Curhan G C, Willett W C, Speizer F E, Stampfer M J
Brigham and Womens' Hospital, Boston, Massachusetts 02115, USA.
Ann Intern Med. 1998 Apr 1;128(7):534-40. doi: 10.7326/0003-4819-128-7-199804010-00003.
An increase in fluid intake is routinely recommended for patients who have had kidney stones to decrease the likelihood of recurrence. However, data on the effect of particular beverages on stone formation in women are limited.
To examine the association between the intake of 17 beverages and risk for kidney stones in women.
Prospective cohort study with 8 years of follow-up.
United States.
81093 women in the Nurses' Health Study who were 40 to 65 years of age in 1986 and had no history of kidney stones.
Beverage use and diet were assessed in 1986 and 1990 with a validated, self-administered food-frequency questionnaire. The main outcome measure was incident symptomatic kidney stones.
During 553 081 person-years of follow-up over an 8-year period, 719 cases of kidney stones were documented. After risk factors other than fluid intake were controlled for, the relative risk for stone formation for women in the highest quintile of total fluid intake compared with women in the lowest quintile was 0.62 (95% CI, 0.48 to 0.80). Inclusion of consumption of specific beverages in the multivariate model significantly added to prediction of risk for kidney stones (P < 0.001). In a multivariate model that adjusted simultaneously for the 17 beverages and other possible risk factors, risk for stone formation decreased by the following amount for each 240-mL (8-oz) serving consumed daily: 10% (CI, 5% to 15%) for caffeinated coffee, 9% (CI, 2% to 15%) for decaffeinated coffee, 8% (CI, 1% to 15%) for tea, and 59% (CI, 32% to 75%) for wine. In contrast, a 44% (CI, 9% to 92%) increase in risk was seen for each 240-mL serving of grapefruit juice consumed daily.
An increase in total fluid intake can reduce risk for kidney stones, and the choice of beverage may be meaningful.
对于有肾结石病史的患者，通常建议增加液体摄入量以降低复发可能性。然而，关于特定饮料对女性结石形成影响的数据有限。
研究17种饮料的摄入量与女性肾结石风险之间的关联。
前瞻性队列研究，随访8年。
美国。
护士健康研究中的81093名女性，她们在1986年年龄为40至65岁，且无肾结石病史。
1986年和1990年使用经过验证的自填式食物频率问卷评估饮料摄入和饮食情况。主要结局指标为有症状的新发肾结石。
在8年的随访期间，共553081人年，记录到719例肾结石病例。在控制了除液体摄入以外的危险因素后，总液体摄入量最高五分位数的女性与最低五分位数的女性相比，结石形成的相对风险为0.62（95%CI，0.48至0.80）。在多变量模型中纳入特定饮料的消费量可显著增强对肾结石风险的预测能力（P<0.001）。在同时调整了17种饮料和其他可能危险因素的多变量模型中，每天每饮用240毫升（8盎司）的下列饮料，结石形成风险降低幅度如下：含咖啡因咖啡降低10%（CI，5%至15%），脱咖啡因咖啡降低9%（CI，2%至15%），茶降低8%（CI，1%至15%），葡萄酒降低59%（CI，32%至75%）。相反，每天每饮用240毫升葡萄柚汁，风险增加44%（CI，9%至92%）。
增加总液体摄入量可降低肾结石风险，饮料的选择可能具有重要意义。
