Abstract
BackgroundUrolithiasis is considered a vital public health issue with a substantial burden on kidney function. Additionally, only few reports focused on the gender difference in patients with urolithiasis. Therefore, this study aimed to compare the clinical characteristics of sex difference and their potential risk for chronic kidney disease (CKD) in patients with urolithiasis.MethodsPatients diagnosed with stone disease from 2013 to 2018 were retrospectively reviewed and divided into two groups by gender. Clinical demographic characteristics, stone location, stone composition, urine chemistries, and renal function were investigated. Univariate and multivariate analyses were used to assess the relationship and potential risk of CKD between sex groups.ResultsA total of 1802 patients were included: 1312 from men and 490 from women. Female patients had a higher rate of hypertension, diabetes, and dyslipidemia. Male patients predominantly had calcium-containing stones, especially calcium oxalate stone, uric acid stone, and struvite stone. Carbonate apatite stone was more frequently found in women. Complex surgeries such as percutaneous nephrolithotomy (PCNL) and ureteroscopic lithotripsy (URSL) were more frequently performed in women than that in men. Multivariate analysis confirmed that age > 60 years (odds ratios [ORs] = 6.36; 95% confidence interval [CI], 3.8–10.8), female sex (ORs = 5.31; 95% CI 3.3–8.4), uric acid stone (ORs = 3.55; 95% CI 2.0–6.4), hypertension (OR = 7.20; 95% CI 3.8–13.7), and diabetes (OR = 7.06; 95% CI 3.1–16.2) were independent predictors of poor prognoses in CKD.ConclusionsThe female gender is significantly associated with a higher prevalence of CKD among patients with urolithiasis. Therefore, women with stone disease may need close renal function monitoring during follow-up.
Highlights
Urolithiasis is considered a vital public health issue with a substantial burden on kidney function
About 38.3% of patients had hypertension, 15.5% had diabetes, 8.3% had a history of dyslipidemia, 20.4% had a history of gout, and 14.8% had hyperuricemia
Univariate analysis showed that age > 60 years, female sex, hypertension, diabetes, uric acid stone, and percutaneous nephrolithotomy (PCNL) operation were risk factors for chronic kidney disease (CKD)
Summary
Urolithiasis is considered a vital public health issue with a substantial burden on kidney function. Only few reports focused on the gender difference in patients with urolithiasis. This study aimed to compare the clinical characteristics of sex difference and their potential risk for chronic kidney disease (CKD) in patients with urolithiasis. Urolithiasis is not an uncommon disease worldwide and is viewed as an important public health issue with a substantial burden on people’s health and considerable national economic consequences [1, 2]. Urolithiasis more frequently occurs in men, but women have a higher chronic kidney disease (CKD) rate [3]. Recent results from the National Health and Nutrition Examination Survey (NHANES) showed that the prevalence of stone disease in men and women was 11.9% and 9.4%, respectively, in the 2017–2018 cycle [4]. The gender gap in urolithiasis prevalence appears to be closing in the past decade, among women younger than 60 years
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