Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu City 30071, Taiwan.
Department of Medicine, MacKay Medical College, New Taipei City 25160, Taiwan.
Int J Environ Res Public Health. 2020 Mar 9;17(5):1762. doi: 10.3390/ijerph17051762.
Renal calculi are common, with male predilection and androgen exposure potentially increasing the risk of renal calculi. Systemic effects of androgen deprivation therapy (ADT) have been observed but the influence of ADT on renal calculi in prostate cancer (PCa) patients is not fully understood. We conducted this population-based study to evaluate the impact of ADT on the subsequent risk of renal calculi. We used the National Health Insurance Research Database of Taiwan to analyze the incidences of renal calculi in ADT patients and non-ADT patients from 2001 to 2013. In total, 3309 patients with PCa were selected. After matching with 1:1 propensity-score analysis, 758 ADT patients with 758 matched non-ADT controls were enrolled in the final analysis. Demographic characteristics were analyzed and Cox regression analysis for calculating the hazard ratios (HR) was performed for the subsequent risk of renal calculi. Finally, 186 (186/1516, 12.3%) patients with diagnosed renal calculi were detected. ADT patients had a lower risk of subsequent renal calculi with an adjusted HR of 0.38 (7% vs. 17.5%, 95% confidence interval (CI) 0.28-0.53; < 0.001) in comparison with the non-ADT group. The Kaplan-Meier curve showed significant differences of cumulative incidences of renal calculi. In conclusion, ADT patients had approximately one-third lower risk of subsequent renal calculi. Further studies are warranted to evaluate the clinical significance.
肾结石很常见，男性易患，雄激素暴露可能会增加肾结石的风险。已经观察到雄激素剥夺疗法 (ADT) 的全身效应，但 ADT 对前列腺癌 (PCa) 患者肾结石的影响尚不完全清楚。我们进行了这项基于人群的研究，以评估 ADT 对肾结石后续风险的影响。我们使用台湾全民健康保险研究数据库，分析了 2001 年至 2013 年间 ADT 患者和非 ADT 患者肾结石的发病率。总共选择了 3309 名 PCa 患者。经过 1:1 倾向评分匹配分析后，共纳入 758 名 ADT 患者和 758 名匹配的非 ADT 对照组进行最终分析。分析了人口统计学特征，并进行 Cox 回归分析计算肾结石的后续风险的风险比 (HR)。最后，检测到 186 名 (186/1516，12.3%) 确诊肾结石患者。与非 ADT 组相比，ADT 患者肾结石的后续风险较低，调整后的 HR 为 0.38(7%比 17.5%，95%置信区间 0.28-0.53；<0.001)。Kaplan-Meier 曲线显示肾结石累积发生率存在显著差异。总之，ADT 患者肾结石的后续风险约降低三分之一。需要进一步研究来评估其临床意义。
