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中华腔镜泌尿外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (05) : 481 -485. doi: 10.3877/cma.j.issn.1674-3253.2023.05.011

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临床研究

腹主动脉钙化患者肾结石成分特点及危险因素分析
徐哲, 罗杰, 吴强, 李忠, 王晓伟, 郑硕, 郝晓东, 王照()   
  1. 050000 石家庄,河北医科大学第一医院泌尿外科
    641100 四川,内江市第二人民医院泌尿外科
  • 收稿日期:2022-09-20 出版日期:2023-10-01
  • 通信作者: 王照
  • 基金资助:
    河北省卫生健康委科研基金项目(20160708); 河北省中医药管理局科研计划项目(2020165)

Analysis of the composition characteristics and risk factors of kidney stones in patients with abdominal arterial calcification

Zhe Xu, Jie Luo, Qiang Wu, Zhong Li, Xiaowei Wang, Shuo Zheng, Xiaodong Hao, Zhao Wang()   

  1. Department of Urology, the First Hospital of Hebei Medical University, Shijiazhuang 050000, China
    Department of Urology the Second People's Hospital of Neijiang City, Sichuan 641100, China
  • Received:2022-09-20 Published:2023-10-01
  • Corresponding author: Zhao Wang
引用本文:

徐哲, 罗杰, 吴强, 李忠, 王晓伟, 郑硕, 郝晓东, 王照. 腹主动脉钙化患者肾结石成分特点及危险因素分析[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(05): 481-485.

Zhe Xu, Jie Luo, Qiang Wu, Zhong Li, Xiaowei Wang, Shuo Zheng, Xiaodong Hao, Zhao Wang. Analysis of the composition characteristics and risk factors of kidney stones in patients with abdominal arterial calcification[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(05): 481-485.

目的

探讨腹主动脉钙化(AAC)患者肾结石成分特点及其形成的危险因素。

方法

选择2021年1月至2022年2月河北医科大学第一医院90例AAC合并肾结石患者为观察组,随机抽取同期体检中心AAC未合并肾结石患者为对照组(88例)。分析观察组结石成分特点,比较两组一般临床资料,采用Logistic回归分析AAC患者形成肾结石的独立危险因素。

结果

观察组结石成分主要为草酸钙结石22例(24.44%)和草酸钙+碳酸磷灰石30例(33.33%)。单因素分析显示观察组男性(P=0.033)、合并高血压(P<0.001)、合并糖尿病(P=0.004)、有吸烟史(P=0.039)患者人数明显多于对照组;血胆固醇(P=0.038)、低密度脂蛋白胆固醇(LDL-C) (P=0.023)、血尿酸(P=0.006)明显高于对照组,高密度脂蛋白胆固醇(HDL-C)明显低于对照组(P=0.001)。Logistic回归分析显示:合并高血压、低HDL-C、高LDL-C及高血尿酸是AAC患者肾结石形成的独立危险因素(OR>1,P<0.05)。

结论

AAC患者肾结石成分主要以草酸钙结石、草酸钙+碳酸磷灰石为主,高血压、低HDL-C、高LDL-C、高血尿酸均是AAC患者形成肾结石的独立危险因素,临床应早期筛查其潜在危险因素并采取相关措施。

Objective

To investigate the composition characteristics and risk factors of renal stone in patients with abdominal aortic calcification (AAC).

Methods

From January 2021 to February 2022, 90 patients with AAC complicated with kidney stones in the First Hospital of Hebei Medical University were selected as the observation group, randomly selected patients with AAC without nephrolithiasis in the physical examination center during the same period as the control group (88 cases). The characteristics of stone composition in the observation group were analyzed, and the clinical data and biochemical indexes of the two groups were compared. Binary Logistic regression was used to analyze the independent risk factors of renal stone formation in patients with AAC.

Results

The stones in the observation group were mainly composed of calcium oxalate stones in 22 cases (24.44%) and calcium oxalate+carbonated apatite in 30 cases (33.33%). Univariate analysis showed that in the observation group, the proportion of patients with male (P=0.033), hypertension (P<0.001), diabetes (P=0.004), smoking history (P=0.039), TC (P=0.038), LDL-C (P=0.023), blood uric acid (P=0.006) were significantly higher than those in the control group, and HDL-C was significantly lower than that in the control group(P=0.001). Logistic regression analysis showed that hypertension, low HDL-C, high LDL-C and hyperuricemia were independent risk factors for renal stone formation in patients with AAC (OR>1, P<0.05).

Conclusions

The main components of kidney stones in patients with AAC are calcium oxalate stones, calcium oxalate+carbonated apatite. Hypertension, low HDL-C, high LDL-C, and hyperuricemia are independent risk factors for the formation of kidney stones in patients with AAC. Potential risk factors should be screened early in clinical practice and relevant measures should be taken.

