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Comparative risk of chronic kidney diseases in patients with urolithiasis and urological interventions: a longitudinal population-based study

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Abstract

Large cohort studies on whether any association existed between urological interventions for urolithiasis and the development of CKD are lacking. From claims data of the National Health Insurance (NHI) program of Taiwan, we identified 54,433 patients newly diagnosed with urolithiasis during 1998–2010. For each case, four individuals without urolithiasis were randomly selected and frequency matched by age, sex, and diagnosis year. Both groups were followed up until the end of 2010. Incident CKD events were identified by the International Classification of Diseases, Ninth Revision (ICD-9) code in the NHI registration database. The overall incidence of periodontal diseases was 1.85-fold greater in the urolithiasis group than in the comparison group (33.9 vs 18.3 per 10,000 person-years; 95 % confidence interval [CI] 1.81–1.90). Compared with the adjusted hazard ratios (aHRs) of nonurolithiasis patients, those of patients with urolithiasis increased with the number of medical visits (from 0.91 [95 % CI 0.83–1.00] to 10.6 [95 % CI 9.48–11.8]) and urological interventions (from 1.22 [95 % CI 1.10–1.35] to 86.4 [95 % CI 67.6–110.6]). The aHR was similar in different urological intervention methods, extracorporeal shock wave lithotripsy, ureteroscopy, percutaneous nephrostolithotomy, and open stone surgery. The urological intervention for urolithiasis is associated with an increased risk of CKD. We should be aware of the risk for CKD, especially in patients who have received multiple urological interventions and those elderly.

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Abbreviations

aHR:

Adjusted hazard ratio

CI:

Confidence interval

CKD:

Chronic kidney disease

ESRD:

End-stage renal disease

ICD-9-CM:

International Classification of Diseases, Ninth Revision, Clinical Modification

NHIRD:

National Health Insurance Research Database

LHID 2000:

Longitudinal Health Insurance Database 2000

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Authors and Affiliations

  1. Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan

    Shih-Yi Lin & I-Kuan Wang

  2. Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan

    Shih-Yi Lin, I-Kuan Wang & Yao Lung Liu

  3. Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan

    Shih-Yi Lin, I-Kuan Wang & Yao Lung Liu

  4. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    Cheng-Li Lin, Fung-Chang Sung & Yen-Jung Chang

  5. College of Medicine, China Medical University, Taichung, Taiwan

    Cheng-Li Lin, Fung-Chang Sung & Yen-Jung Chang

  6. Department of Urology, China Medical University Hospital, Taichung, Taiwan

    Chao-Hsiang Chang, His-Chin Wu & Wen-Chi Chen

  7. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 40447, Taichung, Taiwan

    Chia-Hung Kao

  8. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan

    Chia-Hung Kao

  9. Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan

    Chia-Hung Kao

Authors
  1. Shih-Yi Lin
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  2. Cheng-Li Lin
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  3. Chao-Hsiang Chang
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  4. His-Chin Wu
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  5. Wen-Chi Chen
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  6. I-Kuan Wang
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  7. Yao Lung Liu
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  8. Fung-Chang Sung
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  9. Yen-Jung Chang
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  10. Chia-Hung Kao
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Corresponding author

Correspondence to Chia-Hung Kao.

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Funding

This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW105-TDU-B-212-133019), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037), NRPB Stroke Clinical Trial Consortium (MOST 105-2325-B-039-003), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan.

Conflict of interest

The authors declare no conflicts of interest.

Ethnic approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Review Board of China Medical University (CMUH104-REC2-115).

Informed consent

Because NHIRD database was de-identification, thus this study was exempted from informed consent.

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Lin, SY., Lin, CL., Chang, CH. et al. Comparative risk of chronic kidney diseases in patients with urolithiasis and urological interventions: a longitudinal population-based study. Urolithiasis 45, 465–472 (2017). https://doi.org/10.1007/s00240-016-0929-y

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  • DOI: https://doi.org/10.1007/s00240-016-0929-y

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