Abstract
Renal calculi are common, with male predilection and androgen exposure potentially increasing the risk of renal calculi. Systemic effects of androgen deprivation therapy (ADT) have been observed but the influence of ADT on renal calculi in prostate cancer (PCa) patients is not fully understood. We conducted this population-based study to evaluate the impact of ADT on the subsequent risk of renal calculi. We used the National Health Insurance Research Database of Taiwan to analyze the incidences of renal calculi in ADT patients and non-ADT patients from 2001 to 2013. In total, 3309 patients with PCa were selected. After matching with 1:1 propensity-score analysis, 758 ADT patients with 758 matched non-ADT controls were enrolled in the final analysis. Demographic characteristics were analyzed and Cox regression analysis for calculating the hazard ratios (HR) was performed for the subsequent risk of renal calculi. Finally, 186 (186/1516, 12.3%) patients with diagnosed renal calculi were detected. ADT patients had a lower risk of subsequent renal calculi with an adjusted HR of 0.38 (7% vs. 17.5%, 95% confidence interval (CI) 0.28–0.53; p < 0.001) in comparison with the non-ADT group. The Kaplan–Meier curve showed significant differences of cumulative incidences of renal calculi. In conclusion, ADT patients had approximately one-third lower risk of subsequent renal calculi. Further studies are warranted to evaluate the clinical significance.
Highlights
Prostate cancer (PCa) is a major cancer worldwide, presenting a huge disease burden, and it holds the highest incidence of male cancer in the United States, especially in elderly males [1]
A total of 3309 patients with PCa were identified from NHIRD between 2001 and 2009
A total of 1516 patients with PCa were tracked, and patients under androgen deprivation therapy (ADT) showed a lower risk of renal calculi compared with the non-ADT patients
Summary
This nationwide, population-based large cohort study was conducted using data from the National. Health Insurance Research Database (NHIRD) of Taiwan. The NHIRD is the database of the NHI program, which comprises health and medical records, and is a representative of a nationwide medical database with broad coverage. PCa is a major disease, and patients with a diagnosis have to register a catastrophic illness certification and request a waiver for medical payment. The. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) was used for diagnoses in NHIRD. The diagnosis of PCa was validated by the database of catastrophic illness. Our study was conducted after being approved by the Institutional Review Board of the Tri-Service General
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