注意,妊娠期可能增加肾结石发病风险!
创作:Epi汪 审核:Epi汪 05月07日
  • 纳入首次发生肾结石症状的女性945例,并匹配对照1890例;
  • 妊娠早期发生肾结石的风险无统计学变化,但是在妊娠中期肾结石发生风险增高2.0倍,而孕晚期进一步增加至2.69倍;
  • 在产后0-3个月,肾结石的风险仍增加3.53倍,但是产后1年恢复到基线水平;
  • 即使有怀孕史的女性,再次怀孕也会增加肾结石症状的风险;
  • 该观察性研究无法推断揭示确切的形成时间,只能观察到肾结石症状发作的时间;
  • 怀孕期间的肾结石风险增加对产前咨询很重要。
主编推荐语
Epi汪
近年来,女性的肾结石发病率有所增加,人们担心怀孕事件是否会增加肾结石的发病风险。该病例对照研究提示,女性在妊娠中后期、产后3个月内,其肾结石“发作”的风险都是增高的,但是其机制并不明确,也不清楚肾结石的发生与怀孕是否存在因果关联。但是很明显,对于具备肾结石高危因素的女性来说,怀孕期预防肾结石症状的发生对于产前咨询来说是非常重要的信息。
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Risk of Symptomatic Kidney Stones During and After Pregnancy

妊娠期间和妊娠后发生肾结石症状的风险

10.1053/j.ajkd.2021.01.008

04-15, Article

Abstract & Authors:展开

Abstract:收起
ationale & Objective: There are several wellknown anatomical and physiological changes during pregnancy that could contribute to kidney stone formation, but evidence that they increase the risk of kidney stones during pregnancy is lacking. We determined whether there was an increased risk of a first-time symptomatic
Study Design: A population-based matched case-control study.
Setting & Participants: 945 female first-time symptomatic kidney stone formers aged 15-45 years and 1,890 age-matched female controls in Olmsted County, MN, from 1984-2012. The index date was the date of onset of a symptomatic kidney stone for both the case and her matched controls.
Exposure: The primary exposure was pregnancy with assessment for variation in risk across different time intervals before, during, and after pregnancy. Medical records were manually reviewed to determine the conception and delivery dates for pregnancies.
Outcome: Medical record–validated first-time symptomatic kidney stone.
Analytical Approach: Conditional and unconditional multivariable logistic regression analysis.
Results: Compared with nonpregnant women, the odds of a symptomatic kidney stone forming in women was similar in the first trimester (OR, 0.92; P = 0.8), began to increase during the second trimester (OR, 2.00; P = 0.007), further increased during the third trimester (OR, 2.69; P = 0.001), peaked at 0 to 3 months after delivery(OR, 3.53; P < 0.001), and returned to baseline by 1 year after delivery. These associations persisted after adjustment for age and race or for diabetes mellitus, hypertension, and obesity. These results did not significantly differ by age, race, time period, or number of prior pregnancies. Having a prior pregnancy (delivery date > 1 year ago) was also associated with a first-time symptomatic kidney stone (OR, 1.27; P = 0.01).
Limitations&Conclusions: Observational study design in a predominantly White population. The exact timing of stone formation cannot be determined. Pregnancy increases the risk of a first-time symptomatic kidney stone. This risk peaks close to delivery and then improves by 1 year after delivery, though a modest risk of a kidney stone still exists beyond 1 year after delivery.

First Authors:
Charat Thongprayoon

Correspondence Authors:
Andrew D Rule

All Authors:
Charat Thongprayoon,Lisa E Vaughan,Api Chewcharat,Andrea G Kattah,Felicity T Enders,Rajiv Kumar,John C Lieske,Vernon M Pais,Vesna D Garovic,Andrew D Rule

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Medical Xpress新闻网站

Pregnancy increases kidney stone risk, study finds

2021-04-15

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