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Evaluate urinary stone components' epidemiological features in urolithiasis individuals and explore potential correlations between stone components and patients' clinical characteristics. A retrospective analysis of urinary stone compositions in 496 patients from a northern Taiwan medical center (February 2006 to October 2021) was conducted. We investigated associations between sex, age, body mass index (BMI), hypertension, diabetes mellitus (DM), hyperlipidemia (HLP), gout, coronary artery disease (CAD), cerebral vascular accident (CVA), chronic kidney disease (CKD), habits, urine pH, and three main stone groups: calcium oxalate (CaOx), calcium phosphate (CaP), and uric acid (UA). Males accounted for 66.5% of cases, with a male-to-female ratio of 1.99:1. Males were negatively associated with CaP stones (OR 0.313, p < 0.001) and positively with UA stones (OR 2.456, p = 0.009). Age showed a negative correlation with CaOx stones (OR 0.987, p = 0.040) and a positive correlation with UA stones (OR 1.023, p < 0.001). DM had a protective effect against CaP stones (OR 0.316, p = 0.004). Gout had a positive association with UA stones (OR 2.085, p = 0.035). Smoking was adversely associated with UA stones (OR 0.350, p = 0.018). Higher urine pH was a risk factor for CaP stones (OR 1.641, p = 0.001) and a protective factor against UA stones (OR 0.296, p < 0.001). These results may provide insights into the pathogenesis of urinary stones and the development of preventative strategies for high-risk populations. Further research is required to confirm and expand upon these findings. [ABSTRACT FROM AUTHOR]

Background: Prior studies indicated a link between urinary catheter use and urinary complications, highlighting the need for comprehensive, gender‐specific investigations. This study explored the association through a national retrospective cohort, emphasizing gender disparities and long‐term outcomes. Methods: Our study utilized data from the entire population covered by Taiwan's National Health Insurance Research Database from 2000 to 2017. We included 148,304 patients who had undergone Foley catheter placement and their propensity‐scores matched controls in the study. We evaluated urinary complications, which encompassed urinary tract cancer, urolithiasis, urethral stricture, obstructive uropathy, reflux uropathy, fistula, diverticulum, caruncle, false passage, prolapsed urethral mucosa, urinary tract rupture, and urinary tract infection. These were assessed using the Fine and Gray sub‐distribution proportional hazards model to compare between the Foley and non‐Foley groups. Sensitivity analyses were conducted with different matching ratios. Results: In the study, the non‐Foley group presented a marginally higher mean age (75.24 ± 10.47 years) than the Foley group (74.09 ± 10.47 years). The mean duration of Foley catheterization was 6.1 ± 4.19 years. Men with Foley catheterization exhibited the highest adjusted sub‐distribution hazard ratios for urinary tract cancer (6.57, 95% CI: 5.85–7.37), followed by women with Foley catheterization (4.48, 95% CI: 3.98–5.05), and men without catheterization (1.58, 95% CI: 1.39–1.8) in comparison with women without the procedure. Furthermore, men with Foley catheterization were found to be at the greatest risk for complications such as urolithiasis, urethral stricture, obstructive and reflux uropathy, fistula, diverticulum, caruncle, false passage, prolapsed urethral mucosa, and urinary tract rupture. Conversely, women with urinary catheterization were most susceptible to urinary tract infections. Conclusions: The evidence confirms that urinary catheterization significantly increases urinary complications, particularly among men. Our study underscores the crucial need for healthcare providers to carefully evaluate the necessity of catheterization, aim to shorten its duration whenever feasible, and strictly adhere to established protocols to minimize complications. [ABSTRACT FROM AUTHOR]

Introduction: Hematuria is a worrisome symptom in children and is sometimes associated with urinary tract infections (UTIs). This study aimed to identify useful clinical factors that can predict UTIs in hematuria patients without pyuria in the pediatric emergency department (ED). Methods: We retrospectively recruited patients with hematuria from the pediatric ED. Clinical symptoms, urine biochemistry and microscopic examination results, and blood laboratory tests were analyzed to identify the predictors of UTIs. Patients were divided into the verbal group (age ≥ 2 years) and non-verbal group (age < 2 years) for identifying predictors of UTIs. Causes of hematuria were also investigated. Results: A total of 161 patients with hematuria without pyuria were evaluated. Among symptoms, dysuria was significantly correlated with UTIs. Regarding urine biochemistry data, urine esterase and urine protein > 30 mg/dl were found to be significant parameters for predicting UTIs, while urine esterase and urine nitrite showed significant differences in children with age < 2 years. In the urine microscopic examinations, urine red blood cells (RBC) > 373/µL in children aged ≥ 2 years and urine RBC > 8/µL in children aged < 2 years were associated with UTIs. In addition, UTIs and urinary tract stones were found to be the top two causes of hematuria. Conclusions: Dysuria, urine esterase, urine nitrite, and urine protein may be useful parameters for predicting UTIs in pediatric patients with hematuria but no pyuria in the ED. In addition, a UTI was the most commonly identified etiology of hematuria without pyuria, followed by urinary tract stones. [ABSTRACT FROM AUTHOR]

