Associations between gallbladder surgery and kidney stones: The mediating roles of hypertension and diabetes

Background : Kidney stones are a prevalent urological condition that affects a considerable number of individuals worldwide. However, the connection between gallbladder surgery and the formation of kidney stones, along with the potential mediating effect ofhypertension and diabetes on this relationship, is not fully elucidated. Materials and methods : Data from 6,579 adults aged 20 years or older in the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020 were analyzed. Gallbladder surgery and kidney stone history were determined through questionnaires. Weighted multivariate logistic regression was used to assess associations, subgroup analyses were conducted, and mediation analysis evaluated the mediating effects of metabolic syndrome (MetS), diabetes, hypertension, and estimated glucose disposal rate (eGDR). Results : The prevalence of kidney stones was 10.36%, with significantly higher rates in the gallbladder surgery group (18.88% compared to 9.21%). After adjusting for confounding factors, gallbladder surgery remained independently associated with kidney stones (OR = 1.94, 95% CI: 1.35–2.79). Subgroup analyses indicated stronger associations among vigorous activity individuals (OR = 2.786) and those without MetS (OR = 2.675). Mediation analysis revealed that diabetes, hypertension, and eGDR mediated 3.04%, 5.34%, and 10.54% of the effect, respectively, whereas MetS did not mediate the association. Conclusion : Gallbladder surgery is closely associated with kidney stones, and hypertension and diabetes exert a partial mediating effect. Special attention should be given to the management of hypertension and diabetes in patients who have undergone gallbladder surgery to prevent the formation of kidney stones. Further investigation is necessary to better understand the mechanisms and enhance preventive measures.