Retrospective analysis of susceptibility factors of magnesium ammonium phosphate stone, carbonate apatite and calcium oxalate stone_West China Medical Journal

Authors：

HU Xiao , LIAO Banghua , CHEN Yuntian ,  WEI Xin , WANG Kunjie , LI Hong

Department of Urology / Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

WEI Xin, Email: 183105347@qq.com

Keywords：

Infectious stones; Magnesium ammonium phosphate stone; Carbonate apatite; Metabolic syndrome

DOI：

10.7507/1002-0179.201809032

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Objective To investigate the differences in characteristics and susceptibility factors between infectious stones and calcium oxalate stones, and provide reference value for screening infectious stones in clinical work. Methods According to the results of analysis of stone components in the extracorporeal shock wave lithotripsy center of West China Hospital of Sichuan University between June 2014 and April 2017, 392 patients with infectious stones (including 56 patients with magnesium ammonium phosphate stones in group A and 336 patients with calcium carbonate apatite in group B) and 392 patients with calcium oxalate stone (group C) were selected to discuss the difference of clinical features by retrospectively analyzing the clinical data. Results The proportion of females, the long diameter of stones and the proportion of staghorn stones in group A [75.0%, (3.9±2.5) cm, 41.1%] were higher than those in group B [39.3%, (2.4±1.3) cm, 6.0%], and the proportion of females and the long diameter of stones in group A and B were larger than those in group C [30.1%, (1.9±0.7) cm]; the differences above were statistically significant (P<0.05). There was no significant difference among the three groups in surgically history or complicated factors of urinary tract such as ureteral stricture (P>0.05). The prevalences of diabetes, renal tubular acidosis and hyperlipidemia in patients with infectious stones were higher than those in group C. The prevalences of renal tubular acidosis and hyperlipidemia in group A (16.1%, 39.3%) were higher than those in group B (0.6%, 21.1%), the positive rate of urine culture in group A (58.9%) was higher than that in group B (20.5%), which were both higher than that in group C (8.9%); these differences were statistically significant (P<0.017). The bacteria cultured from urine were mainlyProteus mirabilis and Escherichia coli in group A, and Escherichia coli in group B and group C. Conclusion Patients with large volume of stones, complicated with diabetes, renal tubular acidosis, hyperlipidemia and positive urine culture are more likely to have infectious stones.

Citation： HU Xiao, LIAO Banghua, CHEN Yuntian, WEI Xin, WANG Kunjie, LI Hong. Retrospective analysis of susceptibility factors of magnesium ammonium phosphate stone, carbonate apatite and calcium oxalate stone. West China Medical Journal, 2018, 33(11): 1400-1405. doi: 10.7507/1002-0179.201809032 Copy

