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纯尿酸肾结石与混合性尿酸肾结石的代谢及肾脏特征差异:一项回顾性研究

Metabolic and Renal Profile Differences in Pure vs Mixed Uric Acid Kidney Stones: A Retrospective Study.

作者信息

Li Tianjie, Fu Meng, Liu Xiaodong, Xiao Bo, Li Jianxing

机构信息

Department of Urology, Beijing Tsinghua Changung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, People's Republic of China.

Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China.

出版信息

Int J Gen Med. 2025 Aug 12;18:4403-4410. doi: 10.2147/IJGM.S530926. eCollection 2025.

Abstract

OBJECTIVE

Uric acid stones are commonly classified into pure uric acid stones (PUCS) and mixed uric acid stones with calcium oxalate (MUCS). This study aims to investigate the metabolic differences between PUCS and MUCS patients, in order to inform prevention strategies and guide management and follow-up care for uric acid urolithiasis.

METHODS

We conducted a retrospective analysis of 88 patients diagnosed with uric acid stones (PUCS: 37, MUCS: 51). Comprehensive data were collected, including blood tests and stone composition analysis.

RESULTS

Both PUCS and MUCS patients exhibited obesity, but only PUCS patients showed significant lipid metabolism abnormalities, with HDL levels significantly lower than in MUCS patients (p < 0.05). Renal dysfunction was observed in both groups, but was more severe in the PUCS group, as indicated by higher serum creatinine levels (p < 0.05). Additionally, serum calcium levels were significantly higher in the MUCS group compared to the PUCS group (p < 0.05). No significant differences were found in 24-hour urinary excretion of uric acid, sodium, potassium, chloride, or phosphorus between the two groups.

CONCLUSION

Patients with PUCS exhibit more pronounced disturbances in lipid metabolism and renal function compared to those with MUCS. It is essential to prioritize and enhance the monitoring of metabolic assessments and renal function during the postoperative follow-up of patients with PUCS.

摘要

目的

尿酸结石通常分为纯尿酸结石(PUCS)和含草酸钙的混合尿酸结石(MUCS)。本研究旨在调查PUCS和MUCS患者之间的代谢差异,以便为尿酸尿路结石的预防策略提供依据,并指导管理和后续护理。

方法

我们对88例诊断为尿酸结石的患者进行了回顾性分析(PUCS:37例,MUCS:51例)。收集了包括血液检查和结石成分分析在内的综合数据。

结果

PUCS和MUCS患者均表现出肥胖,但只有PUCS患者出现显著的脂质代谢异常,其高密度脂蛋白水平显著低于MUCS患者(p<0.05)。两组均观察到肾功能障碍,但PUCS组更严重,血清肌酐水平更高表明了这一点(p<0.05)。此外,MUCS组的血清钙水平显著高于PUCS组(p<0.05)。两组之间在尿酸、钠、钾、氯或磷的24小时尿排泄量方面未发现显著差异。

结论

与MUCS患者相比,PUCS患者在脂质代谢和肾功能方面表现出更明显的紊乱。在PUCS患者术后随访期间,必须优先并加强对代谢评估和肾功能的监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26b3/12358317/7b0b25fcea45/IJGM-18-4403-g0001.jpg

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