| アブストラクト | In this study we sought to determine if among individuals with urolithiasis, extracorporeal shock wave lithotripsy (SWL) and ureteroscopy are associated with a higher risk of incident arterial hypertension (HTN) and/or chronic kidney disease (CKD). This was measured in a population-based retrospective study of 11,570 participants with incident urolithiasis and 127,464 without urolithiasis in The Health Improvement Network. Patients with pre-existing HTN and CKD were excluded. The study included 1319 and 919 urolithiasis patients with at least one SWL or URS procedure, respectively. Multivariable Cox regression was used to estimate the hazard ratio for incident CKD stage 3-5 and HTN in separate analyses. Over a median of 3.7 and 4.1 years, 1423 and 595 of urolithiasis participants developed HTN and CKD, respectively. Urolithiasis was associated with a significant hazard ratio each for HTN of 1.42 (95% CI: 1.35, 1.51) and for CKD of 1.82 (1.67, 1.98). SWL was associated with a significant increased risk of HTN 1.34 (1.15, 1.57), while ureteroscopy was not. When further stratified as SWL to the kidney or ureter, only SWL to the kidney was significantly and independently associated with HTN 1.40 (1.19, 1.66). Neither SWL nor ureteroscopy was associated with incident CKD. Since urolithiasis itself was associated with a hazard ratio of 1.42 for HTN, an individual who undergoes SWL to the kidney can be expected to have a significantly increased hazard ratio for HTN of 1.96 (1.67, 2.29) compared with an individual without urolithiasis. |
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| 投稿者 | Denburg, Michelle R; Jemielita, Thomas O; Tasian, Gregory E; Haynes, Kevin; Mucksavage, Phillip; Shults, Justine; Copelovitch, Lawrence |
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| 組織名 | The Children's Hospital of Philadelphia, Perelman School of Medicine at the;University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address:;denburgm@email.chop.edu.;Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine;at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.;Center for Pediatric Clinical Effectiveness, The Children's Hospital of;Philadelphia, Perelman School of Medicine at the University of Pennsylvania,;Philadelphia, Pennsylvania, USA.;Perelman School of Medicine at the University of Pennsylvania, Philadelphia,;Pennsylvania, USA.;University of Pennsylvania, Philadelphia, Pennsylvania, USA; Center for Clinical;Epidemiology and Biostatistics, Perelman School of Medicine at the University of;Pennsylvania, Philadelphia, Pennsylvania, USA.;University of Pennsylvania, Philadelphia, Pennsylvania, USA. |
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