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2.	Bazin D, André G, Weil R, et al. Absence of bacterial imprints on struvite-containing kidney stones: a structural investigation at the mesoscopic and atomic scale. Urology, 2012, 79(4): 786-790.
3.	Williams JJ, Rodman JS, Peterson CM. A randomized double-blind study of acetohydroxamic acid in struvite nephrolithiasis. N Engl J Med, 1984, 311(12): 760-764.
4.	de Cógáin MR, Lieske JC, Vrtiska TJ, et al. Secondarily infected nonstruvite urolithiasis: a prospective evaluation. Urology, 2014, 84(6): 1295-1300.
5.	那彥群, 葉章群, 孫穎浩, 等. 中國泌尿外科疾病診斷治療指南. 北京: 人民衛生出版社, 2013: 95.
6.	Park HS, Lee SY, Kim SM, et al. Prevalence of the metabolic syndrome among Korean adults according to the criteria of the International Diabetes Federation. Diabetes Care, 2006, 29(4): 933-934.
7.	Bichler KH, Eipper E, Naber K, et al. Urinary infection stones. Int J Antimicrob Agents, 2002, 19(6): 488-498.
8.	Hesse A, Heimbach D. Causes of phosphate stone formation and the importance of metaphylaxis by urinary acidification: a review. World J Urol, 1999, 17(5): 308-315.
9.	葉章群. 泌尿系結石研究現況與展望. 中華實驗外科雜志, 2005, 22(3): 261-262.
10.	Flannigan R, Choy WH, Chew B, et al. Renal struvite stones: pathogenesis, microbiology, and management strategies. Nat Rev Urol, 2014, 11(6): 333-341.
11.	Usui Y, Matsuzaki S, Matsushita K, et al. Urolithiasis in geriatric patients. Tokai J Exp Clin Med, 2003, 28(2): 81-87.
12.	Krambeck AE, Lieske JC, Li X, et al. Effect of age on the clinical presentation of incident symptomatic urolithiasis in the general population. J Urol, 2013, 189(1): 158-164.
13.	Bichler KH, Henzler B, Strohmaier WL, et al. The significance of citrate, uromucoid and GAG for diagnosis of renal tubular acidosis in patients with urinary calculi. Urologe A, 1995, 34(6): 437-443.
14.	Tefekli A, Kurtoglu H, Tepeler K, et al. Does the metabolic syndrome or its components affect the outcome of percutaneous nephrolithotomy?. J Endourol, 2008, 22(1): 35-40.
15.	Jeong IG, Kang T, Bang JK, et al. Association between metabolic syndrome and the presence of kidney stones in a screened population. Am J Kidney Dis, 2011, 58(3): 383-388.
16.	Taylor EN, Stampfer MJ, Obesity CG, et al. Obesity, weight gain, and the risk of kidney stones. JAMA, 2005, 293(4): 455-462.
17.	Ando R, Suzuki S, Nagaya T, et al. Impact of insulin resistance, insulin and adiponectin on kidney stones in the Japanese population. Int J Urol, 2011, 18(2): 131-138.
18.	Sakhaee K, Maalouf NM. Metabolic syndrome and uric acid nephrolithiasis. Semin Nephrol, 2008, 28(2): 174-180.
19.	Cho ST, Jung SI, Myung SC, et al. Correlation of metabolic syndrome with urinary stone composition. Int J Urol, 2013, 20(2): 208-213.
20.	Jung HS, Chang IH, Kim KD, et al. Possible relationship between metabolic syndrome traits and nephrolithiasis: incidence for 15 years according to gender. Korean J Urol, 2011, 52(8): 548-553.
21.	Wilding JP. The role of the kidneys in glucose homeostasis in type 2 diabetes: clinical implications and therapeutic significance through sodium glucose co-transporter 2 inhibitors. Metabolism, 2014, 63(10): 1228-1237.
22.	Cameron MA, Maalouf NM, Adams-Huet B, et al. Urine composition in type 2 diabetes: predisposition to uric acid nephrolithiasis. J Am Soc Nephrol, 2006, 17(5): 1422-1428.
23.	Wilke T, B?ttger B, Berg B, et al. Healthcare burden and costs associated with urinary tract infections in type 2 diabetes mellitus patients: an analysis based on a large sample of 456,586 German patients. Nephron, 2016, 132(3): 215-226.
24.	Remer T. Influence of nutrition on acid-base balance: metabolic aspects. Eur J Nutr, 2001, 40(5): 214-220.
25.	Cicerello E, Mangano M, Cova GD, et al. Metabolic evaluation in patients with infected nephrolithiasis: is it necessary?. Arch Ital Urol Androl, 2016, 88(3): 208-211.
26.	Nishio S, Abe Y, Wakatsuki A, et al. Matrix glycosaminoglycan in urinary stones. J Urol, 1985, 134(3): 503-505.
27.	Iida S, Suzuki K, Matsuoka K, et al. Analysis of glycosaminoglycans in human prostate by high-performance liquid chromatography. Br J Urol, 1997, 79(5): 763-769.
28.	Torzewska A, Ró?alski A. In vitro studies on the role of glycosaminoglycans in crystallization intensity during infectious urinary stones formation. APMIS, 2014, 122(6): 505-511.
29.	Englert KM, Mcateer JA, Lingeman JE, et al. High carbonate level of apatite in kidney stones implies infection, but is it predictive?. Urolithiasis, 2013, 41(5): 389-394.
30.	唐寅, 程鴻明, 王坤杰, 等. 四川省 243 例泌尿系結石成分及相關因素分析. 現代泌尿外科雜志, 2016, 21(1): 27-30.
31.	徐勛, 趙振華, 石明, 等. 1168 例泌尿系結石患者結石成分分析及其飲食預防指導. 臨床泌尿外科雜志, 2014(8): 694-696.
32.	張銳, 楚寧, 梁凱, 等. 黑龍江省 628 例尿路結石成分分析. 臨床泌尿外科雜志, 2016(8): 737-739.

