Lael Reinstatler1, Sari Khaleel1, Vernon M Pais2. 1. Section of Urology, Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire; Geisel School of Medicine at Dartmouth (SK), Hanover, New Hampshire. 2. Section of Urology, Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire; Geisel School of Medicine at Dartmouth (SK), Hanover, New Hampshire. Electronic address: Vernon.m.pais.jr@hitchcock.org.
Abstract
PURPOSE: Lithogenic urinary changes develop during pregnancy. Such changes may increase stone proclivity thereafter in working and child rearing aged women. However, to our knowledge such an association has not been previously identified. MATERIALS AND METHODS: We analyzed nationally representative data from the 2007 to 2012 NHANES (National Health and Nutrition Examination Survey) to assess the association between pregnancy and nephrolithiasis. RESULTS: The weighted national prevalence of nephrolithiasis among women 50 years or younger was 6.4% (95% CI 5.4-7.6). The prevalence of nephrolithiasis was significantly higher among women who had been pregnant compared with those who had never been pregnant (7.5% vs 3.2%, p = 0.0004). On univariate regression those who had been pregnant had more than twice the odds of having had kidney stones (OR 2.44, 95% CI 1.50-3.98). An increased likelihood of nephrolithiasis in those with a history of pregnancy persisted on multivariable logistic regression adjusting for age, ethnicity, obesity, history of diabetes, gout, hormone use, water intake and high sodium diet (OR 2.13, 95% CI 1.31-3.45). Finally, the adjusted prevalence of nephrolithiasis increased significantly with an increasing number of pregnancies from 5.2% in those with 0 reported pregnancies to 12.4% in those with 3 or more pregnancies (p = 0.001). CONCLUSIONS: Nephrolithiasis is strongly associated with prior pregnancies. Among women of reproductive age the odds of stones are greater than doubled in those who had been pregnant compared with those who had never been pregnant. Nephrolithiasis prevalence also increases with the increasing number of pregnancies. Future investigation and identification of modifiable risk factors among pregnant patients may allow for a reduction in the burden of stone disease in women.
PURPOSE: Lithogenic urinary changes develop during pregnancy. Such changes may increase stone proclivity thereafter in working and child rearing aged women. However, to our knowledge such an association has not been previously identified. MATERIALS AND METHODS: We analyzed nationally representative data from the 2007 to 2012 NHANES (National Health and Nutrition Examination Survey) to assess the association between pregnancy and nephrolithiasis. RESULTS: The weighted national prevalence of nephrolithiasis among women 50 years or younger was 6.4% (95% CI 5.4-7.6). The prevalence of nephrolithiasis was significantly higher among women who had been pregnant compared with those who had never been pregnant (7.5% vs 3.2%, p = 0.0004). On univariate regression those who had been pregnant had more than twice the odds of having had kidney stones (OR 2.44, 95% CI 1.50-3.98). An increased likelihood of nephrolithiasis in those with a history of pregnancy persisted on multivariable logistic regression adjusting for age, ethnicity, obesity, history of diabetes, gout, hormone use, water intake and high sodium diet (OR 2.13, 95% CI 1.31-3.45). Finally, the adjusted prevalence of nephrolithiasis increased significantly with an increasing number of pregnancies from 5.2% in those with 0 reported pregnancies to 12.4% in those with 3 or more pregnancies (p = 0.001). CONCLUSIONS:Nephrolithiasis is strongly associated with prior pregnancies. Among women of reproductive age the odds of stones are greater than doubled in those who had been pregnant compared with those who had never been pregnant. Nephrolithiasis prevalence also increases with the increasing number of pregnancies. Future investigation and identification of modifiable risk factors among pregnant patients may allow for a reduction in the burden of stone disease in women.
Authors: Lisa E Vaughan; Felicity T Enders; John C Lieske; Vernon M Pais; Marcelino E Rivera; Ramila A Mehta; Terri J Vrtiska; Andrew D Rule Journal: Mayo Clin Proc Date: 2018-12-04 Impact factor: 7.616
Authors: Charat Thongprayoon; Lisa E Vaughan; Api Chewcharat; Andrea G Kattah; Felicity T Enders; Rajiv Kumar; John C Lieske; Vernon M Pais; Vesna D Garovic; Andrew D Rule Journal: Am J Kidney Dis Date: 2021-04-15 Impact factor: 11.072
Authors: Jessica Sheehan Tangren; Camille E Powe; Jeffrey Ecker; Kate Bramham; Elizabeth Ankers; S Ananth Karumanchi; Ravi Thadhani Journal: Clin J Am Soc Nephrol Date: 2018-02-22 Impact factor: 8.237