表1 90例腹主动脉钙化合并肾结石患者结石成分分析
表2 178例腹主动脉钙化患者一般资料及实验室指标比较
表3 腹主动脉钙化患者发生肾结石的危险因素Logistic回归分析
[1]
Scales CD Jr, Smith AC, Hanley JM, et al. Prevalence of kidney stones in the United States [J]. Eur Urol, 2012, 62(1): 160-165.
[2]
黄健. 中国泌尿外科和男科疾病诊断治疗指南: 2019版[M].北京: 科学出版社, 2020, 246-248.
[3]
Strohmaier WL. Course of calcium stone disease without treatment. What can we expect? [J]. Eur Urol, 2000, 37(3): 339-344.
[4]
Li B, Tang Y, Zhou L, et al. Association between aortic calcification and the presence of kidney stones: calcium oxalate calculi in focus [J]. Int Urol Nephrol, 2022, 54(8): 1915-1923.
[5]
Ferraro PM, Marano R, Primiano A, et al. Stone composition and vascular calcifications in patients with nephrolithiasis [J]. J nephrol, 2019, 32(4): 589-594.
[6]
Hsi RS, Spieker AJ, Stoller ML, et al. Coronary artery calcium score and association with recurrent nephrolithiasis: the multi-ethnic study of atherosclerosis [J]. J Urology, 2016, 195(41): 971-976.
[7]
Stern KL, Ward RD, Li J, et al. Nonrenal systemic arterial calcification predicts the formation of kidney stones [J]. J Endourol, 2019, 33(12): 1032-1034.
[8]
Patel ND, Ward RD, Calle J, et al. Vascular disease and kidney stones: abdominal aortic calcifications are associated with low urine pH and hypocitraturia [J]. J Endourol, 2017, 31(9): 956-961.
[9]
Tzelves L, Türk C, Skolarikos A. European Association of Urology Urolithiasis Guidelines: Where Are We Going? [J]. Eur Urol focus, 2021, 7(1): 34-38.
[10]
Lee JY, Andonian S, Bhojani N, et al. Canadian Urological Association Guideline: management of ureteral calculi[J]. Can Urol Assoc J, 2021, 15(12): 1676-1690.
[11]
Assimos D, Krambeck A, Miller NL, et al. Surgical management of stones: American Urological Association/Endourological Society Guideline, PART I [J]. J Urol, 2016, 196(4): 1153-1160.
[12]
Shavit L, Girfoglio D, Vijay V, et al. Vascular calcification and bone mineral density in recurrent kidney stone formers [J]. Clin J Am Soc Nephrol, 2015, 10(2): 278-285.
[13]
Reiner AP, Kahn A, Eisner BH, et al. Kidney stones and subclinical atherosclerosis in young adults: the CARDIA study [J]. J Urology, 2011, 185(3): 920-925.
[14]
Maddahi N, Aghamir SMK, Moddaresi SS, et al. The association of Dietary Approaches to Stop Hypertension-style diet with urinary risk factors of kidney stones formation in men with nephrolithiasis [J]. Clin Nutr ESPEN, 2020, 39(12): 173-179.
[15]
Kohjimoto Y, Sasaki Y, Iguchi M, et al. Association of metabolic syndrome traits and severity of kidney stones: results from a nationwide survey on urolithiasis in Japan [J]. Am J Kidney Dis, 2013, 61(6): 923-929.
[16]
Moreira DM, Friedlander JI, Hartman C, et al. Association of estimated glomerular filtration rate with 24-h urinalysis and stone composition [J]. Urolithiasis, 2016, 44(4): 319-325.
[17]
Liu CJ, Cheng CW, Tsai YS, et al. Crosstalk between renal and vascular calcium signaling: the link between nephrolithiasis and vascular calcification [J]. Int J Mol Sci, 2021, 22(7): 3590-3605.
[18]
Eisner BH, Porten SP, Bechis SK, et al. Hypertension is associated with increased urinary calcium excretion in patients with nephrolithiasis [J]. J Urology, 2010, 183(2): 576-579.
[19]
Khan SR. Is oxidative stress, a link between nephrolithiasis and obesity, hypertension, diabetes, chronic kidney disease, metabolic syndrome? [J]. Urol Res, 2012, 40(2): 95-112.
[20]
Kim YJ, Park MS, Kim WT, et al. Hypertension influences recurrent stone formation in nonobese stone formers [J]. Urology, 2011, 77(5): 1059-1063.
[21]
武佰锁, 郭君毅, 王锦波. 代谢综合征与肾结石的相关性研究进展[J]. 微创泌尿外科杂志, 2019, 8(04): 280-286.
[22]
陈城, 李翔翔, 胡林昆, 等. 血脂异常与泌尿系结石形成的相关性研究[J]. 中华泌尿外科杂志, 2016, 37(09): 698-702.
[23]
Ding Q, Ouyang J, Fan B, et al. Association between Dyslipidemia and Nephrolithiasis Risk in a Chinese Population [J]. Urologia internationalis, 2019, 103(2): 156-165.
[24]
徐宏博, 魏雪栋, 胡林昆, 等. 内脏脂肪面积与尿酸结石形成的相关性研究[J]. 中华泌尿外科杂志, 2019, 40(2): 105-110.
[25]
王乾, 李殷南, 孙宾, 等. 崇明地区泌尿系结石成分分析及与血尿酸的相关性[J]. 国际泌尿系统杂志, 2021, 41(3): 487-491.
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