Top

Published in:

01-04-2015 | Original Article

Increased risk of bone fracture among patients with urinary calculi: a nationwide longitudinal population-based study

Published in: Osteoporosis International | Issue 4/2015

Abstract

Summary

Urinary calculi were associated with higher risk of vertebral and upper limb fracture. Therefore, patients with urinary calculi should be evaluated carefully because they may have a higher risk of subsequent fracture later in life.

Introduction

The contribution of urinary calculi to reduced bone mineral density has been recognized. However, the association of urinary calculi with the risk of fracture remains inconclusive. The aim of the study was to determine the risk of overall fracture and fractures at different anatomic sites in patients with urinary calculi.

Methods

The records of inpatients and outpatients with urinary calculi were retrieved from the Taiwan National Health Insurance Database from 2000 to 2010. Among patients with urinary calculi at the cohort entry, controls were matched using propensity scores on a 1:1 ratio. All subjects were followed up from the date of enrollment until fracture occurrence, death, or December 31, 2010. There were 46,243 Medicare beneficiaries with a diagnosis of urinary calculi and 46,243 controls without calculi enrolled.

Results

Among these patients, 6005 patients with a diagnosis of urinary calculi and 5339 controls developed fractures during a median follow-up period of 5.3 years. Patients with urinary calculi had a higher incidence of fracture compared with controls (23.9 versus 22.1 per 1000 person-years) and a greater risk of overall fractures (adjusted hazard ratio [aHR] 1.08, 95 % confidence interval [CI], 1.04–1.12), mainly located at the vertebrae (aHR 1.15, 95 % CI, 1.06–1.25) and upper limb (aHR 1.07, 95 % CI, 1.01–1.14), but the risk for hip fracture was not increased (aHR 1.09, 95 % CI, 0.96–1.22).

Conclusions

Urinary calculus is independently associated with higher risk of subsequent fracture. Patients with urinary calculi should pay attention to the future vertebral and upper limb fractures.

Cooper C (1997) The crippling consequences of fractures and their impact on quality of life. Am J Med 103:12S–17S, discussion 17S-19SCrossRefPubMed

Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA J Am Med Assoc 301:513–521CrossRef

Liu Y, Peng M, Lin L, Liu X, Qin Y, Hou X (2014) Relationship between American Society of Anesthesiologists (ASA) grade and 1-year mortality in nonagenarians undergoing hip fracture surgery. Osteoporos Int J Established Result Cooperation Between Eur Found Osteoporos Natl Osteoporos Found USA

Autier P, Haentjens P, Bentin J, Baillon JM, Grivegnee AR, Closon MC, Boonen S (2000) Costs induced by hip fractures: a prospective controlled study in Belgium. Belgian Hip Fracture Study Group. Osteoporos Int J Established Result Cooperation Between Eur Found Osteoporos Natl Osteoporos Found USA 11:373–380CrossRef

Lambrelli D, Burge R, Raluy-Callado M, Chen SY, Wu N, Schoenfeld MJ (2014) Retrospective database study to assess the economic impact of hip fracture in the United Kingdom. J Med Econ 17:817–825CrossRefPubMed

Qu B, Ma Y, Yan M, Wu HH, Fan L, Liao DF, Pan XM, Hong Z (2014) The economic burden of fracture patients with osteoporosis in western China. Osteoporos Int J Established Result Cooperation Between Eur Found Osteoporos Natl Osteoporos Found USA 25:1853–1860CrossRef

Coe FL, Evan A, Worcester E (2005) Kidney stone disease. J Clin Invest 115:2598–2608CrossRefPubMedCentralPubMed

Loh NY, Bentley L, Dimke H et al (2013) Autosomal dominant hypercalciuria in a mouse model due to a mutation of the epithelial calcium channel, TRPV5. PLoS One 8:e55412CrossRefPubMedCentralPubMed

Lingeman JE, Saywell RM Jr, Woods JR, Newman DM (1986) Cost analysis of extracorporeal shock wave lithotripsy relative to other surgical and nonsurgical treatment alternatives for urolithiasis. Med Care 24:1151–1160CrossRefPubMed

10.

