Association between multiple chronic conditions and urolithiasis.

PURPOSE

Given the risk factors for stone disease, it is possible that multiple chronic condition (MCC) patients are at increased risk of developing new, recurrent, or worsening urolithiasis. The purpose of our investigation was to evaluate the relationship between MCCs and urolithiasis.

METHODS

Retrospective cohort using outpatient claims data for all adult members (≥18 years) of the Beaumont Employee Health Plan who received outpatient care between 2008 and 2013. Multiple logistic regression adjusted for age, sex, obesity, hyperlipidemia, hypertension, and diabetes was used to assess the relationship between number of comorbid chronic conditions and urolithiasis.

RESULTS

The cohort consisted of 34,173 adult patients with an average age of 40.4 years and 61.2% being female. The prevalence of urolithiasis was 3.1% (n = 1059). Patients with urolithiasis had a significantly higher average number of comorbid chronic conditions (2.4 vs. 1.3, p < 0.001) than patient without urolithiasis. Both crude (OR 1.34; 95% CI 1.30-1.38) and adjusted logistic regression models (OR 1.37; 95% CI 1.31-1.44) revealed a significant relationship between number of comorbid chronic conditions and urolithiasis. More than 81% of patients had one or more co-occurring chronic conditions; the most common MCC combinations associated with urolithiasis were hypertension-hyperlipidemia, chronic back pain, and hyperlipidemia.

CONCLUSION

We report an association between MCCs and urolithiasis. Future research is needed to better understand the temporality and strength of this relationship. Physicians should recognize that urolithiasis and MCCs are closely related and therefore may consider more aggressive primary prevention of chronic disease and improved management of MCCs.