title: Comparative risk of chronic kidney diseases in patients with urolithiasis and urological interventions: a longitudinal population-based study.
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.
authors.affiliation: Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan.|Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.|Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Shih-Yi
authors.initials: SY
authors.lastname: Lin
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Urology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chao-Hsiang
authors.initials: CH
authors.lastname: Chang
authors.affiliation: Department of Urology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: His-Chin
authors.initials: HC
authors.lastname: Wu
authors.affiliation: Department of Urology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Chen
authors.affiliation: Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan.|Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.|Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan.
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.affiliation: Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.|Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Yao Lung
authors.initials: YL
authors.lastname: Liu
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Yen-Jung
authors.initials: YJ
authors.lastname: Chang
authors.affiliation: 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. d10040@mail.cmuh.org.tw.|Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. d10040@mail.cmuh.org.tw.|Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan. d10040@mail.cmuh.org.tw.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008096:Lithotripsy / Q000009:adverse effects*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D000074642:Nephrolithotomy, Percutaneous / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D018666:Ureteroscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D052878:Urolithiasis / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Chronic kidney disease; Extracorporeal shock wave lithotripsy; Ureteroscopy; Urolithiasis; Urological intervention