Composition and prevention of urinary tract stones: analysis of 410 cases

doi:10.3877/cma.j.issn.1674-0785.2024.12.007

Abstract

Abstract:

Objective

To explore the composition of urinary tract stones and analyze their correlation with clinical characteristics, so as to provide scientific basis and precise strategic guidance for effective prevention and treatment of urinary tract stones.

Methods

A total of 410 patients with urinary tract stones who have been living in Xiaodian District, Taiyuan, Shanxi Province for a long time and treated at Peking University First Hospital Taiyuan Hospital from December 2022 to August 2024 were included as the observation group, and 410 healthy individuals who underwent physical examination during the same period were included as the control group. The general information such as age, gender, body mass index(BMI), and daily water intake was compared between 2 groups. Infrared spectroscopy was used to detect the chemical composition of urinary stones in the observation group. Multiple logistic regression analysis was conducted to identify the risk factors for urinary stones. Data from both stone patients and non-stone patients were collected for analysis of influencing factors of 24-hour urinary stone formation.

Results

The contents of citric acid, potassium, and magnesium in the observation group were significantly lower than those of the control group, while the concentrations of oxalic acid, uric acid, calcium, and phosphorus were significantly higher than those of the control group (P＜0.05). Calcium oxalate and carbonate apatite had the highest detection rates, while uric acid, magnesium ammonium phosphate, and calcium hydrogen phosphate had relatively lower detection rates. Multivariate logistic regression analysis showed that BMI, diet with wholesheep soup, daily water intake＜1 L, frequent alcohol consumption, and lack of exercise were independent risk factors for urinary tract stones (P＜0.05). The citric acid level in the stone group was significantly lower than that of the non-stone group, and the potassium content was significantly higher than that of the non-stone group (P＜0.05), indicating that low citric acid and high potassium are independent influencing factors for 24-hour urinary stone formation.

Conclusions

The chemical component of urinary tract stones in patients with urinary tract stones in Xiaodian District, Taiyuan, Shanxi is mainly calcium oxalate, which is more common in the upper urinary tract. Low citric acid and high potassium are independent factors affecting 24-hour urinary stone formation. The occurrence of urinary tract stones is related to various factors such as high BMI, low water intake, diet with whole-sheep soup, and insufficient exercise. Early preventive intervention measures are beneficial for the treatment guidance and prevention of urinary tract stones.

Key words: Urinary tract stones, Stone components, Calcium oxalate, Carbonate apatite

Yingzhong Yang, Yefei Zhang, Yanbin Liu, Haigang Sun, Xiaohe Chai, Meili Guo, Ran Zhang, Guan Gao. Composition and prevention of urinary tract stones: analysis of 410 cases[J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(12): 1118-1124.

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Figures/Tables 4

项目	观察组（n=410）	对照组（n=410）	χ ² 值	P 值
性别[ 例（%）]			0.050	0.822
男性	280（68.29）	277（67.56）
女性	130（31.71）	133（32.44）
BMI[ 例（%）]			8.497	＜0.001
＜18.5 kg/m²	16（3.90）	37（9.03）
18.5～24.9 kg/m²	193（47.07）	288（70.24）
≥ 25 kg/m²	201（49.02）	85（20.73）
每日饮水量[ 例（%）]			9.059	＜0.001
＜1 L	235（57.32）	88（21.46）
1～2 L	116（28.29）	233（56.83）
＞2 L	59（14.39）	89（21.71）
羊汤、牺汤饮食[ 例（%）]			72.006	＜0.001
是（平均每周一次）	284（69.27）	163（39.76）
否（少于平均每周一次）	126（30.73）	247（60.24）
运动锻炼情况[ 例（%）]			12.921	＜0.001
0 次/ 周	170（41.46）	31（7.56）
1～2 次/ 周	125（30.49）	68（16.59）
3～4 次/ 周	66（16.10）	210（51.22）
5 次及以上/ 周	49（11.95）	101（24.63）

结石成分	例数	占比（%）
单纯性结石	223	54.39
草酸钙	115	28.05
碳酸磷灰石	43	10.49
磷酸氢钙	34	8.29
尿酸	15	3.66
磷酸镁铵	10	2.44
尿酸铵	6	1.46
混合性结石	187	45.61
草酸钙+ 碳酸磷灰石	72	17.56
草酸钙+ 尿酸	45	10.98
草酸钙+ 碳酸磷灰石+ 磷酸镁铵	32	7.80
草酸钙+ 磷酸镁铵	21	5.12
碳酸磷灰石+ 磷酸镁铵	17	4.15

自变量	β	SE	Waldχ² 值	P 值	OR 值	95%CI 值
BMI	0.484	0.010	68.569	＜0.001	0.920	0.902～0.938
羊汤、牺汤饮食	0.497	0.220	5.104	0.021	1.644	1.068～2.531
每日饮水量＜1 L	0.622	0.152	16.839	＜0.001	1.863	1.384～2.508
运动锻炼缺乏	0.728	0.173	17.708	＜0.001	2.071	1.475～2.907
常量	4.474	0.440	103.238	＜0.001	87.740	-

组别	例数	柠檬酸（μmol/ml， $\overset{ˉ}{x}$ ±s）	草酸（μmol/ml， $\overset{ˉ}{x}$ ±s）	尿酸（mg/L， $\overset{ˉ}{x}$ ±s）	钠（mmol/L， $\overset{ˉ}{x}$ ±s）	钾（mmol/L， $\overset{ˉ}{x}$ ±s）	钙（mmol/L， $\overset{ˉ}{x}$ ±s）	磷（mmol/L， $\overset{ˉ}{x}$ ±s）	镁（mmol/L， $\overset{ˉ}{x}$ ±s）
结石组	79	1.84±2.02	14.24±8.92	329.35±194.98	118.64±43.36	58.88±31.01	2.38±0.80	3.86±1.36	0.98±0.50
非结石组	100	2.48±2.24	14.95±8.40	324.90±171.71	123.80±47.99	49.89±25.62	2.53±0.91	4.14±1.13	1.11±0.63
t 值		1.981	0.546	0.162	0.745	2.114	1.154	1.504	1.499
P 值		0.049	0.586	0.871	0.457	0.036	0.250	0.134	0.136

组别	例数	柠檬酸（μmol/ml， $\overset{ˉ}{x}$ ±s）	草酸（μmol/ml， $\overset{ˉ}{x}$ ±s）	尿酸（mg/L， $\overset{ˉ}{x}$ ±s）	钠（mmol/L， $\overset{ˉ}{x}$ ±s）	钾（mmol/L， $\overset{ˉ}{x}$ ±s）	钙（mmol/L， $\overset{ˉ}{x}$ ±s）	磷（mmol/L， $\overset{ˉ}{x}$ ±s）	镁（mmol/L， $\overset{ˉ}{x}$ ±s）
结石组	79	1.84±2.02	14.24±8.92	329.35±194.98	118.64±43.36	58.88±31.01	2.38±0.80	3.86±1.36	0.98±0.50
非结石组	100	2.48±2.24	14.95±8.40	324.90±171.71	123.80±47.99	49.89±25.62	2.53±0.91	4.14±1.13	1.11±0.63
t 值		1.981	0.546	0.162	0.745	2.114	1.154	1.504	1.499
P 值		0.049	0.586	0.871	0.457	0.036	0.250	0.134	0.136

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