Background: Patients with gout have an increased risk of urolithiasis and usually need urate-lowering therapy (ULT) for the prevention of disease progression. However, there is a paucity of clinical data regarding the risk of future urolithiasis in ULT users.Methods: This nested case-control study was performed using the Taiwan National Health Insurance Research Database. The aim of this study was to examine whether ULT (xanthine oxidase inhibitors [XOIs] or uricosuric agents) is associated with risk of future urolithiasis in patients with gout. Data were collected from January 2000 to December 2012.Results: This study included 2307 case patients and 2307 matched controls. Case patients had gout that developed into urolithiasis, and control patients had gout but were not diagnosed with urolithiasis during the study period. Patients had a mean age of 56.3 years at diagnosis of gout, and 83.2% were male patients. No association was detected between use of XOIs or uricosuric agents and risk of future urolithiasis. Furthermore, there was no significant difference in the risk of future urolithiasis in patients exposed to various cumulative days of XOI or uricosuric prescriptions.Conclusion: The present study provides evidence that neither XOIs nor uricosuric agents are associated with risk of future urolithiasis in patients with gout. Before the availability of more clinical evidence, ensuring high fluid intake and prospective monitoring of urolithiasis development are still important for uricosuric agent users. [ABSTRACT FROM AUTHOR]

Urolithiasis and osteoporosis are two different pathological entities, but are both important public health issues in older patients. Moreover, the two diseases may share some similar pathogenesis pathway. Currently, few studies focus on the relationship between urolithiasis and osteoporosis. Furthermore, whether the common mobilities influence the long-term osteoporosis rate in urolithiasis patients has never been studied. In the present study, we used the Taiwan National Health Insurance Database (LHID 2000) compiled by the NHI from 1996 to 2013 to determine whether urolithiasis influenced long-term osteoporosis; controls were matched for age, sex, and other comorbidities (including hypertension, diabetes mellitus, dyslipidemia, liver disease, and cardiovascular disease). We included a total of 91,254 patients, including 22,575 patients with urolithiasis and 68,679 control patients. There was a significant difference between the incidence of osteoporosis between the urolithiasis and control groups (adjusted hazard ratio 1.34, 95% CI 1.19-1.79, p < 0.001) during the follow up. The incidence rate of osteoporosis during the follow-up period was 8.87 per 1000 person-years in the urolithiasis group and 6.37 per 1000 person-years in the control group. Based on our results, it is evident that urolithiasis significantly increases the subsequent osteoporosis rate. Though the clinical mechanisms are not fully understood, patients who have a history of urolithiasis may need regular follow-up assessment of bone marrow density. [ABSTRACT FROM AUTHOR]

Background. The purpose of this study was to investigate the relationship between chronic periodontitis (CP) and upper urinary tract stone (UUTS) in Taiwan by using a population-based data set. Methods. A total of 16,292 CP patients and 48,876 randomly-selected controls without chronic periodontitis were selected from the National research database and studied retrospectively. Subjects selected have not been diagnosed with UUTS previously. These subjects were prospectively followed for at least eight years. Cox regression models were used to explore the connection between risk factors and the development of UUTS. Results. The CP patients have a greater chance of developing UUTS compared to controls (1761/16292, 10.8% vs. 4775/48876, 9.8%, p-values < 0.001). Conditioned logistic regression suggested CP increases the risk of UUTS development (HR 1.14, 95% CI [1.08-1.20], p<0:001). After respective adjustment for age, gender, hypertension and diabetes, results showed that CP still increases the risk of developing UUTS (HR 1.14, 95% CI [1.08-1.20], p<0:001). Conclusion. By using a population-based database with a minimum eight 8 follow-up of CP in Taiwan, we discovered patients with CP are more likely to develop UUTS. [ABSTRACT FROM AUTHOR]

