רקע מדעי ומטרה:

Nephrolithiasis (kidney stones) is associated with renal function impairment. Diabetes mellitus may exacerbate kidney damage following nephrolithiasis episodes, and stone composition might further influence renal outcomes. However, the interaction between diabetes and stone type regarding kidney function decline remains understudied.
The study aimed to investigate the impact of diabetes status and kidney stones' composition on kidney function deterioration among patients with nephrolithiasis.

שיטות:

A retrospective cohort analysis was performed using electronic medical records over a period of ten years, involving kidney stones composition analysis. Kidney function deterioration was evaluated using at least two measures: (1) Glomerular filtration rate's (GFR) Delta, the difference between the GFR after stone passage and latest GFR during the study's time. (2) GFR's chronological decline, from pre-stone diagnosis to the most recent measurement. Non-parametric tests (Wilcoxon rank-sum and Kruskal-Wallis) compared kidney function deterioration across diabetes status and stone composition groups.

תוצאות:

Between 2010 and 2023, 7,556 stone analyses from 6,300 individuals were included. Significant differences in kidney function deterioration were found between diabetic and non-diabetic patients, particularly prominent in specific stone types. Diabetic patients had a lower GFR throughout the follow-up period, yet the rate of decline was higher in non-diabetics (p<0.05). A comparison of calcium oxalate and uric acid stones related GFR deterioration, showed a statistically significant deterioration for patients with calcium oxalate calculi.

מסקנות:

Diabetes and specific stone types , (calcium oxalate) were identified as renal function risk factors in nephrolithiasis patients.

חשיבות לרפואת המשפחה:

Clinical practice should prioritize management strategies to mitigate long-term kidney damage effectively post nephrolithiasis.