Investig Clin Urol.  2020 Mar;61(2):188-199. 10.4111/icu.2020.61.2.188.

A prediction model of Nephrolithiasis Risk: A population-based cohort study in Korea

• Mukasa D
• Sung J

• KMID: 2471075
• DOI: http://doi.org/10.4111/icu.2020.61.2.188

Abstract

PURPOSE
Well-validated risk prediction models help to stratify individuals on the basis of their disease risks and to guide health care professionals in decision-making. The incidence of nephrolithiasis has been increasing in Korea. Racial differences in the distribution of and risk for nephrolithiasis have been reported in Asia but no population-specific nephrolithiasis models have been developed. We aimed to develop a simplified nephrolithiasis prediction model for the Korean population by using data from general medical practice.
MATERIALS AND METHODS
This was a prospective, population-based cohort study in Korea. A total of 497,701 participants from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) were enrolled from 2002 to 2010. A Cox proportional hazards model was used.
RESULTS
During a median follow-up time of 8.5 years (range, 2.0-8.9 years) and among 497,701 participants, there were 15,783 cases (3.2%) of nephrolithiasis. The parsimonious model included age, sex, income grade, alcohol consumption, body mass index, total cholesterol, fasting blood glucose, and medical history of diseases. The Harrell's C-statistic was 0.806 (95% confidence interval [CI], 0.790-0.821) and 0.805 (95% CI, 0.782-0.827) in the derivation and validation cohorts, respectively.
CONCLUSIONS
The results of the present study imply that nephrolithiasis risk can be predicted by use of data from general medical practice and based on predictors that clinicians and individuals from the general population are likely to know. This model comprises modifiable risk factors and can be used to identify those at higher risk who can modify their lifestyle to lower their risk for nephrolithiasis. This study also offers an opportunity for external validation or updating of the model through the incorporation of other risk predictors in other settings.

Keyword

Epidemiology; Kidney calculi; Nephrolithiasis; Risk

MeSH Terms

Alcohol Drinking
Asia
Blood Glucose
Body Mass Index
Cholesterol
Cohort Studies*
Delivery of Health Care
Epidemiology
Fasting
Follow-Up Studies
Incidence
Kidney Calculi
Korea*
Life Style
National Health Programs
Nephrolithiasis*
Proportional Hazards Models
Prospective Studies
Risk Factors
Blood Glucose
Cholesterol

Figure

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  Fig. 1 Discrimination and calibration plots in the derivation cohort. (A) Discrimination. (B) Calibration.

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  Fig. 2 Discrimination and calibration plots in the validation cohort. (A) Discrimination. (B) Calibration.

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