Chronic hepatitis B virus infection increases the risk of upper urinary calculi

BMC Urol. 2022 Jun 6;22(1):82. doi: 10.1186/s12894-022-01038-z.

Abstract

Background: Although hepatitis B virus (HBV) is a recognized risk factor for renal diseases, little is known about HBV infection in individuals with upper urinary calculi (UUC). We investigated the relationship between chronic HBV infection and UUC.

Methods: We retrospectively analysed data from 1399 patients who were discharged from the Department of Urology (2017-2018). The diagnosis of UUC was determined using urinary tract ultrasonography or computed tomography, and HBV infection was evaluated by a positive hepatitis B surface antigen (HBsAg) test. Data on patients with and without UUC and HBsAg-positive and HBsAg-negative patients were compared by univariate and multivariate analyses.

Results: Data on chronic HBV infection and UUC were available for 1062 patients, including 514 who presented with UUC and 548 who did not. Overall, 5.8% of total patients, 8.0% of UUC patients and 3.8% of non-UUC patients had chronic HBV infection. UUC patients (41/514) had a significantly higher prevalence of HBsAg positivity (OR 2.175; 95% CI 1.267-3.734; P = 0.004) than non-UUC patients (21/548). After stratifying by sex, the relative odds of HBsAg positivity were statistically significant in men (OR 2.156; 95% CI 1.162-4.003; P = 0.015) but not in women (OR 2.947; 95% CI 0.816-10.643; P = 0.099). The incidence of urinary pH > 6 and staghorn stones was significantly higher in HBsAg-positive UUC patients than in HBsAg-negative UUC patients.

Conclusion: This is the first study to demonstrate that chronic HBV infection is strongly associated with UUC, at least in men. The urinary pH > 6 and staghorn stones were more common in UUC patients with chronic HBV infection.

Keywords: Hepatitis B virus; Risk factors; Urinary calculi; Urine pH; Urolithiasis.

MeSH terms

  • Female
  • Hepatitis B Surface Antigens
  • Hepatitis B virus
  • Hepatitis B* / complications
  • Hepatitis B* / epidemiology
  • Hepatitis B, Chronic* / complications
  • Hepatitis B, Chronic* / epidemiology
  • Humans
  • Male
  • Retrospective Studies
  • Urinary Calculi* / complications
  • Urinary Calculi* / epidemiology
  • Urinary Tract*

Substances

  • Hepatitis B Surface Antigens