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Kidney stones increase risk of chronic kidney disease, may increase risk of end-stage renal disease in general population, researchers report

Monday, November 17 2008 | Comments
Evidence Grade 7 What's This?
By Hunter Kaller

The presence of kidney stones may cause damage to the kidneys and serve as a precursor to chronic kidney disease (CKD), study data indicate.

"Kidney stones lead to CKD in patients with rare genetic diseases (e.g., primary hyperoxaluria), but it is less clear if kidney stones are an important risk factor for CKD in the general population," the authors of the study wrote.

To better answer this question, researchers examined data from the Rochester Epidemiology Project regarding 4,066 individuals in Olmsted County, Minn. who had a first kidney stone from 1986 to 2003 and 10,150 matched controls from the general population who did not have kidney stones (3 controls were matched to each case).

With a mean follow-up of 8.4 years in cases and 8.8 years in controls, results indicated that patients with kidney stones had a significant 60% increase in the risk of developing CKD relative to controls (HR, 1.6; 95% CI, 1.4-1.8). Patients with kidney stones also had a 40% greater risk of developing end-stage renal disease than did controls, though this difference failed to reach statistical significance (HR, 1.4; 95% CI, 0.9-2.2).

Furthermore, patients with kidney stones had significantly increased risks of sustained elevated creatinine for >90 days (defined as serum creatinine concentration >1.3 mg/dL in men and >1.1 mg/dL in women; HR, 1.4 [95% CI, 1.2-1.7]) and sustained reduction in renal function (defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2; HR, 1.4; 95% CI, 1.2-1.6).

Additionally, patients with kidney stones were significantly more likely than controls to have several comorbidities, including diabetes, hypertension, obesity, dyslipidemia, gout, and coronary artery disease, and the increased risk of CKD, elevated creatinine, and reduced renal function remained highly significant after adjusting for age, sex, and comorbidities.

"These data argue kidney stones to be an important risk factor for CKD," the authors of the study concluded.

Patients with kidney stones should be carefully evaluated for CKD and its risk factors, and they should be appropriately treated for any that are identified, added Dr. John Lieske, one of the study's investigators. (Rule A, et al. Poster F-FC202.)

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