In a recent study conducted in Sweden, researchers set out to determine if there was a risk of future urinary stone disease (USD) in a population-based cohort of celiac disease patients without a history of USD. Urinary stone disease (also known as kidney stones) is when a hard mass of crystals separate from the urine and build up on the inner surface of the kidney. Most crystals remain small and pass through the urinary tract easily, but in some people larger masses may form.
The researchers used a population-based cohort study, “Using small intestinal biopsy-proven data from 1969 to 2008 obtained from Swedish pathology departments (n = 28), we identified 28 735 patients with CD (equal to Marsh 3: villous atrophy). Patients were then matched for gender, age, county and calendar year to 142 177 reference individuals from the Swedish general population. We used Cox regression to estimate hazard ratios (HRs) for future urinary stone disease and conditional logistic regression to calculate odds ratios (ORs) for urinary stone disease before diagnosis of CD. Individuals with urinary stone disease were identified through the Swedish National Patient Register that contains data on inpatient care, outpatient care and day surgery.”
During the follow-up period, the researchers found 314 individuals with celiac disease and 1141 reference individuals developed USD, which was a 27% increased risk of USD in celiac (95% confidence interval (CI) = 1.12-1.44). Celiac disease patients had an absolute risk of USD of 107/100 000 person-years (excess risk of 23/100 000). The risk estimates were the same in men and women, and did not change according to the age a patient received a celiac diagnosis. “Conditional logistic regression found that patients with celiac disease were at a slightly increased risk also of prior urinary stone disease (OR = 1.19; 95% CI = 1.06-1.33).”
Researchers noted there were some limitations which needed to be addressed and it could not be ruled out that Celiac is a risk factor for certain subtypes of USDs, but not for others.
In conclusion, the study determined there was a small, but “statistically significant” association between celiac disease and urinary stone disease both before and after a celiac diagnosis. The researchers recommended an increase in awareness of USD in patients with celiac and vice versa, but they did not recommend patients with USD be screened for celiac.
A few facts about Urinary Stone Disease:
– more common in men than women
– prevalent in middle age
– lifetime risk of having USD is 10%, but may be increasing
– symptoms can range from none (silent stones) to severe pain, vomiting, fever and haematuria (stone obstructs the urinary tract)
– surgery is required in some instances (urinary tract infections, stones are too large to pass & other)
– also associated with other comorbidities
– found to be more common in undiagnosed celiac disease patients
To read the complete Abstract: http://www.medscape.com/viewarticle/757844) For more information on Urinary Stone Disease (Kidney Stones): (Slideshow) http://www.medicinenet.com/kidney_stone_pictures_slideshow/article.htm http://kidney.niddk.nih.gov/Kudiseases/pubs/stonesadults/
