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Published on: November 7, 2017
[Cardiovascular risk associated with urolithiasis]
G Raynal1, K Achkar, R El Samad
1Sevice d'urologie et transplantation, CHU d'Amiens-Sud, avenue René-Laënnec, 80054 Amiens cedex 1, France. gauthier.raynal@etud.u-picardie.fr
Insights
Patients with kidney stones (urolithiasis) often have cardiovascular risk factors and events. Integrated management of urolithiasis patients is suggested due to potential indirect cardiovascular risk.
Area of Science:
- Nephrology
- Cardiology
- Epidemiology
Context:
- Urolithiasis is linked to cardiovascular risk factors like hypertension and metabolic syndrome.
- Emerging evidence suggests a connection between kidney stones and stroke.
- Understanding this association is crucial for comprehensive patient care.
Purpose:
- To determine the frequency of cardiovascular risk factors and events in patients before and after urolithiasis management.
- To investigate the incidence of acute coronary syndrome, stroke, and lower limb ischemia in relation to kidney stone treatment.
Summary:
- A retrospective study of 33 patients managed for urolithiasis revealed a high prevalence of cardiovascular risk factors (average >2 per patient).
- Twelve cardiovascular events were recorded, including five prior and seven subsequent to treatment.
- Subsequent events included acute coronary syndrome (with one death), ischemic stroke, and acute lower limb ischemia.
Impact:
- The study highlights a significant association between urolithiasis and cardiovascular events, suggesting urolithiasis may be an indirect cardiovascular risk factor.
- A small sample size necessitates further research to confirm these findings.
- Integrated management of urolithiasis patients, similar to those with erectile dysfunction, is recommended.
Objective:
Urolithiasis appears to be associated with several cardiovascular risk factors (excess salt and animal proteins, hypertension, metabolic syndrome) and, more recently, the development of stroke. The authors describe the frequency of cardiovascular risk factors and cardiovascular events before and after management of urolithiasis.
Method:
The authors retrospectively collected data from patients born before 1956 and managed surgically or instrumentally for urolithiasis in our establishment in 1994 concerning the frequency of cardiovascular risk factors and the incidence of acute coronary syndrome, stroke or acute lower limb ischaemia before or after treatment of urolithiasis.
Results:
Data were obtained for 33 patients, revealing 12 events including five previous events (four cases of acute coronary syndrome, one ischaemic stroke) and seven subsequent events (five cases of acute coronary syndrome with one death, one ischaemic stroke, one case of acute lower limb ischaemia) an average of 5.7 years after management. These 33 patients had an average of more than two risk factors.
Conclusion:
This retrospective study based on a small sample size demonstrated a high frequency of risk factors and cardiovascular events. This correlation needs to be studied in more detail. Urolithiasis could constitute an indirect cardiovascular risk factor dependent on "classical" risk factors, suggesting the need for integrated management of stone patients, in the same way as for patients with erectile dysfunction.
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