Clinical relevance of seasonal changes in the prevalence of ureterolithiasis in the diagnosis of renal colic

Abstract

Ureterolithiasis is one of the most frequently diagnosed urologic diseases worldwide. Its annual incidence in Japan increased three-fold from 1965 to 2005. Ureterolithiasis incidence is affected by numerous factors, including race, sex, body weight, fluid intake, and climate. Here, we aimed to address the latter by considering the effect of seasonal variation on stone incidence and incorporating this information into a predictive model for differential diagnosis of ureteral stone from other conditions with similar presentations. We retrospectively identified 491 patients in our emergency department computer database who complained of back, flank, or lower abdominal pain during 2007–2015. Among them, 358 had stones, as confirmed by computerized tomography or plain abdominal X-ray of kidney–ureter–bladder. We also charted the mean ambient temperatures in our city for a year. The cases of ureteral stones paralleled the ambient temperatures, peaking during the hottest weather. Univariate analysis identified 13 factors associated with ureteral stones. Multivariate analysis narrowed the number to eight: age <60 years, male sex, short duration of pain (<6 h), nausea/vomiting, hydronephrosis, hematuria, history of urinary stone(s), and summer (July–September in Japan). Pain appearing during summer was nine times more likely to be due to a ureteral stone than was pain appearing during other seasons. We incorporated the eight variables identified into a predictive logistic regression model, which yielded good prediction of ureteral stones. Awareness that hot weather is associated with increased incidence of ureterolithiasis could facilitate differential diagnosis, and our prediction model could be useful for screening for ureterolithiasis.

The Urological Association of Asia clinical guideline for urinary stone disease

“…A close relationship between seasons and the incidence of ureterolithiasis has been shown in various geographical areas. [61][62][63][64][65][66][67] Seasonal trends in monthly urinary stone attack rates exist, with the incidence peaking in the summer, which is likely related to the high temperature that leads to fluid losses due to perspiration, 68,69 and perhaps by sunlight-induced increases in the synthesis of 1,25-dihydroxyvitamin D 3 (vitamin D). 65,70 The tendency for increasing incidence of renal colic in parallel with the rise in ambient temperature has been well documented in many countries.…”

Prevalence of microhematuria in renal colic and urolithiasis: a systematic review and meta-analysis

“…De nition of microhematuria was different among the included studies. Six studies included also patients presenting with macroscopic hematuria [14,17,19,22,26,50]. Details on the microhematuria test are reported in Table 2.…”

Predictors of Ureterolithiasis in Emergency Department Patients

“…Известно, что уролитиаз поражает людей преимущественно трудоспособного возраста [Теодорович и др., 2012; Коцарь и др., 2013]. По данным исследователей из Японии, возраст, в котором отмечается пиковая частота дебюта мочекаменной болезни, составляет 50-59 лет у женщин и 40-49 лет у мужчин [Fukuhara et al, 2016]. С эпидемиологической точки зрения, почечная коли ка чаще встречается у лиц младше 60 лет.…”

“…Уролитиаз является одним из самых распространённых урологических заболеваний во всём мире, в том числе и в Российской Федерации [Бакетин и др., 2017;Fukuhara et al, 2016;Fwu et al, 2013]. Этиология мочекаменной болезни считается мультифакторной.…”

“…В настоящее время, однако, остаётся непонятным, влияют ли на вероятность этого диа гноза некоторые другие факторы, в том числе и сезонный. Эмпирически установлено, что существует сезонная вариабельность в отношении заболеваемости уретеролитиазом, что может быть связано со сменой погодных условий [Chen et al, 2008;Basiri et al, 2009;Fukuhara et al, 2016].…”