Salvia miltiorrhiza Bunge (Danshen), a common medicinal plant in traditional Chinese medicine, has been tested effectively to prevent urolithiasis in animals; nevertheless, the clinical application for urolithiasis remains unclear. We thus investigated the clinical effect of Danshen by analyzing the database from the Taiwan National Institute of Health. The cohort “Danshen-users” was prescribed Chinese herb medicine Danshen after the initial diagnosis of calculus. The control group (non-Danshen-users) was not given Danshen after the initial diagnosis of calculus. The date of first using Danshen after new diagnosis date of calculus was considered as index date. The outcome variables were categorized into two categories: the first category included calculus surgical treatment, including extracorporeal shock wave lithotripsy, ureteroscopy, percutaneous nephrostomy with fragmentation, and ureterolithotomy; the second category included any bleeding disorders, including gastrointestinal bleeding, intracranial hemorrhage, and blood transfusions. The incidence of calculus surgical treatment in the Danshen-users was less than that in the non-Danshen-users: 1.071% in 1,000 person-years (200 people followed up for 5 years) and 3.142% in 1,000 person-years, respectively. The adjusted hazard ratio for calculus surgical treatment in the Danshen-users was 0.34 (95% confidence intervals: 0.31–0.38) as compared to the non-Danshen-users. When stratified by sex, the incidence of calculus surgical treatment in Danshen-users was 0.685% in 1,000 person-years and 1.575% in 1,000 person-years for women and men, respectively, which was lower than that in non-Danshen-users. Danshen decreased the ratio of subsequent stone treatment after the first treatment in the study population; there was no increased bleeding risk due to long-term Danshen use. [ABSTRACT FROM AUTHOR]

Large cohort studies on whether any association existed between urological interventions for urolithiasis and the development of CKD are lacking. From claims data of the National Health Insurance (NHI) program of Taiwan, we identified 54,433 patients newly diagnosed with urolithiasis during 1998-2010. For each case, four individuals without urolithiasis were randomly selected and frequency matched by age, sex, and diagnosis year. Both groups were followed up until the end of 2010. Incident CKD events were identified by the International Classification of Diseases, Ninth Revision (ICD-9) code in the NHI registration database. The overall incidence of periodontal diseases was 1.85-fold greater in the urolithiasis group than in the comparison group (33.9 vs 18.3 per 10,000 person-years; 95 % confidence interval [CI] 1.81-1.90). Compared with the adjusted hazard ratios (aHRs) of nonurolithiasis patients, those of patients with urolithiasis increased with the number of medical visits (from 0.91 [95 % CI 0.83-1.00] to 10.6 [95 % CI 9.48-11.8]) and urological interventions (from 1.22 [95 % CI 1.10-1.35] to 86.4 [95 % CI 67.6-110.6]). The aHR was similar in different urological intervention methods, extracorporeal shock wave lithotripsy, ureteroscopy, percutaneous nephrostolithotomy, and open stone surgery. The urological intervention for urolithiasis is associated with an increased risk of CKD. We should be aware of the risk for CKD, especially in patients who have received multiple urological interventions and those elderly. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the correlation of ankylosing spondylitis (AS) with nephrolithiasis by performing a nationwide populationbased cohort study. Patients and methods: The data used in this retrospective cohort study were collected from the Taiwan National Health Insurance Research database. The study included a total of 3,334 AS patients (1,914 males, 1,420 females; mean age 44.51±16.83 years; range 22 to 79 years) and 13,336 non-AS patients (7,656 males, 5,680 females; mean age 44.27±17.01 years; range 21 to 78 years) who had been followed-up on an average of 6.78 years and 6.75 years, respectively, between January 2000 and December 2008. Results: The percentage of newly diagnosed nephrolithiasis was 4.8% in all study subjects. However, the percentages of newly diagnosed nephrolithiasis were 5.76% and 4.58% in the AS and non-AS cohorts, respectively. After adjusting the patients' sex, age, urbanization level, and comorbidities, the hazard ratio obtained from our multivariable Cox model was 1.19. Conclusion: Our study findings indicate that patients with AS are more likely to develop nephrolithiasis than non-AS patients. [ABSTRACT FROM AUTHOR]

