PD47-08 CORONARY ARTERY CALCIUM SCORE AND ASSOCIATION WITH RECURRENT NEPHROLITHIASIS: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS

Abstract

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II1 Apr 2016PD47-08 CORONARY ARTERY CALCIUM SCORE AND ASSOCIATION WITH RECURRENT NEPHROLITHIASIS: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS Ryan Hsi, Andrew Spieker, Marshall Stoller, David Jacobs, Alex Reiner, Robyn McClelland, Arnold Kahn, Thomas Chi, Moyses Mzklo, and Mathew Sorensen Ryan HsiRyan Hsi More articles by this author , Andrew SpiekerAndrew Spieker More articles by this author , Marshall StollerMarshall Stoller More articles by this author , David JacobsDavid Jacobs More articles by this author , Alex ReinerAlex Reiner More articles by this author , Robyn McClellandRobyn McClelland More articles by this author , Arnold KahnArnold Kahn More articles by this author , Thomas ChiThomas Chi More articles by this author , Moyses MzkloMoyses Mzklo More articles by this author , and Mathew SorensenMathew Sorensen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2696AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Kidney stone disease is linked to systemic conditions including hypertension, obesity, diabetes mellitus, and coronary heart disease. Therefore, biologic pathways that result in coronary artery calcification may also lead to the development of nephrolithiasis. Subclinical coronary artery calcification (CAC) is an established predictor of cardiovascular events. CAC is quantified noninvasively by computed tomography, and the calculated CAC score reflects the presence and extent of atherosclerotic disease. While a history of kidney stones has been linked to subclinical carotid atherosclerosis, no study has examined its relationship with CAC. We studied the association between kidney stone history and prevalent CAC from the MESA study. METHODS The Multi-Ethnic Study of Atherosclerosis is a multi-site cohort study of participants aged 45-84 without known cardiovascular disease at baseline (2000-2002). At follow up in 2010-2012, 3,282 participants underwent computed tomography to determine CAC and had kidney stone history assessed by self-report. CAC scores were categorized as none, mild (<100), moderate (101-400), or severe (>400). A cross-sectional analysis was performed adjusting for demographic and dietary factors related to kidney stones. RESULTS Prevalence of kidney stone disease history was approximately 9%, mean age was 69.5±9.3 years, 39% of participants were Caucasian, 47% were men, and 69% had detectable (CAC score >0). Of the stone formers, 129 (44.6%) reported a history of 2 or more stones in the past. Mean±SD CAC score among non-stone formers and stone formers was 279±595 and 380±602, respectively. No difference in CAC score was seen between single stone formers and non-stone formers. Recurrent kidney stone formation was associated with moderate or severe CAC on multivariable logistic regression (versus none or mild CAC) (OR 1.80, 95% CI 1.22-2.67). When CAC scores were separated into none, mild, moderate, and severe CAC, recurrent stone formation was associated with higher CAC score category on multivariable ordinal logistic regression (OR per category 1.44, 95% CI 1.04- 2.01). CONCLUSIONS Recurrent kidney stone formation is associated with subclinical coronary atherosclerosis. This association appeared stronger with CAC severity than with CAC presence. The clinical significance of these findings is that a recurrent stone former, who has no prior cardiac history and is otherwise asymptomatic, may have higher levels of coronary calcification and be at risk for future cardiovascular events. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1173 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Ryan Hsi More articles by this author Andrew Spieker More articles by this author Marshall Stoller More articles by this author David Jacobs More articles by this author Alex Reiner More articles by this author Robyn McClelland More articles by this author Arnold Kahn More articles by this author Thomas Chi More articles by this author Moyses Mzklo More articles by this author Mathew Sorensen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...