Cardiovascular risk factors, ethnicity and infection stone are independent factors associated with reduced renal function in renal stone formers

PLoS One. 2022 Apr 14;17(4):e0265510. doi: 10.1371/journal.pone.0265510. eCollection 2022.

Abstract

Background: Recent evidence suggested the link between nephrolithiasis and renal function impairment. We aimed to determine the renal function profile and potential factors associated with reduced renal function amongst renal stone formers in multi-ethnic Asians.

Methods: We conducted a cross-sectional study involving patients undergoing percutaneous nephrolithotomy between May 2015 and December 2019. Reduced renal function was defined as having estimated glomerular filtration rate < 60 ml/min per 1.73 m2. Renal stone samples were collected and quantified using infrared spectroscopy. Potential factors associated with reduced renal function including age, ethnicity, educational level, history of diabetes, hypertension, gout, hydronephrosis, serum uric acid level, and type of renal stone were evaluated using univariable and multivariable analyses.

Results: A total of 1162 patients from a multi-ethnic population (Malays 67%, Chinese 19%, Indians 13% and indigenous people 1%) with median age of 57 years (Interquartile range 48-64) were enrolled in the study. Almost a third of patients were found with reduced renal function. Multivariable analysis showed that the odds of having reduced renal function increased with age, ethnicity, lower educational level, history of diabetes, hypertension, gout, bilateral hydronephrosis, elevated serum uric acid level and infection stone.

Conclusions: Reduced renal function varies between ethnicities and all age groups of renal stone formers. In addition to age and ethnicity, cardiovascular risk factors including diabetes and hypertension may also need to be taken into account in managing stone patients with reduced renal function.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases*
  • Cross-Sectional Studies
  • Diabetes Mellitus*
  • Ethnicity
  • Female
  • Gout* / complications
  • Heart Disease Risk Factors
  • Humans
  • Hydronephrosis*
  • Hypertension* / complications
  • Hypertension* / epidemiology
  • Kidney
  • Kidney Calculi* / etiology
  • Male
  • Middle Aged
  • Renal Insufficiency*
  • Risk Factors
  • Uric Acid / analysis

Substances

  • Uric Acid

Grants and funding

This work was funded by University Malaya (UM) Research Grant (RG363/15AFR) and Cook Medical Education Fund awarded to SS and JL. Special thanks to Avro Abadi Sdn Bhd for funding the Thermo Scientific Nicolet iS5 Fourier-transform infrared (FT-IR) spectrometer. The funders did not have any additional role in study design, data collection and analysis, decision to publish or preparation of the manuscript.