Independent and interactive effects of kidney stone formation and conventional risk factors for chronic kidney disease: a follow-up study of Japanese men
Independent and interactive effects of kidney stone formation and conventional risk factors for chronic kidney disease: a follow-up study of Japanese men
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DOI：
10.1007/s11255-021-02803-z
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发表时间：
2021-02-24
影响因子：
2
通讯作者：
Yasui, Takahiro
中科院分区：
文献类型：
--
作者：
Ando, Ryosuke;Nagaya, Teruo;Yasui, Takahiro
目的评估肾结石形成与传统危险因素之间的相互作用对慢性肾脏病（CKD）发病率的影响。方法对11,402例基线时无CKD的受试者（男性，30-69岁，日本人）进行了平均4年的观察。使用考克斯比例风险回归模型计算风险比（HR）和95%置信区间（CI），以确定新发慢性肾脏病、肾结石形成与传统风险因素（糖尿病、高血压、超重/肥胖、血脂异常和高尿酸血症/痛风）之间的相关性。我们还研究了肾结石和CKD传统危险因素的相互作用。结果在随访期间，共有2301名男性（20.2%）发生CKD事件。在多变量校正后，发现肾结石增加了CKD事件的风险（HR 1.16; 95% CI 1.03-1.32）。肾结石合并高血压、血脂异常或高尿酸血症/痛风患者发生CKD的风险高于肾结石或其他危险因素患者。然而，没有发现肾结石和其他危险因素之间的显著相互作用会增加CKD风险。另一方面，观察到肾结石和超重/肥胖之间的负交互作用，导致两种因素共存时CKD事件的风险逆转。结论肾结石与慢性肾脏病的发生有关。然而，肾结石和传统的危险因素之间没有发现积极的相互作用对CKD的风险。
Purpose To assess the impact of interactions between kidney stone formation and conventional risk factors on incident chronic kidney disease (CKD). Methods A total of 11,402 subjects (men 30-69 years of age, Japanese) without CKD at baseline were observed over an average period of 4 years. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) to determine the association between incident CKD, kidney stone formation, and conventional risk factors (diabetes mellitus, hypertension, overweight/obesity, dyslipidemia, and hyperuricemia/gout). We also examined the interactions of renal stones and the conventional risk factors for CKD. Results In total, 2301 men (20.2%) developed incident CKD during the follow-up period. After multivariable adjustment, kidney stones were found to increase the risk of incident CKD (HR 1.16; 95% CI 1.03-1.32). Kidney stone formers with hypertension, dyslipidemia, or hyperuricemia/gout presented a greater risk for incident CKD than those who had either kidney stones or other risk factors. However, no significant interactions between kidney stones and other risk factors were found to increase CKD risk. On the other hand, a negative interactive effect between kidney stones and overweight/obesity was observed, leading to reversed risk of incident CKD in coexistence of both factors. Conclusion Kidney stones were linked to a higher risk for the development of CKD. However, no positive interactive effects were identified between renal stones and conventional risk factors on the risk of incident CKD.