Nephrolithiasis predicts ischemic stroke: A longitudinal follow-up study using a national sample cohort

Area of Science:

• Nephrology
• Neurology
• Epidemiology

Background:

• Nephrolithiasis, or kidney stones, is a prevalent condition with potential systemic implications.
• Stroke, encompassing ischemic and hemorrhagic types, represents a major cause of morbidity and mortality.
• Understanding the relationship between nephrolithiasis and stroke risk is crucial for public health.

Purpose of the Study:

• To investigate the association between nephrolithiasis and the incidence of ischemic and hemorrhagic stroke.
• To evaluate stroke risk in a large, nationwide cohort of Korean adults.

Main Methods:

• A nationwide sample cohort from the Korean National Health Insurance Service (NHIS) was utilized (2002-2013).
• Nephrolithiasis patients (n=22,636) were matched 1:4 with controls (n=90,544) based on demographics and comorbidities.
• