Recent data indicates that kidney stone formers (KSF) may have increased biomineralization at anatomic sites throughout the body compared to non-stone formers (NSF). The objective of this study is to compare the volume of non-renal systemic calcifications between KSF and NSF by using a standardized system to analyze calcifications in the abdominal aorta (AA) and splenic artery (SA).
The NSF cohort was obtained from a kidney donor prospectively maintained database. 197 NSF were matched to 197 KSF based on age, gender, and BMI. Non-contrast CT scans were evaluated and semi-automated CT software was utilized to provide an abdominal aorta (AA) and splenic artery (SA) calcification Agatston score. Wilcoxon rank sum test was used on continuous variables and chi-squared test or Fisher's exact test on categorical variables. Odds ratios (OR) were given for a variables influence on the formation of stones or calcifications.
AA and SA calcifications were more prevalent in the KSF group (p = 0.011 and p = 0.027, respectively). KSF were 1.9 times more likely to have intermediate or severe AA calcification than NSF (OR 1.9, p = 0.004). Severe AA calcifications had even a greater association (OR 3.1, p = 0.019). KSF were also more likely to have SA, but this did not reach statistical significance (OR = 3.7, p = 0.103).
Patients with increased systemic calcifications, specifically aortic or splenic calcifications, may be at an increased risk for future kidney stone formation. Patients with these imaging findings and additional risk factors for stone disease may be counseled on the future risk of stones.
Journal of endourology. 2019 Jun 21 [Epub ahead of print]
Karen Lynne Stern, Ryan D Ward, Jianbo Li, Erick Remer, Marshall Stoller, Manoj Monga
Cleveland Clinic Foundation, Urology , 9500 Euclid Avenue, Q10-1 , Cleveland, Ohio, United States , 44195 ; ., Cleveland Clinic Foundation, Imaging Institute , 9500 Euclid Ave , L10 , Cleveland, Ohio, United States , 44195 ; ., Cleveland Clinic Foundation, Department of Quantitative Health Sciences , 9500 Euclid Ave. , Cleveland, Ohio, United States , 44195 ; ., Cleveland Clinic, Imaging Institute , 9500 Euclid Avenue , A21 , Cleveland, Ohio, United States , 44195 ; ., University of California San Francisco, Urology, San Francisco, California, United States ; ., Cleveland Clinic Foundation, Cleveland , Ohio, United States ; .