BMJ：肾结石患者后期患严重肾脏问题可能性较小

肾结石只在较小程度上增加患者后期患上较为严重肾脏问题的危险性，相关研究论文发表在British Medical Journal杂志上。

肾结石是一种常见的疾病，通常是可以预防的，但目前还不清楚肾结石与终末期肾病（俗称肾功能衰竭）及其他肾脏问题是否有关联。因此，加拿大和美国研究团队在着手调查是否肾结石引发肾功能衰竭或其他不良后果如增加慢性肾脏病的风险或提高血液中肌酐水平。他们追踪研究超过300万名患者，平均追访了11年。

医院记录被用来确定肾结石以及后续慢性肾脏病的发展如肾功能​​衰竭、肌酐水平的提高等。在随访过程中，与那些没有肾结石的人相比，23,706例肾结石患者在后续研究研究中。4％的患者发展成为晚期慢性肾脏病，6,581（0.3％）名患者肌酐水平持续性的增加了一倍，5,333（0.2％）的患者出现肾衰竭。而从绝对数来看，肾结石伴有肾脏病的可能性比较小。该研究剔除其他几个可能的危险因素后，肾结石伴有其他肾脏疾病的风险，女性高于男性，年轻人比那些50岁及以上的人要高。研究人员认为肾结石形成中的钙化过程可能是肾功能损害的可能原因。

与肾结石相关的拓展阅读：

• JAMA Internal Medicine：仿瓷餐具盛高温食物可引发肾结石
• JAMA Intern Med：长期服用维C片或增加肾结石风险
• JAMA Intern Med:仿瓷餐具盛高温食物易引发肾结石
• J UROLOGY：肥胖人群更易患肾结石
• 肾结石听诊器 更多信息请点击：有关肾结石更多资讯

Kidney stones and kidney function loss: a cohort study

Objective To investigate whether the presence of kidney stones increase the risk of end stage renal disease (ESRD) or other adverse renal outcomes.

Design A registry cohort study using validated algorithms based on claims and facility utilisation data. Median follow-up of 11 years.

Setting Alberta, Canada, between 1997 and 2009.

Participants 3?089?194 adult patients without ESRD at baseline or a history of pyelonephritis. Of these, 1?954?836 had outpatient serum creatinine measurements and were included in analyses of chronic kidney disease and doubling of serum creatinine level.

Exposure One or more kidney stones during follow-up.

Main outcome measures Incident ESRD, development of stage 3b–5 chronic kidney disease (estimated glomerular filtration rate <45 mL/min/1.73?m2), and sustained doubling of serum creatinine concentration from baseline.

Results 23?706 (0.8%) patients had at least one kidney stone, 5333 (0.2%) developed ESRD, 68?525 (4%) developed stage 3b–5 chronic kidney disease, and 6581 (0.3%) experienced sustained doubling of serum creatinine. Overall, one or more stone episodes during follow-up was associated with increased risk of ESRD (adjusted hazard ratio 2.16 (95% CI 1.79 to 2.62)), new stage 3b–5 chronic kidney disease (hazard ratio 1.74 (1.61 to 1.88)), and doubling of serum creatinine (hazard ratio 1.94 (1.56 to 2.43)), all compared with those without kidney stones during follow-up. The excess risk of adverse outcomes associated with at least one episode of stones seemed greater in women than in men, and in people aged <50 years than in those aged ≥50. However, the risks of all three adverse outcomes in those with at least one episode of stones were significantly higher than in those without stones in both sexes and age strata. The absolute increase in the rate of adverse renal outcomes associated with stones was small: the unadjusted rate of ESRD was 2.48 per million person days in people with one or more episodes of stones versus 0.52 per million person days in people without stones.

Conclusion Even a single kidney stone episode during follow-up was associated with a significant increase in the likelihood of adverse renal outcomes including ESRD. However, the increases were small in absolute terms.