Nephrolithiasis (kidney stones) is an increasingly common condition occurring more frequently in men than women; over the last three decades the overall prevalence in the US population has risen to 8.8%. Links between nephrolithiasis and other systemic diseases have been noted, including subclinical atherosclerosis, hypertension, diabetes, metabolic syndrome, and cardiovascular disease. However, previous studies looking at the association between kidney stones and CHD have often not controlled for important risk factors and have shown inconsistent results.
This paper analysed the association between kidney stones and the risk of incident coronary heart disease (CHD) in three large prospective cohorts (Health Professionals Follow-up Study, Nurses’ Health Studies I and II). The diagnoses of nephrolithiasis and CHD were updated biennially during follow-up. The main outcome measure was the incidence of CHD, defined as fatal or nonfatal myocardial infarction or coronary revascularisation.
Of 242,105 patients participating in the study, 19,678 reported a history of kidney stones. Follow-up lasted up to 24 years in men and up to 18 years in women, over which period 16,838 incident cases occurred. After adjustment for potential confounders, women with a reported history of kidney stones had an increased risk of CHD than those without in two of the three cohorts (Nurses’ Health Studies I [Hazard Ratio 1.18] and II [Hazard Ratio, 1.48]), however there was no significant association seen in men.
This study found a modest, sex-specific increase in the risk of coronary heart disease in women with a history of kidney stones. The pathophysiological basis of this association requires further investigation.
- Ferraro PM, Taylor EN, Eisner BH, et al. History of Kidney Stones and the Risk of Coronary Heart Disease. JAMA 2013;310:408-415.