Twenty-four-hour urine chemistries and the risk of kidney stones among women and men
Twenty-four-hour urine chemistries and the risk of kidney stones among women and men
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DOI：
10.1046/j.1523-1755.2001.00746.x
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发表时间：
2001-06-01
影响因子：
19.6
通讯作者：
Stampfer, MJ
中科院分区：
文献类型：
--
作者：
Curhan, GC;Willett, WC;Stampfer, MJ
背景24小时尿液收集的结果对于选择最合适的干预措施以预防肾结石复发是不可或缺的。然而，目前接受的正常尿值的定义并没有得到文献的有力支持。此外，关于结石形成风险与尿因子水平之间关系的信息很少。不幸的是，大多数以前的研究24小时尿化学是有限的纳入复发性结石形成者和定义不明确的对照。我们收集了807名有肾结石病史的男性和女性以及239名无肾结石病史的男性和女性的24小时尿液样本，他们参与了三项正在进行的大型队列研究：（NHS I;平均年龄61岁），护士健康研究II（NHS II;平均年龄42岁）和卫生专业人员随访研究（HPFS;平均年龄59岁）。结果。在NHS I（P小于或等于0.01）、NHS II（P小于或等于0.13）和HPFS（P小于或等于0.01）中，病例的平均24小时尿钙排泄量高于对照组，尿量低于对照组，但尿草酸盐和柠檬酸盐无差异。在女性中，血尿酸在病例组和对照组中相似，但在男性病例组中较低（P = 0.06）。NHS I（P = 0.26）、NHS II（P = 0.03）和HPFS（P = 0.02）患者中高钙尿症的发生率较高，但对照组中分别有27%、17%和14%的患者也符合高钙尿症的定义。高尿酸血症的发生率在病例组和对照组之间没有差异，但男性的发生率是女性的三倍。在调整其他泌尿因素后，结石形成的相对风险随着所有三个队列中尿钙水平和浓度的增加而增加，但不是线性方式。与尿钙浓度为
Background. Results of a 24-hour urine collection are integral to the selection of the most appropriate intervention to prevent kidney stone recurrence. However, the currently accepted definitions of normal urine values are not firmly supported by the literature. In addition, little information is available about the relationship between risk of stone formation and the levels of urinary factors. Unfortunately, the majority of previous studies of 24-hour urine chemistries were limited by the inclusion of recurrent stone formers and poorly defined controls.Methods. We obtained 24-hour urine collections from 807 men and women with a history of kidney stone disease and 239 without a history who were participants in three large ongoing cohort studies: the Nurses' Health Study I (NHS I; mean age of 61 years), the Nurses' Health Study II (NHS II; mean age of 42 years), and the Health Professionals Follow-up Study (HPFS; mean age of 59 years).Results. Mean 24-hour urine calcium excretion was higher and urine volume was lower in cases than controls in NHS I (P less than or equal to 0.01), NHS II (P less than or equal to 0.13) and HPFS (P less than or equal to 0.01), but urine oxalate and citrate did not differ. Among women, urine uric acid was similar in cases and controls but was lower in cases in men (P = 0.06). The frequency of hypercalciuria was higher among the cases in NHS I (P = 0.26), NHS II (P = 0.03), and HPFS (P = 0.02), but 27, 17, and 14% of the controls, respectively, also met the definition of hypercalciuria. The frequency of hyperoxaluria did not differ between cases and controls, but was three times more common among men compared with women. After adjusting for the other urinary factors, the relative risk of stone formation increased with increasing urine calcium levels and concentration in all three cohorts but not in a linear fashion. Compared with individuals with a urine calcium concentration of