Login to Access Video or Poster Abstract: MP95-07
Sources of Funding: none

Introduction

Nephrolithiasis and sleep apnea (SA) share known risk factors, namely obesity and metabolic syndrome and both have been linked to states of systemic insulin resistance and oxidative stress. However, a direct relationship between nephrolithiasis and SA has not been thoroughly investigated. This study aims to determine whether SA is an independent risk factor for nephrolithiasis.

Methods

From January 1, 2000 to December 31, 2012, a nationwide population-based retrospective cohort analysis was performed on a representative sample of 1,000,000 participants from the National Health Insurance Research Database (NHIRD) in Taiwan. 7,831 adult patients with SA were identified and were directly compared to an age and gender-matched control group of 31,293 participants without SA. The diagnosis of disease was confirmed by International Classification of Disease, 9th revision. Cox proportional hazard regression models were used to evaluate the association between SA and the risk of subsequent nephrolithiasis.

Results

SA patients have an 8.9% incidence of nephrolithiasis, compared to 5.5% of the non-SA control (p<0.001). SA patients also have higher rates of metabolic comorbidities (p<0.001). After adjusting for age, gender and comorbidities, the risk of nephrolithiasis remained significantly increased in the SA group (hazard ratio [HR]=1.35; 95% confidence interval [CI]=1.23-1.47; p<0.001). Greater HRs of nephrolithiasis were observed for male patients (1.21; 95% CI=1.09-1.35; p<0.001) and those aged 20-39 years (1.25; 95% CI=1.06-1.46; p<0.01) in the SA cohort. Risk of nephrolithiasis in SA patients increased significantly with concomitant diabetes mellitus, hypertension, hyperlipidemia, and morbid obesity.

Conclusions

The study provides evidence that patients with SA have an increased risk of subsequent nephrolithiasis compared with patients without SA. Young male SA patients with concomitant comorbidities are at the greatest risk for nephrolithiasis formation.

Funding

none