Kidney stones.
Kidney stones.
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DOI：
10.1038/nrdp.2016.8
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发表时间：
2016-02-25
期刊：
影响因子：
--
通讯作者：
Tiselius HG
中科院分区：
文献类型：
--
作者：
Khan SR;Pearle MS;Robertson WG;Gambaro G;Canales BK;Doizi S;Traxer O;Tiselius HG
肾结石是肾盏和肾盂中的矿物沉积物，其被发现游离或附着于肾乳头。草酸钙是结石的主要成分，大多数结石都是在磷酸钙的基础上形成的，称为兰德尔氏斑（Randall's plaque），存在于肾乳头表面。结石形成非常普遍，发病率高达14.8%，并在不断增加，在首次结石发作的前5年内复发率高达50%。肥胖、糖尿病、高血压和代谢综合征被认为是结石形成的危险因素，而结石形成又会导致高血压、慢性肾病和终末期肾病。症状性肾结石的治疗已经从开放性手术取石术发展到微创腔内泌尿外科治疗，从而降低了患者的发病率，提高了结石清除率和生活质量。预防复发需要行为和营养干预，以及针对结石类型的药物治疗。预防复发的需求很大，这需要更好地了解结石形成的机制，以促进更有效药物的开发。
Kidney stones are mineral deposits in the renal calyces and pelvis that are found free or attached to the renal papillae. They contain crystalline and organic components and are formed when the urine becomes supersaturated with respect to a mineral. Calcium oxalate is the main constituent of most stones, many of which form on a foundation of calcium phosphate called Randall’s plaques, which are present on the renal papillary surface. Stone formation is highly prevalent, with rates of up to 14.8% and increasing, and a recurrence rate of up to 50% within the first 5 years of the initial stone episode. Obesity, diabetes, hypertension and metabolic syndrome are considered risk factors for stone formation, which, in turn, can lead to hypertension, chronic kidney disease and end-stage renal disease. Management of symptomatic kidney stones has evolved from open surgical lithotomy to minimally invasive endourological treatments leading to a reduction in patient morbidity, improved stone-free rates and better quality of life. Prevention of recurrence requires behavioural and nutritional interventions, as well as pharmacological treatments that are specific for the type of stone. There is a great need for recurrence prevention that requires a better understanding of the mechanisms involved in stone formation to facilitate the development of more-effective drugs.
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