Exploring the association between multiple factors and urolithiasis: A retrospective study and Mendelian...

Area of Science:

• Nephrology
• Urology
• Genetics

Background:

• Urinary stones are a common condition with multifactorial causes.
• Understanding the causal links between metabolic factors and stone formation is crucial for prevention.
• Stone composition varies widely and may influence recurrence and associated conditions.

Purpose of the Study:

• To investigate the causal relationships between hypertension, diabetes, body mass index (BMI), and urinary stones using Mendelian randomization.
• To analyze the composition of urinary stones and their association with patient demographics and comorbidities.
• To guide the diagnosis, treatment, and prevention of urinary stone recurrence.

Main Methods:

• Bidirectional Mendelian randomization was employed to assess causal links between hypertension, diabetes, BMI, and urinary stones.
• Retrospective analysis of medical records from 4639 urinary stone patients (July 2015-October 2022).
• Stone composition analysis was performed for all identified calculi.

Main Results:

• Mendelian randomization indicated urinary stones are a potential risk factor for hypertension (OR=8.46).
• No causal relationship was found between diabetes, BMI, and urinary stones.
• Calcium oxalate monohydrate (28.57%) and mixed stones (67.02%) were the most common types. Stone composition correlated with sex, age, hypertension, diabetes, and BMI.
• Peak incidence occurred during the most active working years.

Conclusions:

• Urinary stones may causally influence hypertension, necessitating integrated management.
• Recurrence prevention likely requires addressing multiple stone components and associated patient factors, not just single stone types.
• The findings highlight the complex interplay between metabolic health, demographics, and urinary stone disease.