Kidney Stone Formation is Positively Associated with Conventional Risk Factors for Coronary Heart Disease in Japanese Men

Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. Electronic address: .
The Journal of urology (Impact Factor: 4.47). 11/2012; 189(4). DOI: 10.1016/j.juro.2012.11.045
Source: PubMed


We investigated the association between kidney stones and coronary heart disease risk factors in Japanese men.

Materials and methods:
This cross-sectional study included 13,418 Japanese men 30 to 69 years old who voluntarily underwent medical examination between April 1995 and March 2001. Participants were divided into controls, and past and current kidney stone formers based on ultrasound results and medical history. We evaluated conventional risk factors of coronary heart disease, including overweight/obesity, hypertension, diabetes mellitus, gout/hyperuricemia, dyslipidemia and chronic kidney disease. Associations between coronary heart disease risk factors and kidney stones were investigated.

Of the 13,418 participants 404 current kidney stone formers (3.0%) had kidney stones on ultrasound and 1,231 past kidney stone formers (9.2%) had a history of kidney stones but no kidney stones on medical examination. Body mass index, systolic and diastolic blood pressure, and serum uric acid were significantly higher in past and current kidney stone formers than in controls. Logistic regression analysis indicated that the multivariate adjusted OR for overweight/obesity, hypertension, gout/hyperuricemia and chronic kidney disease significantly increased in the order corresponding to controls, and past and current kidney stone formers.

Kidney stone formers, even past stone formers, are likely to have accumulated risk factors for coronary heart disease. They could be preferentially targeted for coronary heart disease prevention.

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  • No preview · Article · Oct 2013 · The Journal of Urology
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    ABSTRACT: Recent epidemiologic evidence suggests an association between kidney stones and incident cardiovascular disease after adjusting for other cardiovascular risk factors, but results are inconsistent. Meta-analysis of cohort studies. Patients with kidney stones. Cohort studies with data for kidney stones and cardiovascular morbidity identified in PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and conference proceedings through February 27, 2014. Kidney stones as determined by physician diagnosis, clinical coding, or self-reported scales. Cardiovascular disease, coronary heart disease (CHD), and stroke. 6 cohort studies that contained 49,597 patients with kidney stones and 3,558,053 controls, with 133,589 cardiovascular events, were included. Pooled results suggested that kidney stones were associated with an increased adjusted risk estimate for CHD (HR, 1.19; 95%CI, 1.05-1.35; P=0.05; n=6 cohorts) and stroke (HR, 1.40; 95%CI, 1.20-1.64; P<0.001; n=3 cohorts). In particular, kidney stones conferred HRs of 1.29 (95%CI, 1.10-1.52; n=6 cohorts) and 1.31 (95%CI, 1.05-1.65; n=4 cohorts) for myocardial infarction and coronary revascularization, respectively. Moreover, the pooled female cohorts showed a statistically significant association (HR, 1.49; 95%CI, 1.21-1.82; n=4 cohorts), whereas the male cohorts showed no association (HR, 1.15; 95%CI, 0.89-1.50; n=2 cohorts). Results may be limited by substantial heterogeneity, likelihood of residual confounding, and paucity of studies that separately evaluated for effect modification by sex. Kidney stones were associated with increased cardiovascular risk, including the risk for incident CHD or stroke. There is some suggestion that the risk may be higher in women than men. Further prospective studies are needed to determine whether the association is sex specific.
    No preview · Article · May 2014 · American Journal of Kidney Diseases
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    ABSTRACT: Objective: To assess the influence of dyslipidemia on urinary lithogenic metabolites and stone recurrence in stone formers. Materials and methods: We retrospectively selected 321 patients with urolithiasis who had been followed up for >24 months between 2004 and 2009. Fasting blood samples were taken, and serum lipid profiles were measured. All subjects also underwent 24-hour urinary metabolic evaluation and stone analysis. The radiographic appearance of new stones was defined as stone recurrence. Results: There was no significant correlation between lipid profiles and 24-hour urine metabolites (all P >.05). Stone formers with hypertriglyceridemia had significantly higher urinary calcium, sodium, uric acid, magnesium, and potassium excretions. Only in a subgroup of uric acid stone, hypertriglyceridemia was significantly associated with decreased urinary pH. Those with low high-density lipoprotein (HDL) cholesterolemia had higher urinary sodium, magnesium, and potassium excretions, whereas those with high low-density lipoprotein (LDL) cholesterolemia had lower urinary sodium excretion. Stone analysis revealed that uric acid stones were more commonly found in patients with hypertriglyceridemia and low-HDL cholesterolemia. After a median follow-up of 35.0 months, 109 patients (34% of cohort) had stone recurrence. Stone recurrence was more common in the hypertriglyceridemia group compared with the normal triglyceridemia group (45.9% vs 29.7%; P = .005). The multivariate Cox regression model revealed that hypertriglyceridemia is associated independently with stone recurrence (hazard ratio, 1.857; 95% confidence interval, 1.211-2.847; P = .005). Kaplan-Meier curves showed similar results. Conclusion: Our study showed that serum lipid profile is associated with urine metabolic alterations. More importantly, hypertriglyceridemia is independently associated with increased risk for stone recurrence in patients with urolithiasis.
    No preview · Article · Aug 2014 · Urology
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