Idiopathic hypercalciuria and formation of calcium renal stones.
Idiopathic hypercalciuria and formation of calcium renal stones.
复制标题
DOI：
10.1038/nrneph.2016.101
复制
发表时间：
2016-09
期刊：
影响因子：
--
通讯作者：
Evan AP
中科院分区：
文献类型：
--
作者：
Coe FL;Worcester EM;Evan AP
肾结石最常见的表现是无全身性疾病的患者的特发性钙结石。大多数结石主要由草酸钙组成，并在间质磷灰石沉积物的基础上形成，称为兰德尔斑块。相比之下，有些结石主要由磷酸钙组成，如羟基磷灰石或透钙磷石（磷酸氢钙），通常伴有Bellini管中的磷酸钙沉积。这些沉积物会导致局部组织损伤，并可能成为矿物质过度生长的部位。结石的形成是由尿液中草酸钙和透钙磷石的过饱和所驱动的。过饱和水平与液体摄入量以及尿柠檬酸盐和钙的水平有关。当每天尿柠檬酸盐排泄量<400 mg时，结石形成的风险增加，柠檬酸钾治疗已用于预防结石。每天尿钙水平>200毫克也会增加结石风险，并经常导致负钙平衡。肾钙重吸收减少在特发性高钙尿症中起作用。低钠饮食和噻嗪类利尿剂可降低尿钙水平，并可能降低结石复发和骨骼疾病的风险
The most common presentation of nephrolithiasis is idiopathic calcium stones in patients without systemic disease. Most stones are primarily composed of calcium oxalate and form on a base of interstitial apatite deposits, known as Randall’s plaque. By contrast some stones are composed largely of calcium phosphate, as either hydroxyapatite or brushite (calcium monohydrogen phosphate), and are usually accompanied by deposits of calcium phosphate in the Bellini ducts. These deposits result in local tissue damage and might serve as a site of mineral overgrowth. Stone formation is driven by supersaturation of urine with calcium oxalate and brushite. The level of supersaturation is related to fluid intake as well as to the levels of urinary citrate and calcium. Risk of stone formation is increased when urine citrate excretion is <400 mg per day, and treatment with potassium citrate has been used to prevent stones. Urine calcium levels >200 mg per day also increase stone risk and often result in negative calcium balance. Reduced renal calcium reabsorption has a role in idiopathic hypercalciuria. Low sodium diets and thiazide-type diuretics lower urine calcium levels and potentially reduce the risk of stone recurrence and bone diseas
登录
查看更多内容
影响因子：
3.4
作者：
Costa-Bauza, Antonia;Ramis, Margarita;Grases, Felix
通讯作者：
Grases, Felix
影响因子：
4
作者：
Bolland, M. J.;Ames, R. W.;Reid, I. R.
通讯作者：
Reid, I. R.
DOI：
10.1152/ajprenal.00411.2010
发表时间：
2011-02-01
影响因子：
4.2
作者：
Bergsland, Kristin J.;Zisman, Anna L.;Coe, Fredric L.
通讯作者：
Coe, Fredric L.
影响因子：
2.7
作者：
Blackwood, AM;Sagnella, GA;Cappuccio, FP
通讯作者：
Cappuccio, FP
影响因子：
19.6
作者：
COE, FL;PARKS, JH;FAVUS, MJ
通讯作者：
FAVUS, MJ