ConclusionsThis study demonstrates an association between sialolithiasis and nephrolithiasis. The results call for more awareness of this association among physicians and patients with nephrolithiasis.ObjectiveVery few empirical studies have been conducted to explore the potential association between sialolithiasis and nephrolithiasis. As such, the association between sialolithiasis and nephrolithiasis still remains unclear. This study aimed to explore the possible association between sialolithiasis and nephrolithiasis using a population-based dataset.MethodsUsing data from the Taiwan Longitudinal Health Insurance Database 2005, this case-control study identified 966 patients with sialolithiasis as cases and 2898 sex- and age-matched subjects without sialolithiasis as controls. Conditional logistic regressions were conducted to examine the association of sialolithiasis with previously diagnosed nephrolithiasis.ResultsOut of 3864 sampled patients, 165 (4.27%) had prior nephrolithiasis. Using Chi-square test, it was found that there was a significant difference in the prevalence of prior nephrolithiasis between the cases and controls (10.25% vs 2.28%,p < 0.001). Moreover, by conditional logistic regression analysis, the odds ratio of prior nephrolithiasis for cases was 4.74 (95% CI = 3.41–6.58,p < 0.001) when compared to controls after adjusting for monthly income, geographic location, urbanization level of residence, diabetes, hypertension, heart failure, chronic renal disease, and tobacco use. [ABSTRACT FROM PUBLISHER]

Objectives: To investigate the pattern of Traditional Chinese Medicine (TCM) usage for urolithiasis patients in Taiwan and to determine the most common Chinese herbal products used for urolithiasis. Design: Retrospective review of urolithiasis patients treated with TCM treatment. Settings/Location: One million randomly selected samples in the Taiwanese National Health Insurance Research Database between 1997 and 2008. Patients: Eighty-two thousand five hundred and fifty-one newly diagnosed urolithiasis patients. Outcome measures: The correlation between TCM treatment, demographic factors, or medical conditions. Results: A total of 62.6% of urolithiasis patients use TCM treatment. A younger age, female gender, polypharmacy, multiple comorbidities, and stone in the lower urinary tract result in a greater tendency to use TCM, after adjusting for demographic factors. Jia-Wei-Xiao-Yao-San Extract Powder and Ji-Sheng-Shen-Qi-Wan Extract Powder are the most frequently prescribed Chinese medicine formulae. Conclusion: This is the first study to examine the use of and the prescription pattern for TCM in urolithiasis patients using a random, national population-based sample. More than 62% of urolithiasis patients use TCM, and patients with polypharmacy, multiple comorbidities, and stone in the ureter are more likely to use TCM. The most frequently prescribed Chinese medicine formulae were Jia-Wei-Xiao-Yao-San Extract Powder and Ji-Sheng-Shen-Qi-Wan Extract Powder, which were reported to retard the progression of renal failure and alleviate flank pain or tenderness. [ABSTRACT FROM AUTHOR]

Summary: Urinary calculi were associated with higher risk of vertebral and upper limb fracture. Therefore, patients with urinary calculi should be evaluated carefully because they may have a higher risk of subsequent fracture later in life. Introduction: The contribution of urinary calculi to reduced bone mineral density has been recognized. However, the association of urinary calculi with the risk of fracture remains inconclusive. The aim of the study was to determine the risk of overall fracture and fractures at different anatomic sites in patients with urinary calculi. Methods: The records of inpatients and outpatients with urinary calculi were retrieved from the Taiwan National Health Insurance Database from 2000 to 2010. Among patients with urinary calculi at the cohort entry, controls were matched using propensity scores on a 1:1 ratio. All subjects were followed up from the date of enrollment until fracture occurrence, death, or December 31, 2010. There were 46,243 Medicare beneficiaries with a diagnosis of urinary calculi and 46,243 controls without calculi enrolled. Results: Among these patients, 6005 patients with a diagnosis of urinary calculi and 5339 controls developed fractures during a median follow-up period of 5.3 years. Patients with urinary calculi had a higher incidence of fracture compared with controls (23.9 versus 22.1 per 1000 person-years) and a greater risk of overall fractures (adjusted hazard ratio [aHR] 1.08, 95 % confidence interval [CI], 1.04-1.12), mainly located at the vertebrae (aHR 1.15, 95 % CI, 1.06-1.25) and upper limb (aHR 1.07, 95 % CI, 1.01-1.14), but the risk for hip fracture was not increased (aHR 1.09, 95 % CI, 0.96-1.22). Conclusions: Urinary calculus is independently associated with higher risk of subsequent fracture. Patients with urinary calculi should pay attention to the future vertebral and upper limb fractures. [ABSTRACT FROM AUTHOR]

