Participants were 42,136 black and white adults enrolled in the Southern Community Cohort Study between 2002 and 2009, with no history of kidney stones and receiving Medicare or Medicaid services.
Incident kidney stone diagnoses through December 2014 were determined via linkage with Centers for Medicare and Medicaid Services research files. Hazard ratios (HRs) for associations with race and sex were computed from multivariable Cox proportional hazards models adjusting for baseline characteristics, comorbid diseases, and dietary intakes.
During 116,931 and 270,917 person-years of follow-up for whites and blacks, respectively, age-adjusted incidence rates (95% confidence interval [CI]) were 5.98 (4.73-7.23) and 4.50 (3.86-5.14) per 1000 person-years for white men and women, respectively, while corresponding rates among blacks were 2.19 (1.71-2.67) and 2.47 (2.19-2.75) per 1000 person-years. Risk was higher among whites compared to blacks (HR = 2.23, 95% CI 1.97-2.53). Male sex was significantly associated with risk among whites (HR = 1.45, 95% CI 1.20-1.75), but not among blacks (HR = 0.90, 95% CI 0.75-1.07). Formal tests of interaction by race and sex were statistically significant for all models (P = .01 for fully adjusted model).
The association of incident kidney stones with sex differs between whites and blacks. White men have the highest risk, while no difference in risk is observed between black men and women.
Urology. 2018 May 10 [Epub ahead of print]
Ryan S Hsi, Edmond K Kabagambe, Xiang Shu, Xijing Han, Nicole L Miller, Loren Lipworth
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN. Electronic address: ., Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN., International Epidemiology Institute, Rockville, MD., Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN., Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt O'Brien Center for Kidney Disease, Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
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