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Negative impact of being underweight on the outcomes of single-session shockwave lithotripsy in patients with upper urinary tract calculi: a retrospective cohort study

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Abstract

Purpose

To evaluate the association between being underweight and shockwave lithotripsy outcomes.

Methods

This retrospective two-centre cohort study conducted in Japan involved 597 patients diagnosed with a single urinary tract calculus based on computed tomography and who underwent shockwave lithotripsy between 2006 and 2016. We divided the patients into four groups based on their body mass index (underweight, ≤  18.4; normal weight, 18.5–24.9; overweight, 25–29.9; obese,  ≥  30 kg/m2). We performed multivariable logistic regression analysis and estimated the odds ratio for success of single-session shockwave lithotripsy.

Results

Of the 597 patients, 25 (4.2%) were underweight and 34 (5.7%) were obese. After adjusting for age, sex, calculus localisation, maximum stone length, mean stone density, and skin-to-stone distance, being underweight showed a significantly negative association with success of single-session shockwave lithotripsy (odds ratio 0.25, 95% confidence interval 0.09–0.69) compared to being normal weight.

Conclusions

This study showed the negative impact of being underweight on the outcomes of shockwave lithotripsy in patients with upper urinary tract calculi. This finding provides a novel viewpoint regarding the body mass index and should aid improved treatment selection for patients with upper urinary tract calculi.

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Acknowledgements

We would like to thank Editage (www.editage.jp) for English language editing.

Funding

This study did not receive any financial support.

Author information

Authors and Affiliations

  1. Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan

    Takashi Yoshioka, Kenji Omae & Shunichi Fukuhara

  2. Department of Healthcare Epidemiology, Kyoto University School of Public Health in the Graduate School of Medicine, Kyoto, Japan

    Takashi Yoshioka, Kenji Omae & Shunichi Fukuhara

  3. Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University, Fukushima, Japan

    Kenji Omae

  4. Department of Urology, Onomichi Municipal Hospital, Hiroshima, Japan

    Tatsushi Kawada, Yosuke Inoue, Morito Sugimoto & Tadashi Oeda

  5. Department of Urology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan

    Tatsushi Kawada

  6. Department of Urology, Abiko Toho Hospital, Chiba, Japan

    Tomoya Yamasaki, Kei Fujio & Hideo Otsuki

  7. Department of Urology, Kawasaki Medical School General Medical Center, Okayama, Japan

    Shinya Uehara

  8. Department of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan

    Motoo Araki

Authors
  1. Takashi Yoshioka
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  2. Kenji Omae
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  3. Tatsushi Kawada
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  4. Yosuke Inoue
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  5. Morito Sugimoto
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  6. Tadashi Oeda
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  7. Tomoya Yamasaki
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  8. Kei Fujio
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  9. Hideo Otsuki
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  10. Shinya Uehara
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  11. Motoo Araki
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  12. Shunichi Fukuhara
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Contributions

Protocol/project development: T. Yoshioka, KO, T. Yamasaki, KF, HO, SU, MA, and SF. Data collection or management: T. Yoshioka, TK, YI, MS, T. Yamasaki, and HO. Data analysis: TY and KO. Manuscript writing/editing: T. Yoshioka, KO, TK, YI, MS, TO, T. Yamasaki, KF, HO, SU, MA, and SF.

Corresponding author

Correspondence to Kenji Omae.

Ethics declarations

Conflict of interest

None to declare.

Ethical approval

The study was approved by the Institutional Review Board of both hospitals. The data were anonymised before the statistical analysis.

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Electronic supplementary material

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345_2020_3199_MOESM1_ESM.tiff

Flow diagram of this study. A total of 1120 patients underwent SWL in both hospitals. Patients with a maximum stone length of > 20 mm, lower calyceal or multiple calculi, indwelling ureteral stents, and who were lost-to-follow-up were excluded. Patients with missing BMI and confounder data were also excluded. Ultimately, 597 patients were included (TIFF 182 kb)

BMI in our study participants showed an almost normal distribution (TIFF 689 kb)

Supplementary file3 (DOCX 16 kb)

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Supplementary file5 (DOCX 17 kb)

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Yoshioka, T., Omae, K., Kawada, T. et al. Negative impact of being underweight on the outcomes of single-session shockwave lithotripsy in patients with upper urinary tract calculi: a retrospective cohort study. World J Urol 39, 571–577 (2021). https://doi.org/10.1007/s00345-020-03199-8

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  • DOI: https://doi.org/10.1007/s00345-020-03199-8

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