To determine whether percutaneous nephrolithotomy or ureteroscopic lithotripsy lead to the development of hypertension, using the Taiwan National Health Insurance database.
Data were sourced from the Longitudinal Health Insurance Database (LHID2000) of Taiwan, Republic of China, compiled by the Taiwan National Health Insurance database from 1996 to 2010. Percutaneous nephrolithotomy and ureteroscopic lithotripsy were studied as a time-dependent covariate in a Cox proportional hazard model to estimate the hazard ratio for the effect of new onset hypertension.
A total of 2,552 patients were included with 232 PNL percutaneous nephrolithotomy, 1,160 ureteroscopic lithotripsy patients, and 1,160 comparison patients. There was a significant difference between the incidence of new onset hypertension between the percutaneous nephrolithotomy and comparison groups (adjusted hazard ratio 1.48, 95% CI 1.13-1.95, p=0.005). The percutaneous nephrolithotomy group also had a higher incidence of new onset hypertension than the ureteroscopic lithotripsy group (adjusted hazard ratio 1.39, 95% CI 1.06-1.83, p=0.018). The incidence rate of new hypertension during the follow-up period was 44.5 per 1,000 person-years in the percutaneous nephrolithotomy group, 33.0 per 1,000 person-years in the ureteroscopic lithotripsy group, and 30.2 per 1,000 person-years in the comparison group.
An association exists between nephrolithiasis patients who were treated with percutaneous nephrolithotomy and subsequent hypertension diagnosis. Though the exact mechanisms for this phenomenon are not clear, patients who undergo percutaneous nephrolithotomy may need close monitoring of blood pressure during post-operative follow-up.
Urology. 2016 Aug 02 [Epub ahead of print]
Tsu-Ming Chien, Yen-Man Lu, Yii-Her Chou, Wen-Jeng Wu, Chun-Nung Huang
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan., Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan., Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: .