Geographic variation and environmental risk factors for the incidence of initial kidney stones in patients with spinal cord injury

被引:27
作者
Chen, YY [1 ]
Roseman, JM
Devivo, MJ
Huang, CT
机构
[1] Univ Alabama Birmingham, Sch Publ Hlth, Dept Phys Med & Rehabil, Birmingham, AL 35294 USA
[2] Univ Alabama Birmingham, Sch Publ Hlth, Dept Epidemiol, Birmingham, AL 35294 USA
关键词
kidney; spinal cord injuries; calculi; factors; risk;
D O I
10.1016/S0022-5347(05)67440-X
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: Although geographic variability in cases of kidney stones, primarily calcium stones, is reported in the general population, little is known about geographic variability in subjects with spinal cord injury, in whom struvite stones predominate. We examined regional variation in the incidence rate of initial kidney stones and clarified the contributing factors in a spinal cord injury cohort. Materials and Methods: We used data from the national spinal cord injury database between 1986 and 1999 on 7,784 participants from 21 spinal cord injury centers with 24,492 person-years of followup accumulated and 286 incident stone cases. A multilevel Poisson model was constructed to evaluate the ecological effects of latitude, air temperature, water hardness and sunlight index on stone formation while controlling for individual factors, including participant age, race, gender, severity of injury and bladder management. Results: The incidence rate was significantly greater in the southeast and tended to increase with decreasing latitude, similar to the geographic association with kidney stones in the general population. This finding was not explained by differences in individual risk factors. Decreasing water hardness had the strongest effect on stones during year 1 after injury (relative risk 0.6, p <0.001), whereas average annual temperature had the strongest association with stones after year 1 (relative risk 1.1 per 1C increase, p = 0.03). The sunlight index had no association. Conclusions: Our study implies that the increased stone risk in spinal cord injured subjects is potentially preventable by modifying environmental exposure. Etiological factors may be similar to those for kidney stones in the general population.
引用
收藏
页码:21 / 26
页数:6
相关论文
共 19 条
[1]  
Briggs JC, 1977, 78200 US GEOL SURV, P436
[2]  
Burr R G, 1981, Int Rehabil Med, V3, P162
[3]  
BURR RG, 1978, ARCH PHYS MED REHAB, V59, P84
[4]   DRINKING-WATER HARDNESS AND UROLITHIASIS [J].
CHURCHILL, D ;
BRYANT, D ;
FODOR, G ;
GAULT, MH .
ANNALS OF INTERNAL MEDICINE, 1978, 88 (04) :513-514
[5]   REGIONAL VARIATION IN NEPHROLITHIASIS INCIDENCE AND PREVALENCE AMONG UNITED-STATES MEN [J].
CURHAN, GC ;
RIMM, EB ;
WILLETT, WC ;
STAMPFER, MJ .
JOURNAL OF UROLOGY, 1994, 151 (04) :838-841
[6]   A PROSPECTIVE-STUDY OF DIETARY CALCIUM AND OTHER NUTRIENTS AND THE RISK OF SYMPTOMATIC KIDNEY-STONES [J].
CURHAN, GC ;
WILLETT, WC ;
RIMM, EB ;
STAMPFER, MJ .
NEW ENGLAND JOURNAL OF MEDICINE, 1993, 328 (12) :833-838
[7]   THE RISK OF RENAL CALCULI IN SPINAL-CORD INJURY PATIENTS [J].
DEVIVO, MJ ;
FINE, PR ;
CUTTER, GR ;
MAETZ, HM .
JOURNAL OF UROLOGY, 1984, 131 (05) :857-860
[8]   PREDICTING RENAL CALCULUS OCCURRENCE IN SPINAL-CORD INJURY PATIENTS [J].
DEVIVO, MJ ;
FINE, PR .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 1986, 67 (10) :722-725
[9]  
DEVIVO MJ, 1991, WESTERN J MED, V154, P602
[10]   RELATIONSHIP OF MELANOMA AND OTHER SKIN CANCER MORTALITY TO LATITUDE AND ULTRAVIOLET RADIATION IN UNITED-STATES AND CANADA [J].
ELWOOD, JM ;
LEE, JAH ;
WALTER, SD ;
MO, T ;
GREEN, AES .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 1974, 3 (04) :325-332