Association between thrombomodulin and the prevalence of renal calculus: a cross-sectional study from Wuhan central hospital.

BACKGROUND: Renal calculus is a common urological disease with increasing prevalence worldwide. Thrombomodulin (TM) is a marker of endothelial injury and has been associated with various inflammatory conditions. This study aimed to investigate the correlation between plasma thrombomodulin levels and renal calculus. METHODS: A total of 805 participants were enrolled in this cross-sectional study, including 577 healthy controls and 228 renal calculus patients. General demographic data and laboratory indicators were collected from the participants. TM levels were measured by chemiluminescence immunoassay. Univariate and multivariate logistic regression models were used to analyze the correlation between TM and renal calculus, and subgroup analyses were performed. RESULTS: Renal calculus patients showed significantly higher TM levels compared to healthy controls (8.12 vs. 7.6 ng/mL, P = 0.0001). Multivariate analysis revealed TM remained independently associated with renal calculus after adjusting for non-inflammatory covariates (OR = 1.121, P = 0.0031), with the association persisting after additional adjustment for inflammatory markers (OR = 1.176, P = 0.0015). A dose-response trend across TM quartiles was observed, which was partially mediated by inflammatory markers.Patients with UTI and renal calculus complicated by infection showed significantly higher levels of TM, CRP, WBC, and NEU compared to those with simple renal calculus and healthy controls (P < 0.0001). CONCLUSIONS: Elevated plasma TM levels are significantly associated with increased prevalence of renal calculus.This association may be mediated by endothelial dysfunction and inflammatory responses, suggesting that vascular endothelial dysfunction plays a crucial role in the pathogenesis of renal calculus.