A retrospective study on sex difference in patients with urolithiasis: who is more vulnerable to chronic kidney disease?

Urolithiasis is considered a vital public health issue with a substantial burden on kidney function. Additionally, only few reports focused on the gender difference in patients with urolithiasis. Therefore, this study aimed to compare the clinical characteristics of sex difference and their potential risk for chronic kidney disease (CKD) in patients with urolithiasis.

Patients diagnosed with stone disease from 2013 to 2018 were retrospectively reviewed and divided into two groups by gender. Clinical demographic characteristics, stone location, stone composition, urine chemistries, and renal function were investigated. Univariate and multivariate analyses were used to assess the relationship and potential risk of CKD between sex groups.

A total of 1802 patients were included: 1312 from men and 490 from women. Female patients had a higher rate of hypertension, diabetes, and dyslipidemia. Male patients predominantly had calcium-containing stones, especially calcium oxalate stone, uric acid stone, and struvite stone. Carbonate apatite stone was more frequently found in women. Complex surgeries such as percutaneous nephrolithotomy (PCNL) and ureteroscopic lithotripsy (URSL) were more frequently performed in women than that in men. Multivariate analysis confirmed that age > 60 years (odds ratios [ORs] = 6.36; 95% confidence interval [CI], 3.8-10.8), female sex (ORs = 5.31; 95% CI 3.3-8.4), uric acid stone (ORs = 3.55; 95% CI 2.0-6.4), hypertension (OR = 7.20; 95% CI 3.8-13.7), and diabetes (OR = 7.06; 95% CI 3.1-16.2) were independent predictors of poor prognoses in CKD.

The female gender is significantly associated with a higher prevalence of CKD among patients with urolithiasis. Therefore, women with stone disease may need close renal function monitoring during follow-up.

Biology of sex differences. 2021 Jun 07*** epublish ***

Tsu-Ming Chien, Yen-Man Lu, Ching-Chia Li, Wen-Jeng Wu, Hsueh-Wei Chang, Yii-Her Chou

Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan., Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung, 80756, Taiwan., Department of Biomedical Science and Environmental Biology, College of Life Science, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan., Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan. .