INTRODUCTION AND OBJECTIVES: To examine kidney stone disease as a potential risk factor for chronic kidney disease (CKD), end-stage kidney disease and treatment with dialysis (ESKD).
METHODS: The National Health and Nutrition Examination Survey (NHANES 2007-2010) database was interrogated for patients with a history of kidney stones. Demographics and comorbid conditions including age, sex, body mass index (BMI), diabetes, hemoglobin A1c, hypertension, gout and smoking were also assessed. Multivariate analysis adjusting for patient demographics and comorbidities was performed to assess differences in the prevalence of CKD and treatment with dialysis between the two groups. History of nephrolithiasis was assessed by the question "Have you ever had kidney stones?" CKD was defined as patients with either an eGFR of < 60 mL/min/1.73 m2 or a urinary albumin to creatinine ratio >30 mg/g or both. Statistical calculations were performed using Stata software (StataCorp LP, Texas) with determinations of p-values and 95% confidence intervals where appropriate.
RESULTS: The study included an analysis of 5,971 NHANES participants for whom data on CKD and kidney stones was available, of whom 521 reported a history of kidney stones. On multivariate analysis, a history of kidney stones was associated with CKD and treatment with dialysis (OR 1.50 (1.10-2.04) p= 0.013, and 2.37 (1.13- 4.96) p=0.025). This difference appeared to be driven by women, where a history of kidney stones was associated with a higher prevalence of CKD (OR 1.76 (1.13-2.763) p=0.016) and treatment with dialysis (OR 3.26 (1.48-7.16) p=0.004). There was not a significant association between kidney stone history and CKD or treatment with dialysis in men.
CONCLUSIONS: Kidney stone history is associated with an increased risk of CKD and treatment with dialysis among women even after adjusting for co-morbid conditions. Large-scale prospective studies are needed to further characterize the relationship between nephrolithiasis and CKD.
Written by:
Shoag J, Halpern J, Goldfarb DS, Eisner BH. Are you the author?
Department of Urology, Weill Cornell Medical College; New York Harbor VA Healthcare System and NYU School of Medicine; Department of Urology, Massachusetts General Hospital, Harvard Medical School.
Reference: J Urol. 2014 Jun 11. pii: S0022-5347(14)03756-2.
doi: 10.1016/j.juro.2014.05.117
PubMed Abstract
PMID: 24929140
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