International Journal of Epidemiology, Vol 26, 1017-1023, Copyright © 1997 by International Epidemiological Association
GR Najem, JJ Seebode, AJ Samady, M Feuerman and L Friedman
BACKGROUND: It has been reported that a substantial proportion of cases of
hypercalciuria and nephrolithiasis are idiopathic. Several studies
suggested that stressful life events increase lithogenic urinary
constituents (calcium, oxalate and uric acid). OBJECTIVE: To test the
hypothesis that there is an association between stressful life events and
symptomatic kidney stone. METHODS: A case-control study of 200 symptomatic
kidney stone cases and 200 matched controls was designed to test the
hypothesis. In this study, the stressors include those life events that the
subjects perceived as highly stressful and inflicted upon them an intense
emotional impact with apprehension and distress for at least one week in
duration. RESULTS: Ten of eleven (91%) categories and 41 of 60 (68%)
subcategories of stressful events occurred more frequently among cases than
controls. Eighteen stressful events had odds ratios of 1.5 or greater. Of
the seven significant (P < 0.05) variables that were entered into a
multivariate logistic regression model, the following three remained
statistically significant between cases and controls: annual family income
(lower for cases); stressful morgage problems; and emotional life events.
CONCLUSION: The overall prevalence rate of stressful life events was
significantly (P < 0.00001) higher among cases than controls. The data
support the hypothesis that there is an association between stressful life
event(s) and symptomatic kidney stones.
ARTICLES
Stressful life events and risk of symptomatic kidney stones
Department of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School, Newark 07103-2714, USA.
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