Division of Urology, Naval Hospital Yokosuka, Yokosuka, Japan.
Deployment Health Research Department, Naval Health Research Center, San Diego, California.
J Urol. 2017 Aug;198(2):394-400. doi: 10.1016/j.juro.2017.02.074. Epub 2017 Feb 21.
Little is known about the incidence of nephrolithiasis in the United States Navy. Navy pilots must be kidney stone-free and are often referred for treatment of small asymptomatic stones. The primary objectives of this study were to determine the incidence of nephrolithiasis and computerized tomography, proportion undergoing treatment and incidence of stone related mishaps in Navy pilots compared with other Navy personnel.
We retrospectively studied the records of all Navy service members from 2002 to 2011 for nephrolithiasis based on ICD-9 stone codes to determine the mentioned rates. We also reviewed NSC (Naval Safety Center) data for a history of accidents associated with nephrolithiasis. Rates of disease were calculated using person-years of followup and inferential statistics were done using univariable and multivariable analyses.
We evaluated 667,840 Navy personnel with a total of 3,238,331 person-years of followup. The annual incidence of nephrolithiasis was 240/100,000 person-years with a 5-year recurrence rate of 35.3%. On multivariable analysis pilots had nephrolithiasis incidence and treatment rates similar to those of the overall Navy population. Women had a higher incidence of nephrolithiasis compared with men (OR 1.17, p <0.0001). The rate of computerized tomography was lower in pilots than in the rest of the Navy (39 vs 66/10,000 person-years, p <0.0001). No recorded accidents were associated with kidney stones.
Navy pilots had a similar incidence of nephrolithiasis and were no more likely to undergo a surgical procedure. Given that no accidents were associated with nephrolithiasis, this study suggests reconsidering current military policies necessitating pilots to be completely stone-free.
在美国海军中，肾结石的发病率知之甚少。海军飞行员必须没有肾结石，并且经常因治疗小的无症状结石而被转介。本研究的主要目的是确定肾结石的发病率和计算机断层扫描、接受治疗的比例以及与海军飞行员相比，海军其他人员肾结石相关事故的发生率。
我们回顾性地研究了 2002 年至 2011 年所有海军服役人员的记录，根据 ICD-9 结石代码确定上述发病率。我们还查阅了海军安全中心（NSC）的数据，以了解与肾结石相关的事故史。使用随访的人年计算疾病发病率，并使用单变量和多变量分析进行推断统计。
我们评估了 667840 名海军人员，总随访人数为 3238331 人年。肾结石的年发病率为 240/100000 人年，5 年复发率为 35.3%。多变量分析显示，飞行员的肾结石发病率和治疗率与海军总体人群相似。与男性相比，女性肾结石发病率更高（OR 1.17，p <0.0001）。飞行员的计算机断层扫描率低于海军其他人员（39 比 66/10000 人年，p <0.0001）。没有记录到与肾结石相关的事故。
海军飞行员肾结石的发病率相似，接受手术的可能性也不大。由于肾结石没有导致任何事故，因此本研究建议重新考虑当前要求飞行员完全无结石的军事政策。
