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Clin J Am Soc Nephrol. 2014 Mar;9(3):506-12. doi: 10.2215/CJN.04960513. Epub 2013 Dec 5.

Kidney stones and cardiovascular events: a cohort study.

Author information

1
Division of Nephrology, Department of Pediatrics, and, ‡Division of Nephrology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada;, †Division of Nephrology, Department of Medicine, and, §Division of Nephrology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada, ‖Department of Epidemiology, Harvard University, Boston, Massachusetts.

Abstract

BACKGROUND AND OBJECTIVES:

Kidney stones are common in general clinical practice, and their prevalence is increasing. Kidney stone formers often have risk factors associated with atherosclerosis, but it is uncertain whether having a kidney stone is associated with higher risk of cardiovascular events. This study sought to assess the association between one or more kidney stones and the subsequent risk of cardiovascular events.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:

Cohort study of 3,195,452 people aged≥18 years registered in the universal health care system in Alberta, Canada, between 1997 and 2009 (median follow-up of 11 years). People undergoing dialysis or with a kidney transplant at baseline were excluded. The primary outcome was the first acute myocardial infarction (AMI) during follow-up. We also considered other cardiovascular events, including death due to coronary heart disease, percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass grafting (CABG), and stroke.

RESULTS:

In total, 25,532 (0.8%) participants had at least one kidney stone, and 91,465 (3%) individuals had at least one cardiovascular event during follow-up. Compared with people without kidney stones and after adjustment for cardiovascular risk factors and other potential confounders, people who had at least one kidney stone had a higher risk of subsequent AMI (adjusted hazard ratio [HR], 1.40; 95% confidence interval [95% CI], 1.30 to 1.51), PTCA/CABG (HR, 1.63; 95% CI, 1.51 to 1.76), and stroke (HR, 1.26; 95% CI, 1.12 to 1.42). The magnitude of the excess risk associated with a kidney stone appeared more pronounced for younger people than for older people (P<0.001) and for women than men (P=0.01).

CONCLUSIONS:

The occurrence of a kidney stone is associated with a higher risk of cardiovascular events, including AMI, PTCA/CABG, and stroke.

Comment in

PMID:
24311706
PMCID:
PMC3944758
DOI:
10.2215/CJN.04960513
[Indexed for MEDLINE]
Free PMC Article

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