CKD Risk Is Higher in Stone Formers
John Lieske, MD
It is well documented that kidney stones lead to CKD in patients with rare genetic diseases, such as primary hyperoxaluria. It is less clear if kidney stones are an important risk factor for CKD in the general population. In general, researchers have thought that complications of kidney stones only rarely cause CKD in otherwise healthy adults. Previous studies that have looked at this potential link have been small or had limited follow-up.
In the new study, researchers at the Mayo Clinic in Rochester, Minn., studied records of all residents of Olmsted County, Minnesota, over a 20-year span (1984-2003). These data are available though the Rochester Epidemiology Project, an extensive medical documentation system that combines clinical records from the Mayo Clinic and other community health providers in the county.
The investigators compared 4,424 stone formers with 10,995 individuals without stones (controls). The mean follow-up was 8.4 years for stone formers and 8.8 years for controls. After adjusting for age, gender, and comorbidies such as diabetes, obesity, gout, hypertension, hyperlipidemia, alcohol and tobacco use, and cardiovascular disease, stone formers were at 60% higher risk of CKD and 40% higher risk of end-stage renal disease than non-stone-formers.
“We know that people with kidney stones are at higher risk for also having diseases like diabetes and hypertension, and that probably explains part of this association,” said study investigator John Lieske, MD, professor of medicine at Mayo.
“However, even when we controlled for those factors, there was still an increased risk.” Consequently, he said, patients who have kidney stones plus other CKD risk factors may be at even greater risk for progression, and therefore might benefit from more aggressive management of their stone disease.
“This study” Dr. Lieske said, “should be a wake-up call since, in general, people with kidney stones tend not to be evaluated to determine the best treatment strategies to reduce the number of repeated stone attacks.”