Shock wave lithotripsy is not predictive of hypertension among community stone formers at long-term followup

Amy Krambeck, Andrew D. Rule, Xujian Li, Eric J. Bergstralh, Matthew T. Gettman, John C. Lieske

Research output: Contribution to journalArticle

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Abstract

Purpose Concern exists over the subsequent development of hypertension after shock wave lithotripsy for the treatment of symptomatic urolithiasis. Referral bias and lack of long-term followup have been limitations of prior studies. Materials and Methods We identified all Olmsted County, Minnesota residents with a diagnosis of urolithiasis from 1985 to 2008. The charts were electronically queried for hypertension and obesity by diagnostic codes, and use of shock wave lithotripsy by surgical codes. All patients first diagnosed with hypertension before or up to 90 days after the first documented kidney stone were considered to have prevalent hypertension and were excluded from analysis. Cox proportional hazards models were used to assess the association of shock wave lithotripsy with a subsequent diagnosis of hypertension. Results We identified 6,077 patients with incident urolithiasis with more than 90 days of followup. We excluded 1,295 (21.3%) members of the population for prevalent hypertension leaving 4,782 patients with incident urolithiasis for analysis. During an average followup of 8.7 years new onset hypertension was diagnosed in 983 (20.6%) members of the cohort at a mean of 6.0 years from the index stone date. Only 400 (8.4%) patients in the cohort were treated with shock wave lithotripsy. There was no significant association between shock wave lithotripsy and the development of hypertension in univariate (p = 0.33) and multivariate modeling controlling for age, gender and obesity (HR 1.03; 95% CI 0.84, 1.27; p = 0.77). Conclusions In a large population based cohort of kidney stone formers we failed to identify an association between shock wave lithotripsy and the subsequent long-term risk of hypertension.

Original languageEnglish (US)
Pages (from-to)164-169
Number of pages6
JournalJournal of Urology
Volume185
Issue number1
DOIs
StatePublished - Jan 2011
Externally publishedYes

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Lithotripsy
Hypertension
Urolithiasis
Kidney Calculi
Obesity
Proportional Hazards Models
Population
Referral and Consultation

Keywords

  • Hypertension
  • Lithotripsy
  • Urolithiasis

ASJC Scopus subject areas

  • Urology

Cite this

Shock wave lithotripsy is not predictive of hypertension among community stone formers at long-term followup. / Krambeck, Amy; Rule, Andrew D.; Li, Xujian; Bergstralh, Eric J.; Gettman, Matthew T.; Lieske, John C.

In: Journal of Urology, Vol. 185, No. 1, 01.2011, p. 164-169.

Research output: Contribution to journalArticle

Krambeck, Amy ; Rule, Andrew D. ; Li, Xujian ; Bergstralh, Eric J. ; Gettman, Matthew T. ; Lieske, John C. / Shock wave lithotripsy is not predictive of hypertension among community stone formers at long-term followup. In: Journal of Urology. 2011 ; Vol. 185, No. 1. pp. 164-169.
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abstract = "Purpose Concern exists over the subsequent development of hypertension after shock wave lithotripsy for the treatment of symptomatic urolithiasis. Referral bias and lack of long-term followup have been limitations of prior studies. Materials and Methods We identified all Olmsted County, Minnesota residents with a diagnosis of urolithiasis from 1985 to 2008. The charts were electronically queried for hypertension and obesity by diagnostic codes, and use of shock wave lithotripsy by surgical codes. All patients first diagnosed with hypertension before or up to 90 days after the first documented kidney stone were considered to have prevalent hypertension and were excluded from analysis. Cox proportional hazards models were used to assess the association of shock wave lithotripsy with a subsequent diagnosis of hypertension. Results We identified 6,077 patients with incident urolithiasis with more than 90 days of followup. We excluded 1,295 (21.3{\%}) members of the population for prevalent hypertension leaving 4,782 patients with incident urolithiasis for analysis. During an average followup of 8.7 years new onset hypertension was diagnosed in 983 (20.6{\%}) members of the cohort at a mean of 6.0 years from the index stone date. Only 400 (8.4{\%}) patients in the cohort were treated with shock wave lithotripsy. There was no significant association between shock wave lithotripsy and the development of hypertension in univariate (p = 0.33) and multivariate modeling controlling for age, gender and obesity (HR 1.03; 95{\%} CI 0.84, 1.27; p = 0.77). Conclusions In a large population based cohort of kidney stone formers we failed to identify an association between shock wave lithotripsy and the subsequent long-term risk of hypertension.",
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N2 - Purpose Concern exists over the subsequent development of hypertension after shock wave lithotripsy for the treatment of symptomatic urolithiasis. Referral bias and lack of long-term followup have been limitations of prior studies. Materials and Methods We identified all Olmsted County, Minnesota residents with a diagnosis of urolithiasis from 1985 to 2008. The charts were electronically queried for hypertension and obesity by diagnostic codes, and use of shock wave lithotripsy by surgical codes. All patients first diagnosed with hypertension before or up to 90 days after the first documented kidney stone were considered to have prevalent hypertension and were excluded from analysis. Cox proportional hazards models were used to assess the association of shock wave lithotripsy with a subsequent diagnosis of hypertension. Results We identified 6,077 patients with incident urolithiasis with more than 90 days of followup. We excluded 1,295 (21.3%) members of the population for prevalent hypertension leaving 4,782 patients with incident urolithiasis for analysis. During an average followup of 8.7 years new onset hypertension was diagnosed in 983 (20.6%) members of the cohort at a mean of 6.0 years from the index stone date. Only 400 (8.4%) patients in the cohort were treated with shock wave lithotripsy. There was no significant association between shock wave lithotripsy and the development of hypertension in univariate (p = 0.33) and multivariate modeling controlling for age, gender and obesity (HR 1.03; 95% CI 0.84, 1.27; p = 0.77). Conclusions In a large population based cohort of kidney stone formers we failed to identify an association between shock wave lithotripsy and the subsequent long-term risk of hypertension.

AB - Purpose Concern exists over the subsequent development of hypertension after shock wave lithotripsy for the treatment of symptomatic urolithiasis. Referral bias and lack of long-term followup have been limitations of prior studies. Materials and Methods We identified all Olmsted County, Minnesota residents with a diagnosis of urolithiasis from 1985 to 2008. The charts were electronically queried for hypertension and obesity by diagnostic codes, and use of shock wave lithotripsy by surgical codes. All patients first diagnosed with hypertension before or up to 90 days after the first documented kidney stone were considered to have prevalent hypertension and were excluded from analysis. Cox proportional hazards models were used to assess the association of shock wave lithotripsy with a subsequent diagnosis of hypertension. Results We identified 6,077 patients with incident urolithiasis with more than 90 days of followup. We excluded 1,295 (21.3%) members of the population for prevalent hypertension leaving 4,782 patients with incident urolithiasis for analysis. During an average followup of 8.7 years new onset hypertension was diagnosed in 983 (20.6%) members of the cohort at a mean of 6.0 years from the index stone date. Only 400 (8.4%) patients in the cohort were treated with shock wave lithotripsy. There was no significant association between shock wave lithotripsy and the development of hypertension in univariate (p = 0.33) and multivariate modeling controlling for age, gender and obesity (HR 1.03; 95% CI 0.84, 1.27; p = 0.77). Conclusions In a large population based cohort of kidney stone formers we failed to identify an association between shock wave lithotripsy and the subsequent long-term risk of hypertension.

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