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中华临床医师杂志(电子版) ›› 2026, Vol. 20 ›› Issue (02) : 151 -157. doi: 10.3877/cma.j.issn.1674-0785.2026.02.010

综述

脂溶性维生素通过肠肾轴调控肾结石的机制研究进展
周志勇, 姜福金, 王苏贵()   
  1. 223002 江苏淮安,徐州医科大学附属淮安医院
  • 收稿日期:2026-01-12 出版日期:2026-02-28
  • 通信作者: 王苏贵

Mechanisms of lipid-soluble vitamins in regulating kidney stones via the gut-kidney axis

Zhiyong Zhou, Fujin Jiang, Sugui Wang()   

  1. Department of Urology, Huai'an Hospital Affiliated to Xuzhou Medical University, Huai’an 223002, China
  • Received:2026-01-12 Published:2026-02-28
  • Corresponding author: Sugui Wang
引用本文:

周志勇, 姜福金, 王苏贵. 脂溶性维生素通过肠肾轴调控肾结石的机制研究进展[J/OL]. 中华临床医师杂志(电子版), 2026, 20(02): 151-157.

Zhiyong Zhou, Fujin Jiang, Sugui Wang. Mechanisms of lipid-soluble vitamins in regulating kidney stones via the gut-kidney axis[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2026, 20(02): 151-157.

肾结石是泌尿外科常见疾病,其中钙草酸结石占比超75%,其发病与体内代谢失衡密切相关。肠肾轴作为肠道与肾脏间物质交换、信号传递的关键通路,在调控肾脏钙代谢、氧化应激及晶体黏附过程中发挥核心作用,而肠肾轴的调控功能并非独立进行,而是依赖多种活性物质的协同作用,其中脂溶性维生素是关键调控因子之一。脂溶性维生素可以直接调节肠道对钙、草酸等结石相关物质的吸收效率,还可以通过影响肾脏内氧化应激水平、离子转运蛋白活性及维生素依赖蛋白功能,间接干预肾结石的形成,成为连接肠肾轴与肾结石发病机制的重要纽带。本文系统综述了4种脂溶性维生素(维生素A、D、E、K)的代谢特点,及其通过肠肾轴在“肠道吸收-物质转运-肾脏效应”中的发挥的作用,调控相关机制影响肾结石形成的过程,同时指出当前研究局限性及未来研究方向,为肾结石的预防与精准干预提供理论依据。

Kidney stones are a common urological condition, with calcium oxalate stones accounting for more than 75% of cases. Their pathogenesis is closely associated with metabolic imbalance in the body. The gut-kidney axis, as a key pathway for material exchange and signal transmission between the intestine and the kidney, plays a central role in regulating renal calcium metabolism, oxidative stress, and crystal adhesion. However, the regulatory function of the gut-kidney axis does not operate independently; rather, it relies on the synergistic effect of various active substances, among which fat-soluble vitamins are key regulatory factors. Fat-soluble vitamins can directly regulate the intestinal absorption efficiency of stone-related substances such as calcium and oxalic acid. They can also indirectly interfere with kidney stone formation by affecting renal oxidative stress levels, the activity of ion transporters, and the function of vitamin-dependent proteins, thus serving as an important link connecting the gut-kidney axis to the pathogenesis of kidney stones. This article systematically reviews the metabolic characteristics of four fat-soluble vitamins (A, D, E, and K), their roles in the "intestinal absorption-material transport-renal effect" process via the gut-kidney axis, and the mechanisms by which they regulate kidney stone formation. In addition, it highlights the limitations of current research and suggests future research directions, providing a theoretical basis for the prevention and precise intervention of kidney stones.

图1 (脂溶性维生素通过肠肾轴影响肾结石形成机制总览图)。本图以肠肾轴为核心,展示脂溶性维生素A、D、E、K经肠道吸收、与肠道菌群互作,并在肾脏发挥抗氧化、调控钙代谢及抑制晶体沉积等效应,进而影响肾结石发生的完整通路
图2 维生素D特异性通路简图。本图解析维生素D通路,维生素D经活化后结合VDR,调控肠道钙/草酸吸收,与PTH及肠道菌群互作,协同降低尿钙与尿草酸,抑制草酸钙晶体形成,发挥抗肾结石作用
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