Skip to main content

Advertisement

SpringerLink
Log in

Association between sex hormones and kidney stones: analysis of the National Health and Nutrition Examination Survey

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

Increasing age, male gender, and metabolic syndrome are associated with kidney stone formation. As sex hormones change with age, gender, and metabolic syndrome, we hypothesized that sex hormones may underlie the physiologic changes affecting stone formation.

Methods

We analyzed the relationships between testosterone, estradiol, and history of kidney stones using data from 10,193 participants in the Continuous National Health and Nutrition Examination Survey (NHANES) database from 2013–2016. We performed logistic regression analysis to analyze the predictive value of low testosterone and low estradiol on the history of kidney stones in both males and females. Self-reported history of kidney stone diagnosis was the outcome.

Results

After adjusting for risk factors known to be associated with nephrolithiasis such as age, race, BMI, and medical comorbidities including: gout, angina, coronary disease, stroke, asthma, hypertension, and diabetes, multiple regression analysis demonstrated that there is no independent association between sex hormones (testosterone and estradiol) and history of kidney stones in either males or females.

Conclusions

There appears to be no association between sex hormones and history of kidney stones. Whether there is a more complex interaction of sex hormone levels and the shared association with factors such as metabolic syndrome requires additional investigation. Further studies matching menopausal status for women are necessary to further investigate the potential relationship between estrogen and kidney stones.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The datasets generated during and/or analyzed during the current study are available in the NHANES Continuous Data 2013–16 repository: https://wwwn.cdc.gov/nchs/nhanes/ContinuousNhanes/Default.aspx?BeginYear=2013https://wwwn.cdc.gov/nchs/nhanes/ContinuousNhanes/Default.aspx?BeginYear=2015

Code availability

SAS Version 3.8 code available if requested.

References

  1. Lotan Y (2009) Economics and cost of care of stone disease. Adv Chronic Kidney Dis 16(1):5–10. https://doi.org/10.1053/j.ackd.2008.10.002

    Article  PubMed  Google Scholar 

  2. Patel N, Brown RD, Sarkissian C, De S, Monga M (2017) Quality of life and urolithiasis: the patient—reported outcomes measurement information system (PROMIS). Int Braz J Urol Off J Braz Soc Urol 43(5):880–886. https://doi.org/10.1590/S1677-5538.IBJU.2016.0649

    Article  Google Scholar 

  3. Alelign T, Petros B (2018) Kidney stone disease: an update on current concepts. Adv Urol. https://doi.org/10.1155/2018/3068365

    Article  PubMed  PubMed Central  Google Scholar 

  4. Muller M, Grobbee DE, den Tonkelaar I, Lamberts SWJ, van der Schouw YT (2005) Endogenous sex hormones and metabolic syndrome in aging men. J Clin Endocrinol Metab 90(5):2618–2623. https://doi.org/10.1210/jc.2004-1158

    Article  CAS  PubMed  Google Scholar 

  5. Deslypere JP, Vermeulenf A (1984) Leydig cell function in normal men: effect of age, life-style, residence, diet, and activity. J Clin Endocrinol Metab 59(5):955–962. https://doi.org/10.1210/jcem-59-5-955

    Article  CAS  PubMed  Google Scholar 

  6. Spencer CP, Godsland IF, Stevenson JC (1997) Is there a menopausal metabolic syndrome? Gynecol Endocrinol 11(5):341–355. https://doi.org/10.3109/09513599709152559

    Article  CAS  PubMed  Google Scholar 

  7. Peng J-P, Zheng H (2017) Kidney stones may increase the risk of coronary heart disease and stroke. Medicine (Baltimore). https://doi.org/10.1097/MD.0000000000007898

    Article  PubMed Central  Google Scholar 

  8. Kartha GK, Li I, Comhair S, Erzurum SC, Monga M (2017) Co-Occurrence of asthma and nephrolithiasis in children. PLoS ONE. https://doi.org/10.1371/journal.pone.0168813

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kramer HM, Curhan G (2002) The association between gout and nephrolithiasis: the National Health and Nutrition Examination Survey III, 1988–1994. Am J Kidney Dis 40(1):37–42. https://doi.org/10.1053/ajkd.2002.33911

    Article  PubMed  Google Scholar 

  10. Yucel E, DeSantis S, Smith MA, Lopez DS (2018) Association between low-testosterone and kidney stones in US men: the national health and nutrition examination survey 2011–2012. Prev Med Rep 10:248–253. https://doi.org/10.1016/j.pmedr.2018.04.002

    Article  PubMed  PubMed Central  Google Scholar 

  11. Jin-Yi Li, Tie Z, XiaoFeng G et al (2010) Testosterone and androgen receptor in human nephrolithiasis. J Urol 184(6):2360–2363. https://doi.org/10.1016/j.juro.2010.08.009

    Article  CAS  Google Scholar 

  12. M M, M O, H Y, S Y, S Y (1998) A study of the differences between the sexes in epidemiology of urolithiasis. Nihon Hinyokika Gakkai Zasshi Jpn J Urol 89(5):538–545. https://doi.org/10.5980/jpnjurol1989.89.538

    Article  Google Scholar 

  13. Dey J, Creighton A, Lindberg JS et al (2002) Estrogen replacement increased the citrate and calcium excretion rates in postmenopausal women with recurrent urolithiasis. J Urol. 167(1):169–171. https://doi.org/10.1016/S0022-5347(05)65405-5

    Article  CAS  PubMed  Google Scholar 

  14. NHANES - Continuous NHANES Web Tutorial - Sample Design. https://www.cdc.gov/nchs/tutorials/Nhanes/SurveyDesign/SampleDesign/intro.htm. Accessed February 23, 2020.

