JCEM:无症状原发性甲状旁腺功能亢进症患者低镁尿症与肾结石相关

2020-05-07 MedSci原创 MedSci原创

低镁尿症和尿钙镁比均与无症状肾结石有关,除无高钙尿症外,这些对于无症状PHPT患者的肾结石作为危险因素,具有潜在的临床实用性。该研究的结果不支持检测PHPT患者通常被认为与肾结石有关的其他尿液指标。

原发性甲状旁腺功能亢进症(PHPT)患者肾结石的发病机制仍有待阐明。最新指南建议高钙血症(>400mg /天)且结石风险增加的无症状PHPT患者进行甲状旁腺切除术。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,该研究旨在评估无症状散发性PHPT患者尿路结石危险因素及其临床意义。

研究人员通过测量受试者血清和24小时尿液参数,以及进行肾脏超声检查,评估了157例连续就诊的无症状PHPT患者。

在单变量分析中将尿液参数作为连续变量和分类变量进行评估,在对年龄、性别、BMI、eGFR、PTH、25OHD、血清钙、尿液量进行校正的单变量和多变量分析中,仅高钙尿症和低镁尿症与肾结石显著相关[OR为2.14(1.10-4.56);P=0.04;OR为3.06(1.26-7.43);P=0.013]。在多变量分析中,低镁尿症仍与肾结石相关[OR为6.09(1.57-23.5),P=0.009],即使该分析仅限于不伴有高钙尿症的患者。尿钙/镁比也与肾结石症相关(单变量OR为1.62(1.27-2.08);P=0.001和多变量分析OR为1.74(1.25-2.42),P=0.001)。与高钙尿症相比,低镁尿症和尿中钙/镁比的阳性预测值(PPV)较好,但数值较低。

由此可见,低镁尿症和尿钙镁比均与无症状肾结石有关,除无高钙尿症外,这些对于无症状PHPT患者的肾结石作为危险因素,具有潜在的临床实用性。该研究的结果不支持检测PHPT患者通常被认为与肾结石有关的其他尿液指标。

原始出处:

Federica Saponaro.et al.Hypomagnesuria is associated with nephrolithiasis in patients with asymptomatic primary hyperparathyroidism.J Clin Endocrinol Metab.2020.https://doi.org/10.1210/clinem/dgaa233

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    2021-06-24 12192b1am98暂无昵称

    学习了

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    2020-07-12 achengzhao
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    2020-12-10 smallant2015
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    2020-05-07 njwbhuang

    好文章,感谢分享!

    0

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