Clinical Features and Associated Factors of Asymptomatic Nephrolithiasis/Nephrocalcinosis in Primary Aldosteronism
Background Urinary calculi in primary aldosteronism (PA) have been studied almost only in case reports, and most of which have been reported to be associated with nephrolithiasis. Literature review demonstrates that there are few reports on the prevalence, clinical characteristics and possible causa...
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Chinese General Practice Publishing House Co., Ltd
2022-07-01
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| Series: | Zhongguo quanke yixue |
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| Online Access: | https://www.chinagp.net/fileup/1007-9572/PDF/zx20220232.pdf |
| _version_ | 1797217187585327104 |
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| author | Xu CAO, Xianjun ZHU, Yan YANG, Nie TANG, Limei LIU, Hui ZHOU, Lei ZHANG, Ying ZHU, Yi YANG, Wei XIA, Youren LIU |
| author_facet | Xu CAO, Xianjun ZHU, Yan YANG, Nie TANG, Limei LIU, Hui ZHOU, Lei ZHANG, Ying ZHU, Yi YANG, Wei XIA, Youren LIU |
| author_sort | Xu CAO, Xianjun ZHU, Yan YANG, Nie TANG, Limei LIU, Hui ZHOU, Lei ZHANG, Ying ZHU, Yi YANG, Wei XIA, Youren LIU |
| collection | DOAJ |
| description | Background Urinary calculi in primary aldosteronism (PA) have been studied almost only in case reports, and most of which have been reported to be associated with nephrolithiasis. Literature review demonstrates that there are few reports on the prevalence, clinical characteristics and possible causative factors of asymptomatic nephrolithiasis/nephrocalcinosis in PA. Objective To investigate clinical features and possible causative factors of asymptomatic nephrolithiasis/nephrocalcinosis in primary aldosteronism patients in Sichuan. Methods In this retrospective study, we enrolled 147 PA patients from Department of Endocrinology, Sichuan Provincial People's Hospital from January 2017 to April 2021, including 34 also with asymptomatic nephrolithiasis/nephrocalcinosis and 113 patients with PA alone. Clinical data were collected, including sex, age, duration of hypertension, duration of hypokalemia, the lowest serum potassium level in medical history, abnormal glucose metabolism, smoking history, drinking history, systolic blood pressure at admission, diastolic blood pressure at admission, body mass index, waist circumference, estimated glomerular filtration rate (eGFR) , fasting blood glucose, serum uric acid, total protein, albumin, potassium, sodium, calcium, magnesium, phosphorus, carbon dioxide, pH value, bicarbonate (HCO3) , total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, and glycated hemoglobin, plasma aldosterone concentration, direct renin concentration, and aldosterone-renin ratio in upright posture, serum 25 hydroxyvitamin D, and parathyroid hormone (PTH) , 24-hour urinary electrolyte excretion (K, Na, Ca, Mg, P) , urine microalbumin to creatinine ratio, and urinary pH value. Binary Logistic regression analysis was used to explore the independent risk factors of asymptomatic nephrolithiasis/nephrocalcinosis in PA. Results Compared with patients with PA alone, those also with asymptomatic nephrolithiasis/nephrocalcinosis had higher proportion of males, previous or current smokers, and previous or current drinkers, higher mean levels of serum pH value, HCO3 and PTH, longer mean duration of hypertension, as well as lower eGFR (P<0.05) . Binary Logistic regression analysis showed that serum PTH level〔OR=1.009, 95%CI (1.001, 1.017) , P=0.034〕 was associated with asymptomatic nephrolithiasis/nephrocalcinosis in PA. Conclusion Clinical features manifested by PA patients with asymptomatic nephrolithiasis/nephrocalcinosis are as follows: male predominate, longer duration of hypertension, higher rates of smoking and alcohol consumption, and higher serum pH, HCO3 and PTH levels. Elevated serum PTH level or secondary hyperparathyroidism may be associated with increased risk of asymptomatic nephrolithiasis/nephrocalcinosis in PA. |
| first_indexed | 2024-04-24T11:57:52Z |
| format | Article |
| id | doaj.art-a56f6379a9514668b06739a09ec1f19d |
| institution | Directory Open Access Journal |
| issn | 1007-9572 |
| language | zho |
| last_indexed | 2024-04-24T11:57:52Z |
| publishDate | 2022-07-01 |
| publisher | Chinese General Practice Publishing House Co., Ltd |
| record_format | Article |
| series | Zhongguo quanke yixue |
