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肾结石形成与慢性肾脏病传统危险因素的独立及交互作用:一项对日本男性的随访研究

Independent and interactive effects of kidney stone formation and conventional risk factors for chronic kidney disease: a follow-up study of Japanese men.

作者信息

Ando Ryosuke, Nagaya Teruo, Suzuki Sadao, Takahashi Hidekatsu, Kawai Makoto, Taguchi Kazumi, Hamamoto Shuzo, Okada Atsushi, Yasui Takahiro

机构信息

Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.

Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

出版信息

Int Urol Nephrol. 2021 Jun;53(6):1081-1087. doi: 10.1007/s11255-021-02803-z. Epub 2021 Feb 24.

Abstract

PURPOSE

To assess the impact of interactions between kidney stone formation and conventional risk factors on incident chronic kidney disease (CKD).

METHODS

A total of 11,402 subjects (men 30-69 years of age, Japanese) without CKD at baseline were observed over an average period of 4 years. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) to determine the association between incident CKD, kidney stone formation, and conventional risk factors (diabetes mellitus, hypertension, overweight/obesity, dyslipidemia, and hyperuricemia/gout). We also examined the interactions of renal stones and the conventional risk factors for CKD.

RESULTS

In total, 2301 men (20.2%) developed incident CKD during the follow-up period. After multivariable adjustment, kidney stones were found to increase the risk of incident CKD (HR 1.16; 95% CI 1.03-1.32). Kidney stone formers with hypertension, dyslipidemia, or hyperuricemia/gout presented a greater risk for incident CKD than those who had either kidney stones or other risk factors. However, no significant interactions between kidney stones and other risk factors were found to increase CKD risk. On the other hand, a negative interactive effect between kidney stones and overweight/obesity was observed, leading to reversed risk of incident CKD in coexistence of both factors.

CONCLUSION

Kidney stones were linked to a higher risk for the development of CKD. However, no positive interactive effects were identified between renal stones and conventional risk factors on the risk of incident CKD.

摘要

目的

评估肾结石形成与传统危险因素之间的相互作用对新发慢性肾脏病(CKD)的影响。

方法

共观察了11402名基线时无CKD的受试者(30 - 69岁的日本男性),平均观察期为4年。采用Cox比例风险回归模型计算风险比(HRs)及95%置信区间(CIs),以确定新发CKD、肾结石形成与传统危险因素(糖尿病、高血压、超重/肥胖、血脂异常和高尿酸血症/痛风)之间的关联。我们还研究了肾结石与CKD传统危险因素之间的相互作用。

结果

在随访期间,共有2301名男性(20.2%)发生了新发CKD。经过多变量调整后,发现肾结石会增加新发CKD的风险(HR 1.16;95% CI 1.03 - 1.32)。患有高血压、血脂异常或高尿酸血症/痛风的肾结石患者发生新发CKD的风险高于仅患有肾结石或其他危险因素的患者。然而,未发现肾结石与其他危险因素之间存在显著的相互作用会增加CKD风险。另一方面,观察到肾结石与超重/肥胖之间存在负向交互作用,导致两种因素并存时新发CKD的风险逆转。

结论

肾结石与CKD发生风险较高相关。然而,未发现肾结石与传统危险因素之间对新发CKD风险存在正向交互作用。

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