Abstract: SA-PO675
Prevalence of Kidney Stones in Cystic Fibrosis
Session Information
- Bone and Mineral Metabolism: Clinical - II
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Wright, Jeremy F., Maine Medical Center, Portland, Maine, United States
- Goldfarb, David S., NYU Medical School, New York, New York, United States
- Taylor, Eric N., Maine Medical Center, Portland, Maine, United States
- Zuckerman, Jonathan, Maine Medical Center, Portland, Maine, United States
Background
Cystic fibrosis (CF) may predispose patients to urinary stone disease (USD) via several proposed mechanisms including antibiotic exposure and intestinal malabsorption. Prevalence of USD in patients with CF was estimated at 2-6% in studies with mean age 16-27 years. These data are limited by small sample sizes and single-center settings. The CF Foundation Patient Registry (CFFPR) began collecting prevalence data on USD in 2006.
Methods
We studied 29,396 patients in the CFFPR living in 2016 to calculate age-stratified prevalence of USD.USD was assessed by trained CF clinic staff at each encounter. For 15,531 patients age 18 or older we examined associations between age, BMI, demographics, CFTR mutation class, other clinical parameters, and prevalent USD using multivariate logistic regression.
Results
Overall prevalence of USD was 3.1% (95% CI 2.9-3.3%). Prevalence under age 18 years was 0.4% (0.3-0.5%), 18 to 24 years, 3.1% (2.7-3.6%), 25 to 34 years, 6.4% (5.8 -7.1%), 35 to 44 years, 7.5% (6.5-8.5%), and 45 years and older, 6.7% (5.8-7.8%). Mean age of all patients was 21.3 years. We also calculated prevalence for age ranges 20-29, and 30-39 years to compare with published NHANES data for the general population. Stone prevalence was 4.8% and 7.1% in in CF patients within these two age cohorts, respectively, compared to 3.4 and 6.4% in NHANES. Multivariate adjusted odds ratios for stone prevalence were significant for female sex, OR 1.4 (95% CI 1.2-1.7), severe CFTR mutations, OR 1.8 (1.2-2.5), diabetes, OR 1.2 (1.0-1.5), hypertension, OR 1.4 (1.0 -1.9), and chronic macrolide therapy, OR 1.3 (1.1-1.6). BMI was not associated with USD.
Conclusion
USD prevalence in CFFPR may be higher than in the general population and increased with age. Some risk factors for stone disease in the general population appear significant for adult patients with CF, including hypertension and diabetes. However, BMI did not show the same relationship. Several novel associations with USD in CF patients also were identified, including a greater prevalence in women. This study is limited by the method of USD assessment; it is possible patients with more severe CF had higher rates of reported asymptomatic stones incidentally diagnosed due to more frequent imaging. As life expectancy of people with CF increases, the prevalence of USD may also increase.
Funding
- Private Foundation Support