Analysis of Kidney Stones in the Submarine Force

摘要

This report presents the results of a retrospective review of nephrolithiasiswaiver and disqualification packages submitted to Atlantic and Pacific Force Medical Officers over the past three years. General characteristics of stone-formers in the submarine force are described. Medical Officers noted metabolic and environmental conditions predisposing to stone formation in 53% of the individuals. Hypercalciuria (29%), hyperuricosuria (22%), and hypocitraturia (9%) were the most frequently documented disturbances. Analysis of individual laboratory values revealed a greater percentage of abnormalities than noted by Medical Officers. Hypercalciuria (36%), hyperphosphatura (32%), hypocitraturia (19%), elevated urinary sodium (12%), and low urine volume (57%) were the most common laboratory abnormalities. Individuals with no documented predisposition to stone formation, recurrent stone-formers, submariners with retained stones, and personnel from the Pacific Fleet were less likely to be waived of physical standards (p < 0.05). Results indicate that the incidence of metabolic abnormalities in the submarine force is greater than expected and the majority of stone patients have a treatable abnormality. Personnel waivers for nephrolithiasis will need to be prospectively followed over several years to determine additional information (such as recurrence rates with appropriate treatment) and the operational impact of maintaining these individuals' submarine qualifications.... Nephrolithiasis, Kidney stones, Waiver, Submarine personnel.