Gambaro G, Marchini F, Piccoli A, Nassuato M A, Bilora F, Baggio B
Institute of Internal Medicine, Division of Nephrology, University Hospital, Padua, Italy.
J Am Soc Nephrol. 1996 Apr;7(4):608-12. doi: 10.1681/ASN.V74608.
An abnormal erythrocyte transmembrane oxalate flux was described in recurrent idiopathic calcium nephrolithiasis. To verify whether it might represent a risk marker of renal stone disease, two prospective studies were carried out. One hundred ninety patients with idiopathic calcium nephrolithiasis who were enrolled at their first episode of lithiasis during the period 1984 to 1986, form the basis of the first prospective study. The impact of erythrocyte oxalate transport anomaly, gender, familial occurrence of nephrolithiasis, hypercalciuria, hyperoxaluria, and hyperuricosuria on stone recurrence by both bivariate and multivariate analysis of frequencies was assessed. The predictive value of the erythrocyte anomaly for a patient's becoming a stone former was also assessed in five nephrolithiasis families. Recurrence occurred in 57.9% of patients; this was significantly associated with the erythrocyte anomaly, hyperoxaluria, and male gender. However, when using multivariate analysis, only gender and the erythrocyte anomaly were statistically significant and were independent predictors of recurrency. The probability of stone recurrency predicted by the logistic model ranged from 30.1% for women with normal erythrocyte oxalate transport, to 73.4% for men with the erythrocyte anomaly. The family follow-up showed that only subjects with the erythrocyte abnormality become renal stone-formers in the 8-yr survey. By showing the predictive value of the erythrocyte oxalate anomaly for recurrent calcium nephrolithiasis, our findings support the notion that this anomaly is a risk factor in renal stone disease.
复发性特发性钙肾结石患者存在异常的红细胞跨膜草酸通量。为了验证其是否可能是肾结石疾病的风险标志物，开展了两项前瞻性研究。第一项前瞻性研究的基础是1984年至1986年期间首次发生结石时纳入的190例特发性钙肾结石患者。通过频率的双变量和多变量分析，评估红细胞草酸转运异常、性别、肾结石家族史、高钙尿症、高草酸尿症和高尿酸尿症对结石复发的影响。还在五个肾结石家族中评估了红细胞异常对患者成为结石形成者的预测价值。57.9%的患者出现复发；这与红细胞异常、高草酸尿症和男性性别显著相关。然而，使用多变量分析时，只有性别和红细胞异常具有统计学意义，并且是复发的独立预测因素。逻辑模型预测的结石复发概率范围为红细胞草酸转运正常的女性为30.1%，红细胞异常的男性为73.4%。家族随访显示，在8年的调查中，只有红细胞异常的受试者成为肾结石形成者。通过显示红细胞草酸异常对复发性钙肾结石的预测价值，我们的研究结果支持了这一异常是肾结石疾病风险因素的观点。
