P432 ARTERIAL STIFFNESS AND CARDIOVASCULAR RISK IN PATIENTS WITH NEPHROLITIASIS: A 10–YEAR PROSPECTIVE STUDY

Abstract

Abstract Nephrolithiasis is frequently associated with several cardiovascular diseases, and the pathophysiological connection may rely on some common risk factors. In fact, systemic inflammation, promoting oxidative stress, may lead to arterial wall stiffening (which is considered an independent predictor of cardiovascular risk); however, the same mechanism may also play a role in Randall’s plaques deposition, which is a predisposing step to nephrolithiasis. This study aims to examine the correlation between arterial stiffness and nephrolithiasis, exploring its trend across aging. 82 patients (mean age 45±13 years, 36 males) referred to Geriatrics and Nephrology Outpatient Clinic were prospectively enrolled: at baseline and after 10 years they underwent a clinical evaluation (with particular focus on cardiovascular events and risk factors), and arterial stiffness measurement, obtaining carotid–femoral Pulse Wave Velocity (PWVcf) by arterial applanation tonometry. 66 patients were diagnosed with nephrolithiasis, whereas the remaining 16 formed the control group. At baseline, compared to the control group, patients with nephrolithiasis showed higher systolic blood pressure and PWVcf (128±18 vs 117±16 mmHg, p 0.02 and 7.78±1.53 vs 6.50±1.13 m/s, p 0.001 respectively). After 10 years, patients with nephrolithiasis (p 0.001), but not patients without (p 0.081), had a significant raise in PWVcf, as compared to the baseline evaluation (10.64±3 vs 7.78±1.55 m/s); this trend was confirmed even after adjustment for age and sex. In a backward regression model, considering PWVcf variation over the follow up years (ΔPWVcf) as dependent variable, and age, sex, follow up years, Δ mean arterial pressure, Body Mass Index, hypertension and nephrolithiasis as independent variables, nephrolithiasis was proved to be the only significant predictor of ΔPWVcf, accounting for 6.9% of the variance (p 0.027). In conclusion, the present study outlines an increased cardiovascular risk in patients affected by nephrolithiasis, which is represented by higher baseline PWVcf and wider increase in ΔPWVcf within 10 years. These findings endorse a comprehensive evaluation in subjects with nephrolithiasis, moving beyond the nephrological condition, and considering the patient’s cardiovascular risk profile, to identify, to prevent or to treat any possible organ damage.