Objective To investigate the trends of newly diagnosed incidence, medical utilization, and medical costs for pediatric urolithiasis in Taiwan. Materials and Methods The present study uses the National Health Insurance Research Database, which contains the data of all medical benefit claims from the individuals enrolled in the national and single-payer insurance program in Taiwan. The National Health Insurance covered 22,717,053 enrollees, nearly 99% of Taiwan's population. Our analysis includes all subjects aged <18 years with a primary diagnosis of urolithiasis. We analyzed the temporal trend for annual newly diagnosed incidence, medical care visits, and medical costs for pediatric urolithiasis from 1998 to 2007. Results A total of 1474 patients aged <18 years with newly diagnosed urolithiasis were identified, including 719 (48.8%) boys and 755 (51.2%) girls. The overall newly diagnosed rate of urolithiasis in pediatric population was 0.038% in 2007. The peak age stratum of urolithiasis occurrence in 2007 was 15-18 years. The trend of annual newly diagnosed incidences for boys, girls, and all children declined from 1998 to 2007. Furthermore, there were declining trends both in medical costs and annual medical care visits during the study period. Conclusion This is the first nationwide population-based study to indicate the declining trends in newly diagnosed rate, medical care visits, and medical costs for pediatric urolithiasis. These findings help to quantify and establish the burden of pediatric urolithiasis. These findings help to quantify and establish the burden of medical care for pediatric urolithiasis and to further refine the medical policy. [ABSTRACT FROM AUTHOR]

Background and Purpose: To investigate the factors associated with outcomes and medical costs for percutaneous nephrolithotomy (PCNL). Methods: The present study uses a subset of the National Health Insurance Research Database (NHIRD), known as the Longitudinal Health Insurance Database 2005 (LHID 2005), which contains the data of all medical benefit claims from 1997 to 2010 for a subset of 1 million enrollees randomly drawn from the population of 22.72 million persons who were enrolled in 2005. The claims data for all subjects with a diagnosis of urolithiasis who underwent PCNL were analyzed. Hospital and surgeon case volume were classified by quartile. The correlations of all patient, surgeon, and hospital variables with the outcomes and medical costs of PCNL were analyzed by generalized estimating equations. Results: A total of 995 subjects received PCNL. In univariate analysis, PCNL performed by high-volume surgeons (≥12) cost 26% less ($2684 vs $1986) and resulted in a 34.3% shorter hospital stay (6.5 vs 9.9 days) compared with low-volume surgeons (≤3). In multivariate analysis, surgeon volume was a significant predictor for medical cost, length of stay, and intensive care unit transfer but not complications and mortality. Conclusions: Surgeon volume was associated with lower medical costs and shorter length of stay after PCNL. Surgeon volume, however, was not an independent predictor of complications and mortality. Our findings have important implications for urologists and policymakers with regard to the cost and effectiveness of PCNL. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the epidemiology of upper urinary tract stone disease in Taiwan using a nationwide, population based database. Materials and Methods: This study was based on the National Health Insurance Research Database of Taiwan, which contains data on all medical beneficiary claims from 22.72 million enrollees, accounting for almost 99% of the Taiwanese population. The Longitudinal Health Insurance Database 2005, a subset of the National Health Insurance Research Database, contains data on all medical benefit claims from 1997 through 2010 for a subset of 1 million beneficiaries randomly sampled from the 2005 enrollment file. For epidemiological analysis we selected subjects whose claims records included the diagnosis of upper urinary tract urolithiasis. Results: The age adjusted rate of medical care visits for upper urinary tract urolithiasis decreased by 6.5% from 1,367/100,000 subjects in 1998 to 1,278/100,000 in 2010. There was a significantly decreasing trend during the 13-year period in visits from female and all subjects (r2 = 0.86, p = 0.001 and r2 = 0.52, p = 0.005, respectively). In contrast, an increasing trend was noted for male subjects (r2 = 0.45, p = 0.012). The age adjusted prevalence in 2010 was 9.01%, 5.79% and 7.38% in male, female and all subjects, respectively. The overall recurrence rate at 1 and 5 years was 6.12% and 34.71%, respectively. Male subjects had a higher recurrence rate than female subjects. Conclusions: Our study provides important information on the epidemiology of upper urinary tract stone disease in Taiwan, helping to quantify the burden of urolithiasis and establish strategies to decrease the risk of urolithiasis. [ABSTRACT FROM AUTHOR]

