Characterization of Inner Medullary Collecting Duct Plug Formation Among Idiopathic Calcium Oxalate Stone Formers
Characterization of Inner Medullary Collecting Duct Plug Formation Among Idiopathic Calcium Oxalate Stone Formers
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DOI：
10.1016/j.urology.2016.05.026
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发表时间：
2016-08-01
期刊：
影响因子：
2.1
通讯作者：
Krambeck, Amy E.
中科院分区：
文献类型：
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作者：
Rivera, Marcelino;Cockerill, Patrick A.;Krambeck, Amy E.
目的探讨特发性草酸钙(ICaOx)结石患者导管栓子形成的患病率、危险因素及对肾功能的影响。方法和方法对连续一组接受经皮肾取石术的iCaOx结石患者行肾乳头可及性肾乳头摄像，测定斑块和导管栓子所占的表面积百分比(SA)。其中，41例(43%)有导管堵塞。平均斑块SA在低%组和高%组之间没有差异(分别为2.1%和3.4%)。平均%SA斑块数与导管堵塞数无明显相关性(Spearman‘s Rho=0.12，P=0.3)。SA插塞平均值为1%的患者尿液pH值较高(中位数6.5vs6.0，P=0.02)，尿中羟基磷灰石过饱和度升高(中位数5.4vs3.7 Delta G；P=0.04)。与有1%堵塞的患者相比，有1%堵塞的患者有更广泛的导管扩张(P=0.002)。
OBJECTIVE To study the prevalence of, risk factors for, and renal functional consequences of ductal plug formation in idiopathic calcium oxalate (iCaOx) stone formers (SF).PATIENTS AND METHODS Accessible renal papillae were videotaped to determine the percent surface area (SA) occupied by plaque and ductal plug in a consecutive cohort of iCaOx SF undergoing percutaneous nephrolithotomy for stone removal.RESULTS Between 2009 and 2014, iCaOx SF comprised 96 of 240 enrolled patients. Of these, 41 (43%) had ductal plugs. Mean plaque SA did not differ between the low and high % plug groups (2.1% vs 3.4%, respectively). The amounts of mean % SA plaque and ductal plug were not strongly correlated (Spearman's rho= 0.12, P = .3). Patients with >1% mean SA plug had a higher urinary pH (median 6.5 vs 6.0, P = .02) and elevated urinary hydroxyapatite supersaturation (median 5.4 vs 3.7 delta G; P = .04). Those with > 1% plugging had more extensive ductal dilation (P = .002) compared to those with