05). The results of the multivariate logistic regression analysis showed that male gender (OR 1.489, 95% CI 1.028-2.157) and hyperuricemia (OR 1.662, 95% CI 1.113-2.482) were associated with an increased risk of bilateral stone formation (P < 0.05). There are significant differences in biochemical metabolism between unilateral and bilateral upper urinary tract stones. The most common metabolic abnormality in patients with urolithiasis is low urine output, and aggressive water intake is effective in preventing stone formation. For patients with hyperuricemia, a strict dietary regimen is imperative to mitigate the likelihood of bilateral stone formation.
双侧上尿路结石更易导致肾功能损害，但关于双侧上尿路结石的生化代谢研究报道较少。我们收集了2020年6月至2024年6月在北京清华长庚医院住院的555例上尿路结石患者的临床资料，通过CT扫描将其分为单侧结石组和双侧结石组，采用统计学方法分析单侧和双侧结石组之间的代谢差异，并使用多因素logistic回归分析探讨可能影响双侧结石形成的危险因素。共确定单侧结石281例，双侧结石274例。双侧组男性患者比例高于单侧组（P<0.05）。最常见的主要结石成分是一水草酸钙（48.1%），双侧结石组胱氨酸结石的患病率（1.8%）显著高于单侧结石组（0.4%）（P<0.05）。双侧结石组的血尿酸、血尿素氮、血肌酐、尿pH值和24小时尿量均高于单侧组（P<0.05）。最常见的代谢异常是尿量少（45.7%）。双侧结石组高尿酸血症患者比例更高（P<0.05）。多因素logistic回归分析结果显示，男性（OR 1.489，95%CI 1.028-2.157）和高尿酸血症（OR 1.662，95%CI 1.113-2.482）与双侧结石形成风险增加相关（P<0.05）。单侧和双侧上尿路结石在生化代谢方面存在显著差异。尿路结石患者最常见的代谢异常是尿量少，积极饮水对预防结石形成有效。对于高尿酸血症患者，严格的饮食方案对于降低双侧结石形成的可能性至关重要。