Summary: This population-based case-control analysis investigated the association between osteoporosis and prior urinary calculus (UC) in Taiwan. We succeeded in detecting an association between osteoporosis and prior UC (adjusted odds ratio = 1.66). This association was consistent and significant regardless of stone location. Introduction: UC has been demonstrated to be a risk factor for osteoporotic fractures, but no studies to date have directly investigated the association between UC and osteoporosis. This case-control analysis aimed to investigate the association of osteoporosis with prior UC using a population-based dataset in Taiwan. Methods: We first identified 39,840 cases ≥40 years who received their first-time diagnosis of osteoporosis between 2002 and 2009 and then randomly selected 79,680 controls. We used conditional logistic regression analyses to compute the odds ratio (OR) and the corresponding 95 % confidence interval (CI) for having been previously diagnosed with UC between cases and controls. Results: The OR of having been previously diagnosed with UC for patients with osteoporosis was 1.66 (95 % CI = 1.59-1.73) when compared to controls after adjusting for geographic location, urbanization level, type I diabetes mellitus, coronary heart disease, hyperlipidemia, rheumatoid arthritis, stroke, renal disease, Parkinson's disease, hyperthyroidism, chronic hepatopathy, Cushing's syndrome, malabsorption, gastrectomy, obesity, and alcohol abuse/alcohol dependence syndrome. The results consistently showed that osteoporosis was significantly associated with a previous diagnosis of UC regardless of stone location; the adjusted ORs of prior kidney calculus, ureter calculus, bladder calculus, and unspecified calculus when compared to controls were 1.71 (95 % CI = 1.61-1.81), 1.60 (95 % CI = 1.47-1.74), 1.59 (95 % CI = 1.23-2.04), and 1.69 (95 % CI = 1.59-1.80), respectively. Conclusions: This study succeeded in detecting an association between osteoporosis and prior UC. In addition, our findings were consistent and significant regardless of stone location. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence, incidence, associated risk factors, and treatment of pediatric urolithiasis in Taiwan. Methods: The present study used a subset of the National Health Insurance Research Database, known as the Longitudinal Health Insurance Database 2005, which contains the data for all paid medical benefit claims from 1997 to 2006 for a subset of 1 million beneficiaries randomly drawn from the population of 22.72 million individuals during any part of the calendar year 2005. Our analysis included the data of all newly diagnosed pediatric patients with an “International Classification of Disease, 9th revision,” diagnosis of urolithiasis from 1997 through 2006. Results: A total of 1679 pediatric subjects who had newly diagnosed urolithiasis without a previous attack were identified from 1997 to 2006 as the study sample. Of the 1679 patients, 808 were boys (48.1%) and 871 were girls (51.9%). The incidence rate of urolithiasis in 2005 was 0.047%. The peak age of pediatric stone occurrence in the study sample was 15-18 years (49.6%). The most common associated disease was urinary tract infection (34.1% of all subjects). The occurrence rate of pediatric urolithiasis correlated significantly with the urbanization level of the residence and geographic area. Conclusion: Using a nationwide, population-based study provides important clinical and epidemiologic information regarding pediatric urolithiasis. Additional studies are warranted to determine the effect of geographic area and urbanization level on the occurrence of pediatric stone disease. [ABSTRACT FROM AUTHOR]

Purpose: No prospective followup study to date to our knowledge has evaluated the relationship between stone disease and the subsequent risk of diabetes mellitus. In this population based study we examine the relationship between a history of urinary calculi and the risk of diabetes mellitus in Taiwan. Materials and Methods: A total of 23,569 adult patients with new diagnoses of urinary calculi from 2001 to 2003 were recruited together with 70,707 matched enrollees as a comparison cohort. All patients were tracked for a 5-year period from the index health care encounter to identify those who had a subsequent diagnosis of diabetes mellitus. Cox proportional hazards models were used to compute the risk of diabetes mellitus for the study and comparison cohorts. Results: Of a total of 94,276 patients 2,921 (12.39%) from the urinary calculi group and 6,171 (8.73%) from the comparison group received a subsequent diagnosis of diabetes mellitus during the followup period. The stratified Cox proportional analysis showed that, after censoring individuals who died during followup, and adjusting for patient monthly income, geographic location, urbanization level, hypertension, hyperlipidemia and obesity, the hazard of receiving a first diagnosis of diabetes during the 5-year followup was 1.32 times greater for patients with urinary calculi than for those in the comparison cohort (95% CI 1.26–1.39, p <0.001). Conclusions: Our results suggest that patients who receive a diagnosis of urinary calculi are at increased risk for diabetes mellitus at 5-year followup. [ABSTRACT FROM AUTHOR]

