Obstructive and reflux uropathy

Metadata

Name	Obstructive and reflux uropathy (obstr_reflux)
Category	Genitourinary
Sex
Adult	Yes
UUID	3413765a-793e-4c3f-aad1-5d69cf32c168
Definition	Obstructive uropathy: a structural or functional hindrance of normal urine flow. Reflux uropathy: a condition in which urine regurgitates from the bladder back into the ureter.

Ontologies

Disease Ontology (DOID)	DOID_5200
MeSH	D001748
SNOMED-CT	7163005

Key Summary Statistics

Cases from any source

Total	7049
Female (%)	2907 (41%)
Male (%)	4142 (59%)

Year first recorded

Cases linked in all UK Biobank sources

Cross-source concordance

Vertical bars correspond to number of cases per source/intersection; horizontal bars to left correspond to total number of cases per source.

Incidence & prevalence

Baseline prevalence stratified by sex

Female	33.01 (29.15,36.87)
Male	46.2 (41.22,51.17)

Incidence stratified by sex

Female	5.57 (4.96,6.19)
Male	9.74 (8.85,10.63)

Incidence stratified by age

Ages 40-44	5.85 (4.34,7.35)
Ages 45-49	4.32 (3.21,5.43)
Ages 50-54	5.98 (4.77,7.19)
Ages 55-59	5.59 (4.53,6.64)
Ages 60-64	9.31 (8.13,10.48)
Ages 65-69	11.02 (9.55,12.48)

Period prevalence

Methods

Comparison with general population

Sex-standardised prevalence from CALIBER study (Kuan et al. 2019)

Population	Ages 40-49	Ages 50-59	Ages 60-69
UK Biobank	58 (51,65)	71 (64,78)	101 (94,108)
CALIBER	60 (58,62)	77 (75,80)	117 (114,121)

Stratified by age and Townsend deprivation status

Deprivation status	Ages 40-49	Ages 50-59	Ages 60-69
Least deprived	66(48,88)	70(56,86)	82(69,96)
Low	55(39,75)	64(51,79)	104(90,119)
Medium	47(32,65)	64(51,79)	100(86,116)
High	42(30,58)	64(51,79)	98(84,115)
Most deprived	75(60,94)	90(74,108)	124(107,142)

Stratified by age and country

Country	Ages 40-49	Ages 50-59	Ages 60-69
England	61(53,70)	68(61,76)	101(94,109)
Scotland	47(29,70)	80(63,101)	94(77,115)
Wales	36(18,64)	78(56,106)	105(82,132)

Risk factors analysis

‘Healthy’ BMI, smoking status ‘never’, or no hypertension (absence of hypertension records) were considered as reference values.

Hazard Ratio (HR) values with P < 0.0002 were considered to show significant association with disease onset after correction for multiple-testing using the Bonferroni method

N=153321, Events=259

Factor	Level	Hazard Ratio	P value
BMI	overweight	1.47 (1.07, 2.01)	0.0165
BMI	obese	2.46 (1.81, 3.35)	1.19e-08
BMI	underweight	0 (0, Inf)	0.998
smoking	previous	1.06 (0.81, 1.39)	0.676
smoking	current	0.75 (0.46, 1.22)	0.25
hypertension	yes	0.83 (0.58, 1.19)	0.31

