Stone Formers Found to Be at Higher Risk for MI

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Individuals who form kidney stones are at increased risk for myocardial infarction (MI) independent of CKD and other risk factors, according to researchers.

The finding suggests that the development of kidney stones and MI share a common pathophysiologic pathway, they noted. “A history of kidney stones may also be a useful addition in risk stratification algorithms for MI,” the investigators wrote in a paper published online in the Journal of the American Society of Nephrology.

Andrew D. Rule, MD, of Mayo Clinic in Rochester, Minn., and collaborators matched 4,564 stone formers on age and gender with 10,860 controls. The investigators selected subjects from the general population of Olmstead County, Minnesota.

During a mean follow-up of nine years, stone formers had a 38% increased risk for MI compared with controls. After adjusting for the presence of CKD and other comorbidities, the stone formers were at 31% increased risk.

Dr. Rule's team observed that the association between stone forming and MI may reflect shared risk factors for both diseases such as hypertension, diabetes, obesity, and dyslipidemia. They added, however, that the risk for MI in stone formers remained elevated after adjusting for these and other known risk factors for MI, including CKD. “This finding adds to the literature that kidney stones should be viewed as a metabolic disorder with clinical relevance beyond symptomatic urinary tract obstruction,” they wrote.

The researchers noted that one of the strengths of their study was the use of cohorts selected from the general population. Study limitations include lack of information on stone burden and composition, diet, medications, and laboratory test results. In addition, the study population consisted mostly of non-Hispanic whites, so results may not be applicable to other ethnic groups.

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