Matlaga BR, Jansen JP, Meckley LM, Byrne TW, Lingeman JE (2012) Economic outcomes of treatment for ureteral and renal stones: a systematic literature review. J Urol 188:449–454CrossRefPubMedCentralPubMed

11.

Wu W, Yang D, Tiselius HG, Ou L, Liang Y, Zhu H, Li S, Zeng G (2014) The characteristics of the stone and urine composition in Chinese stone formers: primary report of a single-center results. Urology 83:732–737CrossRefPubMed

12.

Frick KK, Bushinsky DA (2003) Molecular mechanisms of primary hypercalciuria. J Am Soc Nephrol JASN 14:1082–1095CrossRef

13.

Coe FL, Bushinsky DA (1984) Pathophysiology of hypercalciuria. Am J Physiol 247:F1–F13PubMed

14.

Krieger NS, Bushinsky DA (2013) The relation between bone and stone formation. Calcif Tissue Int 93:374–381CrossRefPubMedCentralPubMed

15.

Li H, Xie H, Liu W et al (2009) A novel microRNA targeting HDAC5 regulates osteoblast differentiation in mice and contributes to primary osteoporosis in humans. J Clin Invest 119:3666–3677CrossRefPubMedCentralPubMed

16.

Xie H, Cui Z, Wang L et al (2014) PDGF-BB secreted by preosteoclasts induces angiogenesis during coupling with osteogenesis. Nat Med 20:1270–1278CrossRefPubMed

17.

Lawoyin S, Sismilich S, Browne R, Pak CY (1979) Bone mineral content in patients with calcium urolithiasis. Metab Clin Exp 28:1250–1254CrossRefPubMed

18.

Pak CY, Oata M, Lawrence EC, Snyder W (1974) The hypercalciurias. Causes, parathyroid functions, and diagnostic criteria. J Clin Invest 54:387–400CrossRefPubMedCentralPubMed

19.

Arrabal-Polo MA, Del Carmen C-GM, Canales BK, Arrabal-Martin M (2014) Calcium nephrolithiasis and bone demineralization: pathophysiology, diagnosis, and medical management. Curr Opin Urol 24:633–638CrossRefPubMed

20.

Melton LJ 3rd, Crowson CS, Khosla S, Wilson DM, O'Fallon WM (1998) Fracture risk among patients with urolithiasis: a population-based cohort study. Kidney Int 53:459–464CrossRefPubMed

21.

Lauderdale DS, Thisted RA, Wen M, Favus MJ (2001) Bone mineral density and fracture among prevalent kidney stone cases in the Third National Health and Nutrition Examination Survey. J Bone Min Res Off J Am Soc Bone Min Res 16:1893–1898CrossRef

22.

Wang KL, Liu CJ, Chao TF, Huang CM, Wu CH, Chen SJ, Chen TJ, Lin SJ, Chiang CE (2012) Statins, risk of diabetes, and implications on outcomes in the general population. J Am Coll Cardiol 60:1231–1238CrossRefPubMed

23.

Wu CY, Chen YJ, Ho HJ, Hsu YC, Kuo KN, Wu MS, Lin JT (2012) Association between nucleoside analogues and risk of hepatitis B virus-related hepatocellular carcinoma recurrence following liver resection. JAMA J Am Med Assoc 308:1906–1914CrossRef

24.

Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 40:373–383CrossRefPubMed

25.

Chen IJ, Chiang CY, Li YH, et al. (2014) Nationwide cohort study of hip fractures: time trends in the incidence rates and projections up to 2035. Osteoporos Int J Established Result Cooperation Between Eur Found Osteoporos Natl Osteoporos Found USA

26.

Arrabal-Polo MA, Sierra Giron-Prieto M, Orgaz-Molina J, Zuluaga-Gomez A, Arias-Santiago S, Arrabal-Martin M (2013) Calcium renal lithiasis and bone mineral density. Importance Bone Metabol Urinary Lithiasis Actas Urologicas Espanolas 37:362–367

27.

Keller JJ, Lin CC, Kang JH, Lin HC (2013) Association between osteoporosis and urinary calculus: evidence from a population-based study. Osteoporos Int J Established Result Cooperation Between Eur Found Osteoporos Natl Osteoporos Found USA 24:651–657CrossRef

28.

