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

doi:10.3877/cma.j.issn.1674-3253.2023.05.011

Abstract

Abstract:

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.

Key words: Abdominal aortic calcification, Kidney calculi, Stone composition, Risk factors

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]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(05): 481-485.

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References 25

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结石成分	例数	构成比（%）
单一结石	32	35.56
草酸钙结石	22	24.44
磷酸钙结石	1	1.11
碳酸磷灰石	4	4.44
尿酸结石	5	5.56
混合结石	58	64.44
草酸钙+磷酸钙结石	12	13.33
草酸钙+碳酸磷灰石	30	33.33
草酸钙+尿酸结石	3	3.33
草酸钙+磷酸钙+碳酸磷灰石	4	4.44
草酸钙+磷酸钙+尿酸结石	6	6.67
草酸钙+尿酸+碳酸磷灰石	3	3.33

结石成分	例数	构成比（%）
单一结石	32	35.56
草酸钙结石	22	24.44
磷酸钙结石	1	1.11
碳酸磷灰石	4	4.44
尿酸结石	5	5.56
混合结石	58	64.44
草酸钙+磷酸钙结石	12	13.33
草酸钙+碳酸磷灰石	30	33.33
草酸钙+尿酸结石	3	3.33
草酸钙+磷酸钙+碳酸磷灰石	4	4.44
草酸钙+磷酸钙+尿酸结石	6	6.67
草酸钙+尿酸+碳酸磷灰石	3	3.33

组别	例数	年龄(岁)	男性[例(%)]	女性[例(%)]	BMI(kg/m²)	合并高血压[例(%)]	合并糖尿病[例(%)]	有吸烟史[例(%)]
观察组	90	57(51，63)	63(70.00)	27(30.00)	25.70(22.97，27.43)	53(58.89)	20(22.22)	32(35.56)
对照组	88	63(36，66)	48(54.55)	40(45.45)	25.13(23.01，27.48)	19(21.59)	6(6.82)	19(21.59)
统计值		Z=0.914	χ²=4.582		Z=0.428	χ²=25.697	χ²=8.464	χ²=4.245
P值		0.361	0.033		0.669	<0.001	0.004	0.039
组别	有饮酒史[例(%)]	TC(mmol/L)	高TC[例(%)]	HDL-C(mmol/L)	低HDL-C[例(%)]	LDL-C(mmol/L)	高LDL-C[例(%)]
观察组	23(25.56)	4.9±1.1	18(20.00)	0.97(0.86，1.14)	49(54.44)	3.10(2.55，3.55)	11(12.22)
对照组	20(22.73)	4.6±1.0	8(9.09)	1.11(0.99，1.26)	27(30.68)	2.78(2.21，3.27)	2(2.27)
统计值	χ²=0.194	t=2.087	χ²=4.245	Z=3.319	χ²=10.269	Z=2.274	χ²=6.506
P值	0.659	0.038	0.039	0.001	0.001	0.023	0.011
组别	血肌酐(μmol/L)	血白蛋白(g/L)	血尿酸(μmol/L)	高血尿酸[例(%)]	血尿素氮(mmol/L)	血钙(mmol/L)	TG(mmol/L)
观察组	73(62，88)	40±4	435(318，489)	48(53.33)	5.61(4.49，6.65)	2.35(2.29，2.41)	1.31(0.97，1.90)
对照组	75(64，90)	41±4	354(288，426)	22(25.00)	5.35(4.14，6.65)	2.35(2.27，2.42)	1.25(0.92，1.75)
统计值	Z=0.239	t=1.965	Z=2.751	χ²=14.970	Z=0.914	Z=0.389	Z=0.560
P值	0.811	0.051	0.006	<0.001	0.361	0.698	0.575

组别	例数	年龄(岁)	男性[例(%)]	女性[例(%)]	BMI(kg/m²)	合并高血压[例(%)]	合并糖尿病[例(%)]	有吸烟史[例(%)]
观察组	90	57(51，63)	63(70.00)	27(30.00)	25.70(22.97，27.43)	53(58.89)	20(22.22)	32(35.56)
对照组	88	63(36，66)	48(54.55)	40(45.45)	25.13(23.01，27.48)	19(21.59)	6(6.82)	19(21.59)
统计值		Z=0.914	χ²=4.582		Z=0.428	χ²=25.697	χ²=8.464	χ²=4.245
P值		0.361	0.033		0.669	<0.001	0.004	0.039
组别	有饮酒史[例(%)]	TC(mmol/L)	高TC[例(%)]	HDL-C(mmol/L)	低HDL-C[例(%)]	LDL-C(mmol/L)	高LDL-C[例(%)]
观察组	23(25.56)	4.9±1.1	18(20.00)	0.97(0.86，1.14)	49(54.44)	3.10(2.55，3.55)	11(12.22)
对照组	20(22.73)	4.6±1.0	8(9.09)	1.11(0.99，1.26)	27(30.68)	2.78(2.21，3.27)	2(2.27)
统计值	χ²=0.194	t=2.087	χ²=4.245	Z=3.319	χ²=10.269	Z=2.274	χ²=6.506
P值	0.659	0.038	0.039	0.001	0.001	0.023	0.011
组别	血肌酐(μmol/L)	血白蛋白(g/L)	血尿酸(μmol/L)	高血尿酸[例(%)]	血尿素氮(mmol/L)	血钙(mmol/L)	TG(mmol/L)
观察组	73(62，88)	40±4	435(318，489)	48(53.33)	5.61(4.49，6.65)	2.35(2.29，2.41)	1.31(0.97，1.90)
对照组	75(64，90)	41±4	354(288，426)	22(25.00)	5.35(4.14，6.65)	2.35(2.27，2.42)	1.25(0.92，1.75)
统计值	Z=0.239	t=1.965	Z=2.751	χ²=14.970	Z=0.914	Z=0.389	Z=0.560
P值	0.811	0.051	0.006	<0.001	0.361	0.698	0.575

因素	β值	SE值	Wald值	OR值	P值	95%CI
性别	0.116	0.419	0.076	1.122	0.783	0.493~2.553
合并高血压	1.183	0.381	9.634	3.264	0.002	1.546~6.889
合并糖尿病	0.762	0.565	1.823	2.143	0.177	0.709~6.480
有吸烟史	0.728	0.447	2.657	2.071	0.103	0.863~4.972
高TC	0.112	0.616	0.033	1.119	0.855	0.334~3.746
低HDL-C	0.760	0.372	4.177	2.139	0.041	1.032~4.434
高LDL-C	2.248	0.980	5.259	9.468	0.022	1.386~64.659
高血尿酸	0.962	0.376	6.538	2.618	0.011	1.252~5.475

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