title: Surgical interventions for nephrolithiasis in ankylosing spondylitis and the general population.
abstract: OBJECTIVE
  The aim of this study was to estimate rates and type of definitive surgical interventions for nephrolithiasis in Swedish patients with ankylosing spondylitis (AS) compared to the general population.
  
  
  METHODS
  This national prospective cohort study linked data from Swedish population and healthcare registries. Incidence rates and interventions for nephrolithiasis during follow-up in patients with AS were compared to general population comparator (GPC) subjects.
  
  
  RESULTS
  In total, 8572 AS patients were followed for 49,959 person-years and 39,639 matched GPCs were followed for 225,221 person-years. Mean age at study entry was 46 years [interquartile range (IQR) 36-56 years] and 65% were male. In AS patients with a diagnosis of nephrolithiasis during the study period, 29% (72/250) underwent similar intervention for nephrolithiasis compared to 24% (114/466) GPCs (p = 0.21). The incidence rate ratio (RR) in overall AS patients was 2.9 [95% confidence interval (CI) 2.1-3.8] during a median follow-up of 6.2 years (IQR 3.2-8.6 years). With prior diagnosis of nephrolithiasis, the RR for AS patients compared to GPCs was 3.7 (95% CI 1.8-7.7); without prior nephrolithiasis the RR was 2.1 (95% CI 1.5-3.0). Increasing age [odds ratio (OR) 1.02, 95% CI 1.01-1.03], prior nephrolithiasis diagnosis (OR 3.3, 95% CI 1.97-5.62) and atherosclerotic cardiac disease (OR 2.0, 95% CI 1.03-3.91) were identified as predictors of intervention for nephrolithiasis.
  
  
  CONCLUSIONS
  Patients with AS have an almost three-fold increased risk of surgical intervention for kidney stones, with similar management, compared to the general population.
authors.affiliation: a Department of Urology, Skåne University Hospital, Lund University , Malmö, Sweden.
authors.forename: Ane Krag
authors.initials: AK
authors.lastname: Jakobsen
authors.affiliation: b Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg , Gothenburg, Sweden.|c Department of Clinical Sciences, Section of Rheumatology, Lund University , Malmö, Sweden.
authors.forename: L T H
authors.initials: LTH
authors.lastname: Jacobsson
authors.affiliation: a Department of Urology, Skåne University Hospital, Lund University , Malmö, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Patschan
authors.affiliation: a Department of Urology, Skåne University Hospital, Lund University , Malmö, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Hopfgarten
authors.affiliation: d Clinical Epidemiology Unit and Rheumatology Unit, Department of Medicine (Solna), Karolinska Institutet , Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Askling
authors.affiliation: c Department of Clinical Sciences, Section of Rheumatology, Lund University , Malmö, Sweden.|e The Parker Institute, Department of Rheumatology, Copenhagen University Hospital , Frederiksberg, Denmark.
authors.forename: L E
authors.initials: LE
authors.lastname: Kristensen
keywords: Ankylosing spondylitis; comparative study; lithotripsy; nephrolithiasis; percutaneous nephrolithotomy; ureteroscopy