Abstract: Background: This study aims to investigate the association between urinary melamine concentration and the risk of urolithiasis in adult. Methods: From 2003 to 2007, 11 and 22 patients diagnosed with upper urinary tract uric acid urolithiasis and calcium urolithiasis, respectively, were recruited from Kaohsiung Medical University Hospital. For comparison, we randomly collected 22 sex- and age-matched subjects who come to the same hospital for regular health check-up at the same period of time. Urinary melamine concentration was measured by the method of triple-quadrupole liquid chromatography tandem mass spectrometry (LC-MS/MS). Wilcoxon rank sum test was used to compare the urinary melamine concentrations in uric acid urolithiasis patients with controls as well as in calcium urolithiasis patients with controls. FDR (false discovery rate) was used to correct the p-values for two comparisons. Results: Subjects with uric acid urolithiasis (median: 0.50 vs 0.06μg/mmol creatinine, Wilcoxon test: FDR_p =0.024) and with calcium urolithiasis (median: 0.14 vs 0.06, FDR_p =0.024) had significantly higher urinary melamine concentration than controls. Based on the ROC curves, subjects whose melamine levels were over 0.262 and 0.037μg/mmol creatinine, respectively, might have significant risks to have uric acid and calcium urolithiasis. Conclusion: This preliminary study suggests that exposure to even low-dose melamine-related products still have the potential to develop both uric acid and calcium urolithiasis in adults. [Copyright &y& Elsevier]

Purpose: To evaluate the independent and combined effects of alcohol drinking, cigarette smoking and betel quid chewing on the risk of calcium urolithiasis. Methods: A total of 354 cases diagnosed with calcium urolithiasis and 354 age- and sex-matched healthy controls were recruited from Kaohsiung Medical University Hospital between June 2003 and February 2007. All subjects completed a detailed questionnaire survey and provided blood and urine samples for biochemical evaluation. Results: Current cigarette smoking (odds ratio [OR], 1.66; 95% confidence interval [95%CI], 1.11–2.50; p =0.014) and current betel quid chewing (OR, 1.97; 95%CI, 1.06–3.64; p =0.032), but not current alcohol drinking, were found to be independent risk factors for the development of calcium urolithiasis. The joint risk of current cigarette smoking and current betel quid chewing was increased 3.73-fold (OR, 3.73; 95%CI, 1.81–7.70, p <0.001) compared to those who had neither habit. Conclusions: Both cigarette smoking and betel quid chewing are independent risk factors for the development of calcium urolithiasis. The risk effect is even strengthened when subjects have both habits. These findings suggest users can greatly reduce the risk of calcium urolithiasis if they quit these two habits. [Copyright &y& Elsevier]

Introduction: A nationwide survey was conducted to investigate the prevalence of upper urinary calculi in Taiwan. Materials and Methods: A postal questionnaire was mailed to 27,758 people, 0.2% of the adults in Taiwan. Results: Of the 4,588 valid respondents, 440 had at least one episode of upper urinary calculus disease. The overall prevalence was 9.6% (14.5% in males and 4.3% in females). Men were more prone to nephrolithiasis than women (age-adjusted prevalence of 12.2% in men and 3.1% in women, p = 0). The ‘stone belt’ was localized in the Midwest region of Taiwan. A gender- and age-adjusted multivariate analysis revealed that alcohol consumption and family history of kidney stone were significant risk factors for stone occurrence. Compared with general population, the odds ratios for stone disease in inhabitants whose father, mother and both parents with stone history were 3.44 [95% confidence interval (CI), 2.33–5.07], 4.79 (95% CI, 2.85–8.07) and 10.40 (95% CI, 3.75–28.84), respectively. The subtropical temperature and gradually higher socioeconomic standards of living may contribute to the high prevalence. Inhabitants in the Midwest region have higher risk to develop stones. Conclusions: Further studies are needed to investigate the exact cause of these regional variations of stone prevalence. Nevertheless, the present study provides an additional piece of information on worldwide epidemiology of urolithiasis.Copyright © 2002 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