| spelling | doaj.art-a56f6379a9514668b06739a09ec1f19d2024-04-09T03:41:43ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722022-07-0125212635263910.12114/j.issn.1007-9572.2022.0232Clinical Features and Associated Factors of Asymptomatic Nephrolithiasis/Nephrocalcinosis in Primary AldosteronismXu CAO, Xianjun ZHU, Yan YANG, Nie TANG, Limei LIU, Hui ZHOU, Lei ZHANG, Ying ZHU, Yi YANG, Wei XIA, Youren LIU0Department of Endocrinology, Sichuan Provincial People's Hospital/Sichuan Academy of Medical Sciences, Chengdu 610072, ChinaBackground Urinary calculi in primary aldosteronism (PA) have been studied almost only in case reports, and most of which have been reported to be associated with nephrolithiasis. Literature review demonstrates that there are few reports on the prevalence, clinical characteristics and possible causative factors of asymptomatic nephrolithiasis/nephrocalcinosis in PA. Objective To investigate clinical features and possible causative factors of asymptomatic nephrolithiasis/nephrocalcinosis in primary aldosteronism patients in Sichuan. Methods In this retrospective study, we enrolled 147 PA patients from Department of Endocrinology, Sichuan Provincial People's Hospital from January 2017 to April 2021, including 34 also with asymptomatic nephrolithiasis/nephrocalcinosis and 113 patients with PA alone. Clinical data were collected, including sex, age, duration of hypertension, duration of hypokalemia, the lowest serum potassium level in medical history, abnormal glucose metabolism, smoking history, drinking history, systolic blood pressure at admission, diastolic blood pressure at admission, body mass index, waist circumference, estimated glomerular filtration rate (eGFR) , fasting blood glucose, serum uric acid, total protein, albumin, potassium, sodium, calcium, magnesium, phosphorus, carbon dioxide, pH value, bicarbonate (HCO3) , total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, and glycated hemoglobin, plasma aldosterone concentration, direct renin concentration, and aldosterone-renin ratio in upright posture, serum 25 hydroxyvitamin D, and parathyroid hormone (PTH) , 24-hour urinary electrolyte excretion (K, Na, Ca, Mg, P) , urine microalbumin to creatinine ratio, and urinary pH value. Binary Logistic regression analysis was used to explore the independent risk factors of asymptomatic nephrolithiasis/nephrocalcinosis in PA. Results Compared with patients with PA alone, those also with asymptomatic nephrolithiasis/nephrocalcinosis had higher proportion of males, previous or current smokers, and previous or current drinkers, higher mean levels of serum pH value, HCO3 and PTH, longer mean duration of hypertension, as well as lower eGFR (P<0.05) . Binary Logistic regression analysis showed that serum PTH level〔OR=1.009, 95%CI (1.001, 1.017) , P=0.034〕 was associated with asymptomatic nephrolithiasis/nephrocalcinosis in PA. Conclusion Clinical features manifested by PA patients with asymptomatic nephrolithiasis/nephrocalcinosis are as follows: male predominate, longer duration of hypertension, higher rates of smoking and alcohol consumption, and higher serum pH, HCO3 and PTH levels. Elevated serum PTH level or secondary hyperparathyroidism may be associated with increased risk of asymptomatic nephrolithiasis/nephrocalcinosis in PA.https://www.chinagp.net/fileup/1007-9572/PDF/zx20220232.pdfhyperaldosteronism|kidney calculi|nephrocalcinosis|disease attributes|root cause analysis |
| spellingShingle | Xu CAO, Xianjun ZHU, Yan YANG, Nie TANG, Limei LIU, Hui ZHOU, Lei ZHANG, Ying ZHU, Yi YANG, Wei XIA, Youren LIU Clinical Features and Associated Factors of Asymptomatic Nephrolithiasis/Nephrocalcinosis in Primary Aldosteronism Zhongguo quanke yixue hyperaldosteronism|kidney calculi|nephrocalcinosis|disease attributes|root cause analysis |
| title | Clinical Features and Associated Factors of Asymptomatic Nephrolithiasis/Nephrocalcinosis in Primary Aldosteronism |
| title_full | Clinical Features and Associated Factors of Asymptomatic Nephrolithiasis/Nephrocalcinosis in Primary Aldosteronism |
| title_fullStr | Clinical Features and Associated Factors of Asymptomatic Nephrolithiasis/Nephrocalcinosis in Primary Aldosteronism |
| title_full_unstemmed | Clinical Features and Associated Factors of Asymptomatic Nephrolithiasis/Nephrocalcinosis in Primary Aldosteronism |
| title_short | Clinical Features and Associated Factors of Asymptomatic Nephrolithiasis/Nephrocalcinosis in Primary Aldosteronism |
| title_sort | clinical features and associated factors of asymptomatic nephrolithiasis nephrocalcinosis in primary aldosteronism |
| topic | hyperaldosteronism|kidney calculi|nephrocalcinosis|disease attributes|root cause analysis |
| url | https://www.chinagp.net/fileup/1007-9572/PDF/zx20220232.pdf |
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