Kidney stone disease (KSD) has been linked to increased risk of adverse cardiovascular (CV) and bone events, raising the hypothesis of a shared pathogenic pathway. However, it is unclear whether these events commonly occur in the same stone-forming individual. We examined the occurrence of CV and bone events in individuals with a history of KSD and analyzed their characteristics.
We analyzed three large prospective cohorts, the Health Professionals Follow-up Study (HPFS, men) and the Nurses' Health Study (NHS, women) I and II. Individuals with a self-reported diagnosis of KSD during follow-up and no previous CV or bone events at the time of KSD diagnosis were included in the study and followed until the development of a CV event (fatal or non-fatal myocardial infarction, coronary revascularization) and a bone event (fracture, osteoporosis); individuals who developed cancer or died were censored. Characteristics of stone formers experiencing only one event (CV or bone), both events, or none were compared using multinomial logistic regression models.
Our study included data from 14 709 individuals with KSD. In HPFS, 28.7% of the participants experienced at least one event: 17.4% a CV event, 8.5% a bone event and 2.8% both. In NHS I, 46.0% of the participants experienced at least one event: 7.3% a CV event, 32.8% a bone event and 5.9% both. In NHS II, 27.1% of the participants experienced at least one event: 2.0% a CV event, 23.9% a bone event and 1.1% both. Across cohorts, age, BMI, thiazide use, calcium and vitamin D supplementation, and prevalence of hypertension and diabetes did not identify specific high-risk subgroups.
CV and bone events are common in KSD; however, their co-occurrence in the same stone-forming individual is relatively rare. CV disease and bone disease are unlikely to share major risk factors in individuals with KSD.
Clinical kidney journal. 2026 May 18*** epublish ***
Pietro Manuel Ferraro, Eric N Taylor, Giovanni Gambaro, Gary C Curhan
Section of Nephrology, Department of Medicine, Università degli Studi di Verona, Verona, Italy., Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.