Patients who have nephrolithiasis or urolithiasis as the cause of end-stage kidney disease (ESKD) may have a better cardiovascular risk profile compared with patients whose ESKD is due to diabetes or hypertension, investigators suggested at the 58th European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Congress.
Among 1,048,006 patients in the United States Renal Data Service (USRDS) database, the underlying cause of end-stage kidney disease (ESKD) was nephrolithiasis or urolithiasis for 0.2% of patients, cystic kidney disease for 1.6%, glomerulonephritis for 8.1%, hypertension for 30.4%, and diabetes for 47%.
The composite cardiovascular event rate, which included myocardial infarction, stroke, and cardiovascular death, was 74.4 per 1000 person-years for stone formers, Jingyin Yan, MD, PhD, and colleagues from Baylor College of Medicine in Houston, Texas reported. Patients with diabetes or hypertension had 57% and 33% increased risks for cardiovascular events, respectively, compared with stone formers. Patients with glomerulonephritis had no greater cardiovascular risk, whereas patients with cystic kidney disease had a 14% lower risk.
Stone formers tended to be older, female, and White. They had lower rates of major comorbidities, higher serum albumin and hemoglobin concentrations, and lower body mass index. They also had lower estimated glomerular filtration rates at dialysis initiation.
“Patients with kidney failure presumably from nephro- or urolithiasis have distinct cardiovascular risk profiles, with lower major cardiovascular event rates compared with patients whose kidney failure was due to diabetes or hypertension, but slight higher rates compared with those with cystic kidney disease,” Dr Yan’s team concluded in their study abstract.
Yan J, Winkelmayer W, Niu J. Nephrolithiasis as cause of kidney failure and major cardiovascular outcomes in incident dialysis patients. Presented at the 58th ERA-EDTA Congress 2021, June 5-8, 2021. Abstract MO114.