Presented by: Micah Levy
Icahn School of Medicine at Mount Sinai

Introduction

With rising rates of kidney stones, cirrhosis, and liver transplants, it is important to understand the possible association between liver failure, management with transplantation, and the formation of kidney stones.

Materials

The 2004-2017 New York Statewide Planning and Research Cooperative System database was queried for patients in 4 groups: controls (Co) representing the general population who had received a medical exam regardless of the reason or any normal or abnormal findings, cirrhosis (Cr), liver transplant (Lt), and stone risk factors (Rf) representing anyone with at least one of the following: obesity, hypertension, or diabetes. The first 100,000 patients in each group were queried. Though duplicates were removed to minimize overlap within groups, some Co, Cr, or Lt patients may still have the above stone risk factors. Differences in stone rates (SR) between each group and within groups before and after their coded diagnosis were analyzed.

Results

,

196,737 cases were analyzed (Co: 45,890, Cr: 42,694, Lt: 19,129, Rf: 89,024). SR were 1.76% (Co), 2.72% (Cr), 4.30% (Lt), and 4.81% (Rf) with significant differences between all 4 groups (p < 0.001, p = 0.002 for Lt vs. Rf), suggesting higher SR in Cr and Lt compared to the general public, but not as high as those with known risk factors. There was no significant difference in the pre-diagnosis SR between Co and Cr (1.85% vs. 1.95%, p = 0.271), suggesting the onset of Cr is associated with an increased SR as before the diagnosis of Cr, these patients had similar SR to controls. When comparing SR within groups before and after diagnosis, Co showed no significant difference before or after their general medical exam (p = 0.333), while Cr, Lt, and Rf showed significantly higher SR following their diagnoses (p < 0.001). This too suggests that compared to Co, the onset of liver failure and liver transplant may be associated with higher SR.

Conclusion

Patients with Cr and those managed with Lt have significantly higher SR compared to general public controls, but significantly lower SR compared to patients with stone risk factors. Interestingly, as SR were higher in Lt compared to Cr, this may suggest that transplantation may not reduce, but may in fact increase this association.

Funding

None

Co-Authors

Aaron Walt,
Icahn School of Medicine at Mount Sinai

Christopher Connors,
Icahn School of Medicine at Mount Sinai

Daniel Wang,
Icahn School of Medicine at Mount Sinai

Juan Arroyave Villada,
Icahn School of Medicine at Mount Sinai

Hasan Bilal,
Icahn School of Medicine at Mount Sinai

Francisca Larenas,
Icahn School of Medicine at Mount Sinai

Michael Palese,
Icahn School of Medicine at Mount Sinai