Relationship Between Glomerular Filtration Rate and 24-Hour Urine Composition in Patients With Nephrolithiasis
Relationship Between Glomerular Filtration Rate and 24-Hour Urine Composition in Patients With Nephrolithiasis
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DOI：
10.1016/j.urology.2011.12.019
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发表时间：
2012-07-01
期刊：
影响因子：
2.1
通讯作者：
Eisner, Brian H.
中科院分区：
文献类型：
--
作者：
Gershman, Boris;Sheth, Sonali;Eisner, Brian H.
目的 研究肾结石患者 GFR 与 24 小时尿液成分之间的关系，以了解肾功能如何影响结石风险。肾小球滤过率 (GFR) 的改变与许多生理变化有关。方法对来自 2 个代谢结石诊所的患者进行了机构审查委员会批准的回顾性审查。采用单因素方差分析和多元线性回归模型评估 GFR 五分位与 24 小时尿液成分之间的关系。 结果 本研究共纳入 403 名患者（241 名男性，162 名女性），平均年龄为 52.6 +/- 14.2 岁。在单变量分析中，GFR 降低五分位数与尿钙、柠檬酸盐、草酸钙过饱和度和磷酸钙过饱和度的显着降低相关（均 P < .05）。在多元线性回归模型中，GFR降低五分位与尿钙（β = -11.2，95% CI = -18.3至4.01）、尿柠檬酸盐（β = -32.4，95% CI = -54.1至10.8）、草酸盐（β = -1.83，95% CI = -2.85至0.81）、草酸钙过饱和（β = -0.58，95% CI = 0.84 至 0.33）和磷酸钙过饱和（β = -0.09，95% CI = 0.17 至 0.02），以及尿镁增加（β = 3.40，95% CI = 0.7 至 6.1）。 结论 GFR 降低与尿钙、草酸盐和柠檬酸盐减少，尿镁增加。这些发现对于患有结石病和肾功能受损的患者的治疗具有重要意义。泌尿学 80: 38-42, 2012。(c) 2012 Elsevier Inc.
OBJECTIVE To examine the relationship between GFR and 24-hour urine composition in patients with nephrolithiasis to understand how renal function may affect stone risk. Alterations in glomerular filtration rate (GFR) are associated with a number of physiological changes.METHODS A retrospective, institutional review board-approved review of patients from 2 metabolic stone clinics was performed. One-way analysis of variance and multivariate linear regression models were used to evaluate the relationship between GFR quintile and 24-hour urine composition.RESULTS A total of 403 patients (241 male, 162 female) with a mean age of 52.6 +/- 14.2 years were included in the study. On univariate analysis, decreasing GFR by quintile was associated with significant reductions in urine calcium, citrate, supersaturation of calcium oxalate, and supersaturation of calcium phosphate (P < .05 for each). In multivariate linear regression models, decreasing GFR by quintile was associated with significant decreases in urine calcium (beta = -11.2, 95% CI = -18.3 to 4.01), urine citrate (beta = -32.4, 95% CI = -54.1 to 10.8), oxalate (beta = -1.83, 95% CI = -2.85 to 0.81), supersaturation of calcium oxalate (beta = -0.58, 95% CI = 0.84 to 0.33) and supersaturation of calcium phosphate (beta = -0.09, 95% CI = 0.17 to 0.02), as well as an increase in urine magnesium (beta = 3.40, 95% CI = 0.7 to 6.1).CONCLUSION Reduction in GFR is associated with decreased urine calcium, oxalate, and citrate, and increased urine magnesium. These findings have implications for treatment of patients with stone disease and impaired renal function. UROLOGY 80: 38-42, 2012. (c) 2012 Elsevier Inc.