Caudarella R, Vescini F, Buffa A, La Manna G, Stefoni S (2004) Osteoporosis and urolithiasis. Urol Int 72(Suppl 1):17–19CrossRefPubMed

29.

Keaveny TM, Wachtel EF, Ford CM, Hayes WC (1994) Differences between the tensile and compressive strengths of bovine tibial trabecular bone depend on modulus. J Biomech 27:1137–1146CrossRefPubMed

30.

Melton LJ 3rd, Kan SH, Frye MA, Wahner HW, O'Fallon WM, Riggs BL (1989) Epidemiology of vertebral fractures in women. Am J Epidemiol 129:1000–1011PubMed

31.

Homminga J, Weinans H, Gowin W, Felsenberg D, Huiskes R (2001) Osteoporosis changes the amount of vertebral trabecular bone at risk of fracture but not the vertebral load distribution. Spine 26:1555–1561CrossRefPubMed

32.

Melton LJ 3rd, Crowson CS, O'Fallon WM (1999) Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int J Established Result Cooperation Between Eur Found Osteoporos Natl Osteoporos Found USA 9:29–37CrossRef

33.

Bushinsky DA, Willett T, Asplin JR, Culbertson C, Che SP, Grynpas M (2011) Chlorthalidone improves vertebral bone quality in genetic hypercalciuric stone-forming rats. J Bone Mineral Res Off J Am Soc Bone Min Res 26:1904–1912CrossRef

34.

Sella S, Cattelan C, Realdi G, Giannini S (2008) Bone disease in primary hypercalciuria. Clin Cases Min Bone Metabol Off J Italian Soc Osteoporos Min Metabol Skelet Dis 5:118–126

35.

Carrasco-Valiente J, Anglada-Curado FJ, Aguilar-Melero P, Gonzalez-Ojeda R, Muntane-Relat J, Padillo-Ruiz FJ, Requena-Tapia MJ (2012) State of acute phase markers and oxidative stress in patients with kidney stones in the urinary tract. Actas Urol Esp 36:296–301CrossRefPubMed

36.

Szlosarek P, Charles KA, Balkwill FR (2006) Tumour necrosis factor-alpha as a tumour promoter. Eur J Cancer 42:745–750CrossRefPubMed

37.

Montalcini T, Romeo S, Ferro Y, Migliaccio V, Gazzaruso C, Pujia A (2013) Osteoporosis in chronic inflammatory disease: the role of malnutrition. Endocrine 43:59–64CrossRefPubMed

38.

Samelson EJ, Hannan MT, Zhang Y, Genant HK, Felson DT, Kiel DP (2006) Incidence and risk factors for vertebral fracture in women and men: 25-year follow-up results from the population-based Framingham study. J Bone Min Res Off J Am Soc Bone Min Res 21:1207–1214CrossRef

39.

Sacks H, Chalmers TC, Smith H Jr (1982) Randomized versus historical controls for clinical trials. Am J Med 72:233–240CrossRefPubMed

40.

Benson K, Hartz AJ (2000) A comparison of observational studies and randomized, controlled trials. Am J Ophthalmol 130:688CrossRefPubMed

Title: Increased risk of bone fracture among patients with urinary calculi: a nationwide longitudinal population-based study
Publication date: 01-04-2015
Published in: Osteoporosis International / Issue 4/2015
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-014-2998-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Increased risk of bone fracture among patients with urinary calculi: a nationwide longitudinal population-based study

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2015

Bone histomorphometry in a long-term hemodialysis patient with hypoparathyroidism and sarcoidosis

Vitamin D and bone development

Exercise training, creatine supplementation, and bone health in ovariectomized rats

Erratum to: Efficacy of combined treatment with alendronate (ALN) and eldecalcitol, a new active vitamin D analog, compared to that of concomitant ALN, vitamin D plus calcium treatment in Japanese patients with primary osteoporosis

US Preventative Services Task Force FRAX threshold has a low sensitivity to detect osteoporosis in women ages 50–64 years

The social gradient of fractures at any skeletal site in men and women: data from the Geelong Osteoporosis Study Fracture Grid