Definition

UK Biobank field id	Description	Code	Value
41202	Diagnoses - main ICD10	N13.0	Hydronephrosis with ureteropelvic junction obstruction
41202	Diagnoses - main ICD10	N13.1	Hydronephrosis with ureteral stricture, not elsewhere classified
41202	Diagnoses - main ICD10	N13.2	Hydronephrosis with renal and ureteral calculous obstruction
41202	Diagnoses - main ICD10	N13.3	Other and unspecified hydronephrosis
41202	Diagnoses - main ICD10	N13.4	Hydroureter
41202	Diagnoses - main ICD10	N13.5	Kinking and stricture of ureter without hydronephrosis
41202	Diagnoses - main ICD10	N13.6	Pyonephrosis
41202	Diagnoses - main ICD10	N13.7	Vesicoureteral-reflux-associated uropathy
41202	Diagnoses - main ICD10	N13.8	Other obstructive and reflux uropathy
41202	Diagnoses - main ICD10	N13.9	Obstructive and reflux uropathy, unspecified
41204	Diagnoses - secondary ICD10	N13.0	Hydronephrosis with ureteropelvic junction obstruction
41204	Diagnoses - secondary ICD10	N13.1	Hydronephrosis with ureteral stricture, not elsewhere classified
41204	Diagnoses - secondary ICD10	N13.2	Hydronephrosis with renal and ureteral calculous obstruction
41204	Diagnoses - secondary ICD10	N13.3	Other and unspecified hydronephrosis
41204	Diagnoses - secondary ICD10	N13.4	Hydroureter
41204	Diagnoses - secondary ICD10	N13.5	Kinking and stricture of ureter without hydronephrosis
41204	Diagnoses - secondary ICD10	N13.6	Pyonephrosis
41204	Diagnoses - secondary ICD10	N13.7	Vesicoureteral-reflux-associated uropathy
41204	Diagnoses - secondary ICD10	N13.8	Other obstructive and reflux uropathy
41204	Diagnoses - secondary ICD10	N13.9	Obstructive and reflux uropathy, unspecified
40001	Underlying (primary) cause of death: ICD10	N13.0	Hydronephrosis with ureteropelvic junction obstruction
40001	Underlying (primary) cause of death: ICD10	N13.1	Hydronephrosis with ureteral stricture, not elsewhere classified
40001	Underlying (primary) cause of death: ICD10	N13.2	Hydronephrosis with renal and ureteral calculous obstruction
40001	Underlying (primary) cause of death: ICD10	N13.3	Other and unspecified hydronephrosis
40001	Underlying (primary) cause of death: ICD10	N13.4	Hydroureter
40001	Underlying (primary) cause of death: ICD10	N13.5	Kinking and stricture of ureter without hydronephrosis
40001	Underlying (primary) cause of death: ICD10	N13.6	Pyonephrosis
40001	Underlying (primary) cause of death: ICD10	N13.7	Vesicoureteral-reflux-associated uropathy
40001	Underlying (primary) cause of death: ICD10	N13.8	Other obstructive and reflux uropathy
40001	Underlying (primary) cause of death: ICD10	N13.9	Obstructive and reflux uropathy, unspecified
40002	Contributory (secondary) causes of death: ICD10	N13.0	Hydronephrosis with ureteropelvic junction obstruction
40002	Contributory (secondary) causes of death: ICD10	N13.1	Hydronephrosis with ureteral stricture, not elsewhere classified
40002	Contributory (secondary) causes of death: ICD10	N13.2	Hydronephrosis with renal and ureteral calculous obstruction
40002	Contributory (secondary) causes of death: ICD10	N13.3	Other and unspecified hydronephrosis
40002	Contributory (secondary) causes of death: ICD10	N13.4	Hydroureter
40002	Contributory (secondary) causes of death: ICD10	N13.5	Kinking and stricture of ureter without hydronephrosis
40002	Contributory (secondary) causes of death: ICD10	N13.6	Pyonephrosis
40002	Contributory (secondary) causes of death: ICD10	N13.7	Vesicoureteral-reflux-associated uropathy
40002	Contributory (secondary) causes of death: ICD10	N13.8	Other obstructive and reflux uropathy
40002	Contributory (secondary) causes of death: ICD10	N13.9	Obstructive and reflux uropathy, unspecified
42040	GP clinical event records	K110.00	Hydrocalycosis
42040	GP clinical event records	K111.00	Hydroureteronephrosis
42040	GP clinical event records	K112.00	Hydronephrosis with renal and ureteral calculous obstruction
42040	GP clinical event records	K113.00	Hydronephrosis with ureteropelvic junction obstruction
42040	GP clinical event records	K113.11	Hydronephrosis with pelviureteric junction obstruction
42040	GP clinical event records	K11..00	Hydronephrosis
42040	GP clinical event records	K11X.00	Hydronephrosis with ureteral stricture NEC
42040	GP clinical event records	K11z.00	Hydronephrosis NOS
42040	GP clinical event records	K133000	Postoperative ureteric constriction
42040	GP clinical event records	K133100	Stricture of pelviureteric junction
42040	GP clinical event records	K133.00	Stricture of ureter
42040	GP clinical event records	K133z00	Stricture of ureter NOS
42040	GP clinical event records	K134000	Idiopathic retroperitoneal fibrosis
42040	GP clinical event records	K134.00	Other ureteric obstruction
42040	GP clinical event records	K134z00	Occlusion of ureter NOS
42040	GP clinical event records	K135.00	Hydroureter
42040	GP clinical event records	K137.00	Vesicoureteric reflux
42040	GP clinical event records	K137.11	Ureteric reflux
42040	GP clinical event records	K196.00	Urinary obstruction unspecified
42040	GP clinical event records	K196.11	Obstructive uropathy, unspecified
42040	GP clinical event records	Kyu1100	[X]Other and unspecified hydronephrosis
42040	GP clinical event records	Kyu1200	[X]Other obstructive and reflux uropathy
42040	GP clinical event records	Kyu1300	[X]Obstructive and reflux uropathy, unspecified
42040	GP clinical event records	Kyu1F00	[X]Hydronephrosis with ureteral stricture NEC
42040	GP clinical event records	XE0e4	Urinary obstruction unspecified
42040	GP clinical event records	XE0e4	Urinary obstruction unspecified
42040	GP clinical event records	XaCMe	Hydronephrosis with ureteropelvic junction obstruction