1. Preminger GM, Assimos DG, Lingeman JE, et al. Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol, 2005, 173(6): 1991-2000.
2. Bazin D, André G, Weil R, et al. Absence of bacterial imprints on struvite-containing kidney stones: a structural investigation at the mesoscopic and atomic scale. Urology, 2012, 79(4): 786-790.
3. Williams JJ, Rodman JS, Peterson CM. A randomized double-blind study of acetohydroxamic acid in struvite nephrolithiasis. N Engl J Med, 1984, 311(12): 760-764.
4. de Cógáin MR, Lieske JC, Vrtiska TJ, et al. Secondarily infected nonstruvite urolithiasis: a prospective evaluation. Urology, 2014, 84(6): 1295-1300.
5. 那彥群, 葉章群, 孫穎浩, 等. 中國泌尿外科疾病診斷治療指南. 北京: 人民衛生出版社, 2013: 95.
6. Park HS, Lee SY, Kim SM, et al. Prevalence of the metabolic syndrome among Korean adults according to the criteria of the International Diabetes Federation. Diabetes Care, 2006, 29(4): 933-934.
7. Bichler KH, Eipper E, Naber K, et al. Urinary infection stones. Int J Antimicrob Agents, 2002, 19(6): 488-498.
8. Hesse A, Heimbach D. Causes of phosphate stone formation and the importance of metaphylaxis by urinary acidification: a review. World J Urol, 1999, 17(5): 308-315.
9. 葉章群. 泌尿系結石研究現況與展望. 中華實驗外科雜志, 2005, 22(3): 261-262.
10. Flannigan R, Choy WH, Chew B, et al. Renal struvite stones: pathogenesis, microbiology, and management strategies. Nat Rev Urol, 2014, 11(6): 333-341.
11. Usui Y, Matsuzaki S, Matsushita K, et al. Urolithiasis in geriatric patients. Tokai J Exp Clin Med, 2003, 28(2): 81-87.
12. Krambeck AE, Lieske JC, Li X, et al. Effect of age on the clinical presentation of incident symptomatic urolithiasis in the general population. J Urol, 2013, 189(1): 158-164.
13. Bichler KH, Henzler B, Strohmaier WL, et al. The significance of citrate, uromucoid and GAG for diagnosis of renal tubular acidosis in patients with urinary calculi. Urologe A, 1995, 34(6): 437-443.
14. Tefekli A, Kurtoglu H, Tepeler K, et al. Does the metabolic syndrome or its components affect the outcome of percutaneous nephrolithotomy?. J Endourol, 2008, 22(1): 35-40.
15. Jeong IG, Kang T, Bang JK, et al. Association between metabolic syndrome and the presence of kidney stones in a screened population. Am J Kidney Dis, 2011, 58(3): 383-388.
16. Taylor EN, Stampfer MJ, Obesity CG, et al. Obesity, weight gain, and the risk of kidney stones. JAMA, 2005, 293(4): 455-462.
17. Ando R, Suzuki S, Nagaya T, et al. Impact of insulin resistance, insulin and adiponectin on kidney stones in the Japanese population. Int J Urol, 2011, 18(2): 131-138.
18. Sakhaee K, Maalouf NM. Metabolic syndrome and uric acid nephrolithiasis. Semin Nephrol, 2008, 28(2): 174-180.
19. Cho ST, Jung SI, Myung SC, et al. Correlation of metabolic syndrome with urinary stone composition. Int J Urol, 2013, 20(2): 208-213.
20. Jung HS, Chang IH, Kim KD, et al. Possible relationship between metabolic syndrome traits and nephrolithiasis: incidence for 15 years according to gender. Korean J Urol, 2011, 52(8): 548-553.
21. Wilding JP. The role of the kidneys in glucose homeostasis in type 2 diabetes: clinical implications and therapeutic significance through sodium glucose co-transporter 2 inhibitors. Metabolism, 2014, 63(10): 1228-1237.
22. Cameron MA, Maalouf NM, Adams-Huet B, et al. Urine composition in type 2 diabetes: predisposition to uric acid nephrolithiasis. J Am Soc Nephrol, 2006, 17(5): 1422-1428.
23. Wilke T, B?ttger B, Berg B, et al. Healthcare burden and costs associated with urinary tract infections in type 2 diabetes mellitus patients: an analysis based on a large sample of 456,586 German patients. Nephron, 2016, 132(3): 215-226.
24. Remer T. Influence of nutrition on acid-base balance: metabolic aspects. Eur J Nutr, 2001, 40(5): 214-220.
25. Cicerello E, Mangano M, Cova GD, et al. Metabolic evaluation in patients with infected nephrolithiasis: is it necessary?. Arch Ital Urol Androl, 2016, 88(3): 208-211.
26. Nishio S, Abe Y, Wakatsuki A, et al. Matrix glycosaminoglycan in urinary stones. J Urol, 1985, 134(3): 503-505.
27. Iida S, Suzuki K, Matsuoka K, et al. Analysis of glycosaminoglycans in human prostate by high-performance liquid chromatography. Br J Urol, 1997, 79(5): 763-769.
28. Torzewska A, Ró?alski A. In vitro studies on the role of glycosaminoglycans in crystallization intensity during infectious urinary stones formation. APMIS, 2014, 122(6): 505-511.
29. Englert KM, Mcateer JA, Lingeman JE, et al. High carbonate level of apatite in kidney stones implies infection, but is it predictive?. Urolithiasis, 2013, 41(5): 389-394.
30. 唐寅, 程鴻明, 王坤杰, 等. 四川省 243 例泌尿系結石成分及相關因素分析. 現代泌尿外科雜志, 2016, 21(1): 27-30.
31. 徐勛, 趙振華, 石明, 等. 1168 例泌尿系結石患者結石成分分析及其飲食預防指導. 臨床泌尿外科雜志, 2014(8): 694-696.
32. 張銳, 楚寧, 梁凱, 等. 黑龍江省 628 例尿路結石成分分析. 臨床泌尿外科雜志, 2016(8): 737-739.

West China Medical Journal

Retrospective analysis of susceptibility factors of magnesium ammonium phosphate stone, carbonate apatite and calcium oxalate stone

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