Essential arterial hypertension and stone disease

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Urology

Background:

• Cross-sectional studies indicate a higher prevalence of nephrolithiasis in hypertensive individuals.
• The precise pathogenic link between hypertension and kidney stone formation remains unclear.

Purpose of the Study:

• To investigate the baseline stone risk profile in patients with stable essential hypertension compared to normotensive controls.
• To assess the long-term incidence of kidney stone formation in both hypertensive and normotensive subjects.

Main Methods:

• A cohort study involving 132 hypertensive patients and 135 age- and sex-matched normotensive controls.
• Baseline assessment of urine stone risk factors, including salt supersaturation.
• Minimum five-year follow-up to monitor kidney stone formation.

Main Results:

• Hypertensive males exhibited higher urine calcium, magnesium, uric acid, and oxalate levels, with greater supersaturation for calcium oxalate and calcium phosphate.
• Hypertensive females showed elevated urine calcium, phosphorus, and oxalate, with increased calcium oxalate supersaturation.
• The incidence of stone episodes was significantly higher in hypertensive patients (14.3%) compared to normotensive controls (2.9%).
• Calcium oxalate supersaturation predicted calcium calculi, while uric acid supersaturation predicted uric acid calculi.

Conclusions:

• Hypertension is associated with a substantially increased risk of renal stone formation, especially in overweight individuals.
• Elevated urinary calcium, oxalate, and supersaturation of calcium oxalate and uric acid are critical factors in stone development.
• Obesity, high salt intake, and consumption of animal proteins may contribute to this increased risk.