藥物引發之尿路結石與結晶性腎病變

Drug-Induced Renal Stones and Crystalline Nephropathy

陳畇通(Yun-Tung Chen) ； 董淳武(Chun-Wu Tung) ； 林俊良(Chun-Liang Lin)

《腎臟與透析》 33卷1期 (2021/03) Pp. 1-5

https://doi.org/10.6340/KD.202103_33(1).0001

摘要

許多因素可造成腎臟結石，而其中1～2%是藥物引起的。機轉可分為兩大類：一是經腎臟代謝但溶解度差的藥物在尿液中結晶形成結石；二是藥物影響尿液的酸鹼度或代謝作用而形成的結石。大部分的藥物結石無法在X光上顯影，但可由腎臟超音波或無對比劑電腦斷層偵測，紅外線光譜儀與X光衍射分析可診斷含有藥物成分腎結石。藥物引發之尿路結石與結晶性腎病變的危險因子包含與病患和與藥物相關等兩類。考量病人現有藥物、尿液的pH值及飲水利尿是預防或治療結石的可靠方式。

關鍵字

尿路結石 ； 腎結石 ； 藥品相關副作用

並列摘要

There are many factors that may increase the risk of developing kidney stones. Among them, 1-2% are caused by drugs. The mechanism of drug-induced calculi may be divided into two groups. The first one includes poorly soluble drugs with high urine excretion and crystallized in the urine. The second group includes drugs that cause urinary calculi as a result of metabolic effects. Most drug-induced renal stones cannot be visualized on X-ray, but are detectable by renal sonography or non-contrast computed tomography. Infrared spectroscopy or X-ray diffraction is essential to identify drug-containing renal caliculi. The risk factors of drug-induced urinary calculi and crystal nephropathy include two types: patient-related and drug-related. Specific patient-dependent risk factors also exist in relation to urine pH, the volume of diuresis, and other factors, and thus providing a basis for preventive or curative measures against stone formation.

並列關鍵字

urinary caliculi ； nephrolithiasis ； drug-related side effects