Abstract
ObjectiveKidney stone disease seems to be associated with an increased risk of incident cardiovascular outcomes; the aim of this study is to identify differences in 24-h urine excretory profiles and stone composition among stone formers with and without cardiovascular disease (CVD).MethodsData from patients attending the Department of Renal Medicine’s metabolic stone clinic from 1995 to 2012 were reviewed. The sample was divided according to the presence or absence of CVD (myocardial infarction, angina, coronary revascularization, or surgery for calcified heart valves). Univariable and multivariable regression models, adjusted for age, sex, BMI, hypertension, diabetes, eGFR, plasma bicarbonate and potential renal acid load of foods were used to investigate differences across groups.Results1826 patients had available data for 24-h urine analysis. Among these, 108 (5.9%) had a history of CVD. Those with CVD were older, have higher prevalence of hypertension and diabetes and lower eGFR. Univariable analysis showed that patients with CVD had significantly lower 24-h urinary excretions for citrate (2.4 vs 2.6 mmol/24 h, p = 0.04), magnesium (3.9 vs 4.2 mmol/24 h, p = 0.03) and urinary pH (6.1 vs 6.2, p = 0.02). After adjustment for confounders, differences in urinary citrate and magnesium excretions remained significant. No differences in the probability of stone formation or stone compositions were found.ConclusionsStoneformers with CVD have lower renal alkali excretion, possibly suggesting higheracid retention in stone formers with cardiovascular comorbidities. Randomizedclinical trials including medications and a controlled diet design are neededto confirm the results presented here.Graphic abstract
Highlights
MethodsNephrolithiasis is a medical condition with a high prevalence in the general population in Europe and the United States [1, 2]
MulƟvariable linear regression analysis adjusted for age, sex, BMI, diabetes, hypertension, eGFR, plasma bicarbonate and PRAL
Nephrolithiasis has been linked to an increased likelihood of developing chronic kidney disease (CKD) and of cardiovascular events [9], suggesting that kidney stone disease is a systemic disorder, but the reasons for these associations is still unknown
Summary
MethodsNephrolithiasis is a medical condition with a high prevalence in the general population in Europe and the United States [1, 2]. Years Females Hypertension Diabetes BMI eGFR, mL/min/1.73m2, CKD-EPI Serum sodium, mmol/L Serum potassium, mmol/L Plasma bicarbonate, mmol/L Serum calcium, mmol/L Serum phosphate, mmol/L Serum magnesium, mmol/L Urine citrate, mmol/day Urine potassium, mmol/day Urine magnesium, mmol/day Urine oxalate, mmol/day Urine calcium, mmol/day Urine uric acid, mmol/day Urine creatinine, mmol/day Urine sodium, mmol/day Urine pH Urine volume, L/day Low urine volume Hypocitraturia Hypercalciuria Hyperuricosuria Hyperoxaluria PSF CaOx PSF CaPi PSF UA
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