The analysis of urolithiasis incidence in the contralateral kidney of unilateral nephrectomy patients

目的 探讨单侧肾切除术后对侧肾脏成石状况及特点.方法 回顾性分析2010年6月至2016年6月收治的1 048例行单侧肾切除术患者的病例资料.男596例,女452例.肾切除时年龄16 ～ 87岁,平均58.7岁.213例合并代谢综合征,532例合并代谢综合征组分.164例既往有泌尿系结石病史.对1 048例患者术后对侧肾脏的成石状况进行随访,分析对侧肾脏继发结石的特点,比较不同性别、年龄、合并症和泌尿系结石既往史患者肾切除术后对侧肾脏的成石差异.结果 本研究1 048例患者随访0.5 ～6.0年,平均3.2年.89例术后对侧肾脏发生结石,发生率为8.5％,高于我国普通人群泌尿系结石的发生率(1％～5％).男性和女性肾切除后对侧肾脏结石的发生率分别为9.1％(54/596)和7.7％ (35/452).＜30岁者肾切除后对侧肾脏结石的发生率为8.6％(3/35);30 ～49岁者为12.5％(34/272);50 ～69岁者为7.3％(37/504);≥70岁者为6.3％(15/237).合并代谢综合征组分者肾切除后对侧肾脏结石的发生率为12.2％(65/532),合并代谢综合征者的发生率为19.7％ (42/213),不合并代谢综合征组分者的发生率为4.7％(24/516).既往有泌尿系结石病史者肾切除后对侧肾脏结石的发生率为30.5％(50/164),既往无泌尿系结石病史者为4.4％(39/884).结论 单侧肾切除术后对侧肾脏结石形成的风险增加,合并代谢综合征及既往有泌尿系结石病史者尤为明显.Objective To analyze the incidence of urinary stone formation in the contralateral kidney of unilateral nephrectomy patients.Methods 1048 patients,including 596 males and 452 females,underwent unilateral nephrectomy from June 2010 to June 2016.Their age ranged from 16-87 years old (mean 58.7 years old).532 patients combined with components of metabolic syndrome and 213 patients with metabolic syndrome.164 patients had a previous history of urolithiasis.The incidence of urinary stone formation in the contralateral kidney after nephrectomy was recorded and analyzed.The urolithiasis incidences in different gender,age,comorbidity and history of urolithiasis patients after uninephrectomy were compared.Results All patients were followed up within 0.5 to 6 years (mean 3.2 years).89 patients suffered from urinary stones in the contralateral kidney after uninephrectomy.The incidence of urinary stone formation in the contralateral kidney was 8.5％ (89/1048),which was higher than that in general population of China.1％-5％.The urolithiasis incidence was 9.1％ (54/596)in male patients and 7.7％ (35/452)in female patients after nephrectomy.The incidence of urinary stone formation was 8.6％ (3/35)in patients aged under 30 years old,12.5％ (34/272) in patients aged 30-49 years old,7.3％ (37/504) in patients aged 50-69 years old,6.3％ (15/237)in patients aged 70 and over.The incidence of urinary stone formation was 12.2％ (65/532) in patients with components of metabolic syndrome after nephrectomy and 19.7％ (42/213) in patients with metabolic syndrome,while the incidence was 4.7％ (24/516)in patients without components of metabolic syndrome.In patients with history of urolithiasis,the incidence was up to 30.5％ (50/164) after nephrectomy,while 4.4％ (39/884)in patients without history of urolithiasis.Conclusions The incidence of urinary stone formation in the contralateral kidney of uninephrectomy patients was higher,especially in patients with metabolic syndrome or urolithiasis history.Patients after unilateral nephrectomy are more vulnerable to urolithiasis.Jiangxi Engineering Research Center for Prevention and Treatment of Urolithiasis Program from the Department of Science and Technology of Jiangxi Province in China (S2016PTGCD0041)江西省结石防治工程技术研究中心建设项目9683-6863