  15. Taylor EN, Stampfer MJ, Curhan GC (2005) Obesity, weight gain, and the risk of kidney stones. JAMA 293(4):455–462. https://doi.org/10.1001/jama.293.4.455

    Article  CAS  PubMed  Google Scholar 

  16. Hormone and Vitamin D Standardization Programs (HoSt/VDSCP) | CDC. https://www.cdc.gov/labstandards/hs.html. Published May 23, 2019. Accessed February 23, 2020.

  17. Hsi RS, Kabagambe EK, Shu X, Han X, Miller NL, Lipworth L (2018) Race- and sex-related differences in nephrolithiasis risk among blacks and whites in the southern community cohort study. Urology 118:36–42. https://doi.org/10.1016/j.urology.2018.04.036

    Article  PubMed  PubMed Central  Google Scholar 

  18. Taylor EN, Stampfer MJ, Curhan GC (2005) Diabetes mellitus and the risk of nephrolithiasis. Kidney Int 68(3):1230–1235. https://doi.org/10.1111/j.1523-1755.2005.00516.x

    Article  PubMed  Google Scholar 

  19. Kidney stones and hypertension: population based study of an independent clinical association. | The BMJ. https://www.bmj.com/content/300/6734/1234.short. Accessed February 23, 2020.

  20. Bhasin S, Basaria S (2011) Diagnosis and treatment of hypogonadism in men. Best Pract Res Clin Endocrinol Metab 25(2):251–270. https://doi.org/10.1016/j.beem.2010.12.002

    Article  CAS  PubMed  Google Scholar 

  21. Riggs BL (2000) The mechanisms of estrogen regulation of bone resorption. J Clin Invest 106(10):1203–1204

    Article  CAS  Google Scholar 

  22. Cigarrán S, Pousa M, Castro MJ et al (2013) Endogenous testosterone, muscle strength, and fat-free mass in men with chronic kidney disease. J Ren Nutr 23(5):e89–e95. https://doi.org/10.1053/j.jrn.2012.08.007

    Article  CAS  PubMed  Google Scholar 

  23. Verthelyi D (2001) Sex hormones as immunomodulators in health and disease. Int Immunopharmacol 1(6):983–993. https://doi.org/10.1016/S1567-5769(01)00044-3

    Article  CAS  PubMed  Google Scholar 

  24. Cunningham GR (2015) Testosterone and metabolic syndrome. Asian J Androl 17(2):192–196. https://doi.org/10.4103/1008-682X.148068

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Bassil N, Alkaade S, Morley JE (2009) The benefits and risks of testosterone replacement therapy: a review. Ther Clin Risk Manag 5:427–448

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Investigators WG for the WHI (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the women’s health initiative randomized controlled trial. JAMA 288(3):321–333. https://doi.org/10.1001/jama.288.3.321

    Article  Google Scholar 

  27. Naghii MR, Babaei M, Hedayati M (2014) Androgens involvement in the pathogenesis of renal stones formation. PLoS ONE 9(4):e93790. https://doi.org/10.1371/journal.pone.0093790

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Department of Urology, University of Miami, Miami, FL, USA

    Sirpi Nackeeran, Jonathan Katz, Ranjith Ramasamy & Robert Marcovich

Authors
  1. Sirpi Nackeeran
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jonathan Katz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ranjith Ramasamy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert Marcovich
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

S Nackeeran: project development, data management, data analysis, and manuscript writing, J Katz: Project development, data management, and manuscript writing, R Ramasamy: project development and manuscript editing, and R Marcovich: project development.

Corresponding author

Correspondence to Sirpi Nackeeran.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was done using Public Data from the National Center for Health Statistics (NCHS) program, the National Health and Nutrition Examination Survey (NHANES). The data have been de-identified and it has not been merged or augmented in a way that has compromised the privacy of the participants. Therefore, no further approval was required and the study follows ethical guidelines.

Informed consent

Participant data were obtained from the publicly available NHANES database, and therefore, no additional consent was obtained.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nackeeran, S., Katz, J., Ramasamy, R. et al. Association between sex hormones and kidney stones: analysis of the National Health and Nutrition Examination Survey. World J Urol 39, 1269–1275 (2021). https://doi.org/10.1007/s00345-020-03286-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-020-03286-w

Keywords

Search

Navigation