In this paper, we present an Internet of things (IoT)-based data collection system for the risk assessment of urinary stone formation, or urolithiasis, by the measurement and storage of four parameters in urine: pH, concentrations of ionized calcium (Ca2+), uric acid and total dissolved solids. The measurements collected by the system from patients and healthy individuals grouped by age and gender will be stored in a cloud database. These will be used in the training phase of an artificial intelligence (AI) machine learning process utilizing the logistics regression model. The trained model provides a binary risk assessment, indicating if the end user is either a stone-former or not. For system validation, standard chemical solutions were used. Preliminary results indicated a sufficient measurement range, falling within the physiological range, and resolution for pH (2.0–10.0, +/−0.1), Ca2+(0.1–3.0 mmol/l, +/−0.05), uric acid (20–500 ppm, +/−1) and conductivity (1.0–40.0 mS/cm, +/−0.1), exhibiting high correlation with standard instruments. We intend to deploy this system in few hospitals in Taiwan to collect the data of patients' urine, with analysis aided by urologist assessments for the risk of urolithiasis. The modularized design allows future modification and expansion to accommodate other sensing analytes. [ABSTRACT FROM AUTHOR]

A response by Fernando J. Garca López and colleagues to a letter to the editor about their article on urolithiasis incidence in adults in Taiwan is presented.

Abstract: 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 &y& Elsevier]

Background: Healthcare providers have many health-related risk factors that might contribute to urolithiasis: a heavy workload, a stressful workplace, and an unhealthy quality of life. However, the urolithiasis risk in healthcare providers is not clear.Methods: Using Taiwan's National Health Insurance Research Database, we identified 50,226 physicians, 20,677 pharmacists, 122,357 nurses, and 25,059 other healthcare providers as the study cohort and then randomly selected an identical number of patients who are not healthcare providers (general population) as the comparison cohort for this study. Conditional logistical regression analysis was used to compare the urolithiasis risk between healthcare providers and comparisons. Physician specialty subgroups were also analyzed.Results: Physicians had a lower urolithiasis risk than did the general population (adjusted odds ratio [AOR]: 0.682; 95 % confidence interval [CI]: 0.634-0.732) and other healthcare providers (AOR: 0.661; 95 % CI 0.588-0.742) after adjusting for hypertension, diabetes, hyperlipidemia, coronary artery disease, and residence location. For pharmacists, nurses, and other healthcare providers, the urolithiasis risk was not significantly different than that for general population. Subgroup analysis showed that surgeons and family medicine physicians had a lower urolithiasis risk than did physician comparisons (AOR: 0.778; 95 % CI: 0.630-0.962 and AOR: 0.737; 95 % CI: 0.564-0.962, respectively).Conclusions: Although job stress and heavy workloads affect physicians' health, physicians had a lower urolithiasis risk than did the general population and other healthcare providers. This might be attributable to their greater medical knowledge and access to healthcare. Our findings provide useful information for public health policy makers about the disease risks of healthcare providers. [ABSTRACT FROM AUTHOR]

Objective: Whether migraine is associated with urinary calculi is an unresolved issue, although topiramate, a migraine-preventive agent, is known to contribute to this complication. This study investigates the association between migraine and the risk of urinary calculi., Methods: We identified a total of 147,399 patients aged ≥18 years with migraine diagnoses recorded in the Taiwan National Health Insurance Research Database between 2005 and 2009. Each patient was randomly matched with one individual without headache using propensity scores. All participants were followed from the date of enrollment until urinary calculi development, death, or the end of 2010., Results: The risk of urinary calculi was greater in the migraine than the control cohort (adjusted hazard ratio (aHR), 1.58; 95% confidence interval (CI), 1.52-1.63; p < 0.001, irrespective of the influence of topiramate. The risk was higher in younger and female patients. The magnitude of the risk was proportional to the annual frequency of clinic visits for headache (≥6 vs. <3, aHR = 1.11; 95% CI, 1.04-1.17; p = 0.002), but did not differ between migraine patients with and without aura., Conclusions: Our study showed migraine was associated with an increased risk of urinary calculi, independent of topiramate use. A higher frequency of clinic visits was associated with a greater risk., (© International Headache Society 2014.)