Uric Acid nephrolithiasis: recent progress and future directions.
Uric Acid nephrolithiasis: recent progress and future directions.
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发表时间：
2007
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通讯作者：
Tin C. Ngo;D. Assimos
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作者：
Tin C. Ngo;D. Assimos
在过去的几十年里，尿石症在工业化国家的患病率一直在上升。尿酸结石占尿路结石的很大比例。某些危险因素可能参与了尿酸肾结石的发病机制，包括高尿酸尿、低尿量和持续性低尿pH。患有严重高尿酸尿症的患者患尿酸结石的风险很高。这些情况包括慢性腹泻状态；骨髓增生性疾病；胰岛素抵抗，包括糖尿病；以及单基因代谢障碍，如Lesch-Nyhan综合征。计算机断层扫描可以提供明确的诊断。除非有严重梗阻、进行性氮质血症、严重感染或持续疼痛的病例，尿酸肾结石患者的初始治疗应是药物溶解疗法，因为这种方法在大多数病例中是成功的。尿酸肾结石的流行病学和病理生理学的全面回顾对于诊断、治疗和预防这种疾病患者的结石是至关重要的。
The prevalence of urolithiasis has been increasing for the past few decades in industrialized nations. Uric acid calculi account for a significant percentage of urinary stones. Certain risk factors may be involved in the pathogenesis of uric acid nephrolithiasis, including hyperuricosuria, low urinary volume, and persistently low urinary pH. Patients with medical conditions that promote profound hyperuricosuria are at high risk of developing uric acid calculi. These conditions include chronic diarrheal states; myeloproliferative disorders; insulin resistance, including diabetes mellitus; and monogenic metabolic disorders, such as Lesch-Nyhan syndrome. Computed tomography can provide a definitive diagnosis. Except in cases in which there is severe obstruction, progressive azotemia, serious infection, or unremitting pain, the initial treatment of patients with uric acid nephrolithiasis should be medical dissolution therapy because this approach is successful in the majority of cases. A thorough review of the epidemiology and pathophysiology of uric acid nephrolithiasis is crucial for the diagnosis, treatment, and prevention of stones in patients with this condition.