Clinical implications of abundant calcium phosphate in routinely analyzed kidney stones
Clinical implications of abundant calcium phosphate in routinely analyzed kidney stones
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DOI：
10.1111/j.1523-1755.2004.00803.x
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发表时间：
2004-08-01
影响因子：
19.6
通讯作者：
Lingeman, JE
中科院分区：
文献类型：
--
作者：
Parks, JH;Worcester, EM;Lingeman, JE
背景为了更好地描述高磷酸钙（CaP）结石丰度的肾结石患者的临床表型，我们在这里介绍了大量结石形成者（SF）的临床和实验室检查结果，结石CaP范围为0%至100%。我们的目的是告知临床医生和突出似乎值得进一步研究的领域。我们计算了1201例患者所有结石的平均CaP百分比（CaP%），并将其分为CaOx（N = 1011）或CaP（N = 190）。性别差异、结石形成率、尿结石危险因素、体外冲击波碎石术（ESWL）治疗和治疗期间复发与结石CaP含量相关。30年来，CaP%一直在上升，尤其是在女性中。经结石数量和结石病持续时间调整的ESWL率在CaP SF组较高（0.6 vs. 1.86和0.73 vs. 1.82，CaOx vs. CaP，男性和女性，P < 0.001），尤其是当结石含有透钙磷石时透钙磷石组男、女分别为2.90 vs.1.02和3.11 vs.1.35（P < 0.001）。尿pH和CaP过饱和度与CaP%呈剂量反应关系。CaP和CaOx SF的复发率没有差异，并且两者在药物预防下都很好。Stone CaP%已经上升了三十年。CaP SF，特别是透钙磷石结石，比CaOx SF接受更多的ESWL治疗，不能用结石数量或结石疾病的持续时间来解释。尿液过饱和解释了高CaP%。高CaP%不会妨碍结石的预防。
Background. To better portray the clinical phenotype of kidney stone patients with high calcium phosphate (CaP) stone abundance, we present here clinical and laboratory findings of large numbers of stone formers (SF) with stone CaP ranging from 0% to 100%. Our purpose was to inform clinicians and highlight areas that seem to deserve further research.Methods. We calculated average percent CaP (CaP%) in all stones of 1201 patients, and classified them into CaOx (N = 1011) or CaP (N = 190). Sex differences, stone formation rates, urine stone risk factors, extracorporeal shock wave lithotripsy (ESWL) treatments, and relapse during treatment were quantified in relation to stone CaP content.Results. CaP% has risen for three decades, especially among women. ESWL rates adjusted for numbers of stones and duration of stone disease were higher in CaP SF (0.6 vs. 1.86 and 0.73 vs. 1.82, CaOx vs. CaP, men and women, respectively, P < 0.001), and especially when stones contained brushite (2.90 vs. 1.02 and 3.11 vs. 1.35, brushite vs. not, males and females, respectively, P < 0.001). Urine pH and CaP supersaturation rose in proportion to CaP% in a dose response manner. Relapse rates of CaP and CaOx SF did not differ, and both did well with medical prevention.Conclusion. Stone CaP% has risen for three decades. CaP SF, particularly with brushite stones, receive more ESWL treatments than CaOx SF, not explained by stone number or duration of stone disease. Urine supersaturations explain the high CaP%. High CaP% does not hamper medical stone prevention.