Biochemical and Hemodynamic Characterization of Nephrolithiasis Patients visiting National Transplant Centre, Bhaktapur, Nepal

B. Katwal, N. Gautam, Sujata Shrestha, Lushan Singh, R. Gautam, Rojan Adhikari, H. Baral, S. Jha, Goody Jha
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Abstract

In present scenario, nephrolithiasis (renal stones) are more prevalent and highly related with morbidity worldwide. The aim of the study is to associate different biochemical and hemodynamic parameters of renal stones and to see post-operative outcomes. Hundred patients from January 2019 to January 2021 having renal stone in ultrasonography at Shahid Dharmbhakta National Transplant Centre Bhaktapur are included in the study. All variables are measured following the standard protocol. Nephrolithiasis was found to be frequent in male population (60%) who has a habit of regular alcohol intake (65%, p=0.009) and mixed dietary habit (mostly non-vegetarians) (92%, p= 0.042). Calcium oxalate either solely (21%) or mixed type (41%) were higher in proportion. The most common dyslipidemia in recurrent cases were hypercholesterolemia and increased LDL (p<0.001). The significant increase in serum urea (p=0.006) and creatinine (p=0.004) signify decrease in eGFR (p=0.007). Serum creatinine with IQR (1-2.5 mg/dl) was noticed significantly higher in others stone group V in contrast to mixed calcium containing stones group IV. Hydronephrosis was seen in 96% of patient, 7% developed post-operative complication comprising 57% haematuria, 28.5% wound infection and 14.5 % chest infection. Biochemical and hemodynamic parameters should be incorporated in nephrolithiasis to rule out risk of dyslipidemia, chronic kidney disorder and stratify the risk group based on stone composition.
尼泊尔巴克塔普尔国家移植中心肾结石患者的生化和血流动力学特征
在目前的情况下,肾结石(肾结石)在世界范围内更为普遍,并且与发病率高度相关。本研究的目的是将肾结石的不同生化和血液动力学参数联系起来,并观察术后结果。该研究包括2019年1月至2021年1月在巴克塔普尔Shahid Dharmbhakta国家移植中心接受超声检查的100名肾结石患者。所有变量均按照标准方案进行测量。肾结石在有规律饮酒习惯(65%,p=0.009)和混合饮食习惯(大多数是非素食者)(92%,p=0.042)的男性人群(60%)中很常见。草酸钙单独(21%)或混合型(41%)的比例更高。复发病例中最常见的血脂异常是高胆固醇血症和低密度脂蛋白增加(p<0.001)。血清尿素(p=0.006)和肌酐(p=0.002)的显著增加表明eGFR降低(p=0.005)。与混合含钙结石组IV相比,其他结石组V的IQR(1-2.5 mg/dl)血清肌酐显著升高。96%的患者出现肾积水,7%的患者出现术后并发症,包括57%的血尿、28.5%的伤口感染和14.5%的胸部感染。肾结石应纳入生化和血液动力学参数,以排除血脂异常、慢性肾脏疾病的风险,并根据结石成分对风险组进行分层。
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