1. An increased risk of coronary heart disease was found women with a history of renal stones.
2. The same association was not demonstrated in men with similarly adjusted variables.
Evidence Rating Level: 2 (Good)
Study Rundown: Nephrolithiasis is a common disease with increasing prevalence. Its relation to other systemic diseases, especially those of cardiac etiology, has previously been implicated in clinical studies. This study sought to better analyze the relation between the presence of kidney stone disease and risk of future coronary heart disease. After an analysis that adjusted for numerous variables, there was a moderate, though statistically significant, increase in risk of coronary heart disease in women with a history of renal stones. The same association, however, was not demonstrated in men with similarly adjusted variables. Though this study included over 200,000 participants and accounted for a host of variables, there were still some limitations in the study. The study did not have renal function data of participants but used a separate study’s data to postulate a conclusion for this study. Considering the close relationship between renal and cardiovascular functioning, and the potential effects of stones on renal function, such data would be an important piece to this puzzle. Furthermore, both disease states have numerous lifestyle and medical risk factors, making it extremely difficult to include and account for all in one study, thus a common risk factor to both diseases can easily be missed. Nonetheless, this study provides insight into a potential association between two very common disease states.
Relevant Reading: Kidney stones associate with increased risk of myocardial infarction
In-Depth [prospective cohort study]: This study included 45,748 men and 196,357 women. The main study outcomes were defined as fatal or nonfatal myocardial infarction, or coronary revascularization. Follow up included biennial questionnaires regarding occurrence of stones or study outcomes with confirmation via medical records. Separate age-adjusted Hazard Ratios (HR) demonstrated an increased risk of cardiac outcomes with a history of renal stones. However, when 2 different multivariable-adjusted HR’s were calculated only the female cohorts showed any significant difference in outcome rates. After combining both female cohorts, multivariable-adjusted analysis demonstrated HR’s of 1.30 (95%CI, 1.04-1.62) for total coronary heart disease, 1.26 (95%CI, 1.11-1.43) for any myocardial infarction, and 1.29 (95%CI, 1.07-1.55) for revascularization in women with history of stones. There were no significant differences found in men.
By Sam Moradian and Brittany Hasty
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