The association between domestic water hardness and kidney stone disease: a prospective cohort study from the UK Biobank

作者：Jiahao Zhang, Hongcheng Luo, Haoliang Wu, Yuxin Qian, Zhicheng Tang, Di Wang, Zhibiao Li, Hanxiong Zheng, Fucai Tang, Zhaohui He · 发表于：International Journal of Surgery · 年份：2024 · DOI：10.1097/js9.0000000000002198 · 被引用次数：20 · 研究领域：Kidney Stones and Urolithiasis Treatments、Magnesium in Health and Disease、Parathyroid Disorders and Treatments

BACKGROUND: Kidney stone disease is a common surgical disease and a significant public health issue, which may be influenced by environmental factors such as domestic water hardness and its related minerals. Previous studies have shown inconsistent and controversial results regarding the impact of domestic water hardness on kidney stone formation. METHODS: This prospective cohort study analyzed data from 288 041 participants in the UK Biobank with no prior history of kidney stones from 2006 to 2024. The exposures were domestic water hardness, calcium concentration, calcium carbonate concentration, and magnesium concentration. The main outcomes were the disease status and onset time of kidney stone diseases. The confounding factors of model adjustment included age, sex, ethnicity, economic level, education level, Townsend Deprivation Index, Index of Multiple Deprivation, assessment center, body mass index, drug history influencing the metabolism of calcium and magnesium, and water intake based on the directed acyclic graph of causal hypothesis. The association between domestic water hardness and kidney stones was assessed using the Cox regression models, sensitivity analyses, subgroup and interactive analyses. RESULTS: During the follow-up period, 3298 participants (1.14%) developed kidney stones. In all participants, the mean concentration of calcium, calcium carbonate, and magnesium was 52.61, 135.01, and 4.66 mg/L, respectively. In Cox regression models, higher magnesium le...