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Unlabelled: Study Type--Disease prevalence study (cohort design) Level of Evidence 2a. What's known on the subject? and What does the study add? Several studies have estimated the potential association of urinary calculus (UC) with chronic kidney disease (CKD). However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system. We found that patients with CKD were consistently more likely than comparison subjects to have been previously diagnosed with kidney calculus (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.95-2.27), ureter calculus (OR 1.68, 95% CI 1.51-1.85), bladder calculus (OR 1.49, 95% CI 1.13-1.98), and unspecified calculus (OR 1.89, 95% CI 1.74-2.06). We concluded that there was an association between CKD and UC regardless of stone location., Objective: • To explore the association of chronic kidney disease (CKD) with prior kidney calculus, ureter calculus, and bladder calculus using a population-based dataset in Taiwan. Several studies have estimated the potential association of urinary calculus (UC) with CKD. However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system., Patients and Methods: • We identified 21,474 patients who received their first-time diagnosis of CKD between 2001 and 2009. • The 21,474 controls were frequency-matched with cases for sex, age group, and index year. • We used conditional logistic regression analyses to compute the odds ratio (OR) and corresponding 95% confidence interval (CI) as an estimation of association between CKD and having been previously diagnosed with UC., Results: • The results show that compared with controls, the OR of prior UC for cases was 1.91 (95% CI 1.81-2.01, P < 0.001) after adjusting for potential confounders. • Furthermore, cases were consistently more likely than controls to have been previously diagnosed with kidney calculus (OR 2.10, 95% CI 1.95-2.27), ureter calculus (OR 1.68, 95% CI 1.51-1.85), bladder calculus (OR 1.49, 95% CI 1.13-1.98), and unspecified UC (OR 1.89, 95% CI 1.74-2.06)., Conclusion: • We concluded that there was an association between ckd and UC regardless of stone location., (© 2012 BJU INTERNATIONAL.)

Unlabelled: Study Type--Prognosis (cohort) Level of Evidence 2b. What's known on the subject? and What does the study add? Although early studies failed to detect an association between urinary calculi (UC) and subsequent cardiovascular risk, there is growing evidence among more recent research supporting this association with some studies more specifically suggesting that stroke is a major concern for UC sufferers. After adjusting for potential confounding factors, UC patients were more likely to have experienced a stroke then those without UC during the five-year follow-up period (hazard ratio = 1.43, 95% Cl = 1.35-1.50, P < 0.001)., Objective: • To examine in a population-based study the relationship between a history of nephrolithiasis and/or ureterolithiasis and the subsequent risk of stroke, as previous studies have shown that stone disease is associated with several cardiovascular risk factors. However, none of the studies that have investigated the relationship between urinary calculi (UC) and stroke were able to detect an association at a significant level., Patients and Methods: • We used data sourced from the Taiwan Longitudinal Health Insurance Database 2000. • In all, 25,181 adult patients newly diagnosed with UC were recruited as a study cohort, along with 125,905 matched enrolees with no history of stone disease as a comparison cohort. • All the subjects were tracked for a 5-year period beginning from their index ambulatory care visits, and those who subsequently had a stroke identified. • Cox proportional hazards regressions were used to compare the risk of stroke between the study and comparison cohorts., Results: • During the 5-year follow-up period, the incidence rate of stroke was 1.78 (95% confidence interval [CI] 1.71-1.86) per 100 person-years in patients with UC and 1.25 (95% CI 1.22-1.27) per 100 person-years in patients without UC. • After adjusting for hypertension, diabetes, hyperlipidaemia, cardiovascular disease, urbanization level, gout, and obesity, patients with UC were more likely to have had a stroke than those without UC during the 5-year follow-up period (hazard ratio 1.43, 95% CI 1.35-1.50, P < 0.001)., Conclusion: • Our results suggest that there is an increased risk of stroke during the first 5 years after a diagnosis of UC., (© 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.)

This study investigated the risk of subsequent depressive disorders (DD) following a diagnosis of urinary calculi (UC) in Taiwan. In total, 67,917 adult patients newly diagnosed with UC were recruited, along with 153,951 age-matched enrollees who were used as a comparison group. A stratified Cox proportional hazard regression analysis revealed that the adjusted hazard of DD within a 1-year period following diagnosis with UC was 1.75 times greater for patients with UC than for comparison patients., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: To hypothesize an association between obstructive sleep apnea (OSA) and urinary calculi (UC) and assess the presence of such an association using a national population-based dataset. Elevated systemic proinflammatory pathways found in OSA patients may be linked to increased cardiovascular risk. Similar pathways have been identified in patients with UC., Materials and Methods: We identified 53,791 patients who had received a new diagnosis of UC between 2003 and 2008 from a dataset based on Taiwan's National Health Insurance program. We randomly selected 161,373 controls and then identified subjects with prior OSA in both groups. Odds ratios (ORs) for prior OSA in UC patients compared with controls were estimated in conditional logistic regression analyses by sex and by age group., Results: Prevalences of prior OSA were 1.2% in all subjects, 1.5% in patients with UC, and 1.1% in controls. After adjusting for patients' monthly income, geographic location, urbanization level, hypertension, diabetes, coronary heart disease and hyperlipidemia, and obesity, the OR for prior OSA in UC patients was 1.38 (95% CI 1.30-1.49) compared with controls. Prior OSA was associated with UC both in both males (OR 1.30, 95% CI 1.18-1.41) and females (OR 1.45, 95% CI 1.22-1.67). Notably, the adjusted OR was most pronounced in the youngest age group, <35 years (OR 2.57, 95% CI 1.97-3.34)., Conclusions: We conclude that patients with UC had a higher prevalence of prior OSA. The OR for prior OSA was most pronounced in the youngest age group., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Introduction: Stone disease is associated with systemic metabolic and hormonal disorders that share common risk factors with erectile dysfunction (ED); however, few studies have investigated the association between ED and urinary calculi (UC)., Aim: This case-control study aims to estimate the association of ED with UC using a nationwide, population-based database in Taiwan., Methods: We identified 5,620 patients with ED as the study group and randomly selected 16,860 patients as the controls. We estimated the odds ratio (OR) and 95% confidence interval (CI) of having previously been diagnosed with UC according to the presence/absence of ED using conditional logistic regression after adjusting for hypertension, diabetes, coronary heart disease, and hyperlipidemia., Main Outcome Measure: We measured the prevalence and risk of UC between the cases and controls. We only included UC cases if the UC diagnosis was made previous to the index date., Results: Of the sampled patients, 3,855 (17.2%) were found to have been diagnosed with UC prior to the index date; 1,251 (22.3%) ED patients and 2,604 (15.4%) controls had been diagnosed with UC, respectively. After adjusting for confounders, the OR in ED patients who had prior UC was 1.46 (95% CI = 1.35-1.58) when compared with controls. The ORs of UC for ED patients were somewhat higher in younger groups. In particular, when compared with controls the adjusted OR in ED patients between 40 and 49 years old for prior UC was 1.73 (95% CI = 1.48-2.02)., Conclusions: ED is associated with cases having a prior diagnosis of UC, particularly in younger populations., (© 2011 International Society for Sexual Medicine.)