Abstract
The pathogenesis of renal stones is an intricate process and varies widely depending on the composition of stones. There is also a marked geographic variability, strongly attributable to the mean annual temperature (MAT) and, to a lesser extent, on the seasons. Previous investigations report peaks in Emergency Department (ED) visits for renal colic during the summer. The aim of the present investigation is to assess the influence of day-by-day climate changes on the number of visits due to renal colic in our ED (city of Parma, located in the Po river valley, with a temperate continental climate). A total of 8,168 colic episodes were retrieved from our database during a period of 2,557 days (from 1 January 2002 to 31 December 2008). Over the same period 557,990 patients were admitted to our ED, renal colic visits representing 1.46% of the total. The linear regression analysis fitting the mean number of colic visits per day and the mean daily temperature displays a very high and significant correlation (R = 0.88, p < 0.0001). A multiple linear regression analysis between the mean temperature of each of the 30 days preceding the colic episode also shows strong correlations, being the strongest on the 5th–7th days (R = 0.80, p < 0.0001 on the 6th day before the colic episode), and a weaker but highly significant correlation on days 14 (R = 0.77, p < 0.0001) and 20 (R = 0.70, p < 0.0001) before the colic episode. Taken together, these findings suggest a kind of “acceleration” process of stone formation caused by the hot climate and, perhaps, by dietary variations during the summer. This process might trigger a sudden growth of the stone and, finally, the resulting clinical episode.
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Pearle MS, Calhoun EA, Curhan GC (2005) Urologic diseases in America project: urolithiasis. J Urol 173:848–857
Shokeir AA (2002) Renal colic: new concepts related to pathophysiology, diagnosis and treatment. Curr Opin Urol 12:263–269
Worcester EM, Coe FL (2010) Calcium kidney stones. N Engl J Med 363:954–963
Johnson CM, Wilson DM, O’Fallon WM, Malek RS, Kurland LT (1979) Renal stone epidemiology: a 25-year study in Rochester, Minnesota. Kidney Int 16:624–631
Borghi L, Schianchi T, Meschi T, Guerra A, Allegri F, Maggiore U, Novarini A (2002) Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med 346:77–84
Brikowski TH, Lotan Y, Pearle MS (2008) Climate-related increase in the prevalence of urolithiasis in the United States. Proc Nat Acad Sci 105:9841–9846
Robertson WG (2003) Renal stones in the tropics. Semin Nephro l23:77–87
Esho JO (1978) The rarity of urinary calculus in Nigeria. Trop Geogr Med 30:477
Modlin M (1967) The etiology of renal stone. Ann R Coll Surg Engl 40:155
Abdel-Halim RE, Al-Hadramy MS, Hussein M, Baghlaf AO, Sibbai AA, Noorwali AW (1989) The prevalence of urolithiasis in the western region of Saudi Arabia: a population study. In: Walker VR, Sutton RAL, Cameron ECB, Pak CYC, Robertson WG (eds) Urolithiasis. Plenum, New York, p 711
Johnny UV, Monu (1989) Pattern of urolithiasis in Benin City, Nigeria. JAMA 81:695–698
Al-Hadramy MS (1997) Seasonal variation of urinary stone colic in Arabia. J Pak Med Assoc 47:281–284
Basiri A, Moghaddam SM, Khoddam R, Nejad ST, Hakimi A (2004) Monthly variations of urinary stone colic in Iran and its relationship to the fasting month of Ramadan. J Pak Med Assoc 54:6–8
Barker DJ, Donnan SP (1978) Regional variations in the incidence of upper urinary tract stones in England and Wales. Br Med J 1:67–70
Fujita K (1979) Epidemiology of urinary stone colic. Eur Urol 5:26–28
Prince CL, Scardino PL (1960) A statistical analysis of ureteral calculi. J Urol 83:561–565
Al-Dabbagh TQ, Fahadi K (1977) Seasonal variations in the incidence of ureteric colic. Br J Urol 49:269–275
Laerum E (1983) Urolithiasis in general practice: an epidemiological study from a Norwegian district. Scand J Nephrol 17:313–319
El-Reshaid K, Mughal H, Kapoor M (1997) Epidemiological profile, mineral metabolic pattern and crystallographic analysis of urolithiasis in Kuwait. Eur J Epidemiol 13:229–234
Trinchieri A, Coppi F, Montanari E, Del Nero A, Zanetti G, Pisani E (2000) Increase in the prevalence of symptomatic upper urinary tract stones during the past ten years. Eur Urol 37:23–25
Stamatelou KK, Francis ME, Curhan GC, Jones CA (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63:1817–1823
Cramer JS, Forrest K (2006) Renal lithiasis: addressing the risks of austere desert deployments. Aviat Space Environ Med 77:649–653
Chen Y-K, Lin H-C, Chen C-S, Yeh S-D (2008) Seasonal variations in urinary calculi attacks and their association with climate: a population-based study. J Urol 179:564–569
Borghi L, Meschi T, Amato F, Novarini A, Romanelli A, Cigala F (1993) Hot occupation and nephrolithiasis. J Urol 150:1757–1760
Atan L, Andreoni C, Ortiz V, Silva EK, Pitta R, Atan F, Srougi M (2005) High kidney stone risk in men working in steel industry at hot temperatures. Urology 65:859–861
Evans K, Costabile RA (2005) Time to development of symptomatic urinary calculi in a high-risk environment. J Urol 173:858–861
Diniz DH, Schor N, Blay SL (2006) Stressful life events and painful recurrent colic of renal lithiasis. J Urol 176(6 Pt 1):2483–2487
Chauhan V, Eskin B, Allegra JR, Cochrane DG (2004) Effect of season, age and gender on renal colic incidence. Am J Emerg Med 22:560–563
Boscolo-Berto R, Dal Moro F, Abate A, Arandjelovic G, Tosato F, Bassi P (2008) Do weather conditions influence the onset of renal colic? A novel approach to analysis. Urol Int 80:19–25
Cupisti A, Pasquali E, Lusso S, Carlino F, Orsitto E, Melandri R (2008) Renal colic in Pisa emergency department: epidemiology diagnostics and treatment patterns. Intern Emerg Med 3:241–244
Pincus S, Macbean C, Taylor D (2010) The effects of temperature, age and sex on presentations of renal colic in Melbourne, Australia. Eur J Emerg Med 17(6):328–331
Curhan GC, Willett WC, Knight EL, Stampfer MJ (2004) Dietary factors and the risk of incident kidney stones in younger women (Nurses’ Health Study II). Arch Intern Med 164:885–891
Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A (1996) Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol 155:839–843
Curhan GC, Willett WC, Rimm EB, Spiegelman D, Stampfer MJ (1996) Prospective study of beverage use and the risk of kidney stones. Am J Epidemiol 143:240–247
Odvina CV (2006) Comparative value of orange juice versus lemonade in reducing stone-forming risk. Clin J Am SocNephrol 1:1269–1274
Taylor EN, Curhan GC (2008) Determinants of 24-hour urinary oxalate excretion. Clin J Am SocNephrol 3:1453–1460
Traxer O, Huet B, Poindexter J, Pak CY, Pearle MS (2003) Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 170:397–401
Taylor EN, Stampfer MJ, Curhan GC (2004) Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 15:3225–3232
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Cervellin, G., Comelli, I., Comelli, D. et al. Regional short-term climate variations influence on the number of visits for renal colic in a large urban Emergency Department: results of a 7-year survey. Intern Emerg Med 6, 141–147 (2011). https://doi.org/10.1007/s11739-011-0518-6
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DOI: https://doi.org/10.1007/s11739-011-0518-6