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Kidney stones and subclinical atherosclerosis in young adults: the CARDIA study
Alexander P Reiner1, Arnold Kahn, Brian H Eisner
1Department of Epidemiology, University of Washington, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Insights
A history of kidney stones is linked to subclinical carotid atherosclerosis in young adults. This finding suggests shared risk factors and pathophysiology between kidney stones (nephrolithiasis) and atherosclerosis.
Area of Science:
- Cardiovascular Health
- Nephrology
- Epidemiology
Background:
- Nephrolithiasis (kidney stones) and atherosclerosis (hardening of the arteries) may share common risk factors.
- Previous research has not examined the link between kidney stones and subclinical atherosclerotic disease.
Purpose of the Study:
- To investigate the association between nephrolithiasis and subclinical carotid atherosclerosis.
- To assess the relationship using carotid wall thickness and carotid stenosis measurements.
Main Methods:
- Utilized data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a US-based observational cohort.
- Included 5,115 white and African-American participants aged 18-30 at baseline (1985-1986).
- Assessed carotid atherosclerosis via B-mode ultrasound at the year 20 examination.
Main Results:
- 200 participants (3.9%) reported a history of kidney stones by year 20.
- Symptomatic kidney stones were associated with increased carotid wall thickness, particularly in the internal carotid/bulb region.
- A history of kidney stones showed a significant association with carotid atherosclerosis (OR 1.6, p=0.01) after adjusting for risk factors.
Conclusions:
- A history of kidney stones is associated with subclinical carotid atherosclerosis in young adults.
- This association supports the hypothesis that nephrolithiasis and atherosclerosis share common underlying risk factors or disease processes.
Purpose:
Recent reports suggest that nephrolithiasis and atherosclerosis share a number of risk factors. To our knowledge there has been no previous examination of the relationship between kidney stones and subclinical atherosclerotic disease. We studied the relationship between nephrolithiasis, and carotid wall thickness and carotid stenosis assessed by B-mode ultrasound in the general community using data from the CARDIA study.
Materials And Methods:
The CARDIA study is a United States, population based, observational study of 5,115 white and African-American men and women between the ages of 18 and 30 years at recruitment in 1985 to 1986.
Results:
By the year 20 examination 200 (3.9%) CARDIA participants had reported ever having kidney stones. Symptomatic kidney stones were associated with greater carotid wall thickness measured at the year 20 examination, particularly of the internal carotid/bulb region. Using a composite dichotomous end point of carotid stenosis and/or the upper quartile of internal carotid/bulb wall thickness, the association of kidney stones with carotid atherosclerosis was significant (OR 1.6, 95% CI 1.1-2.3, p=0.01), even after adjusting for major atherosclerotic risk factors.
Conclusions:
The association between a history of kidney stones and subclinical carotid atherosclerosis in young adults adds further support to the notion that nephrolithiasis and atherosclerosis share common systemic risk factors and/or pathophysiology.
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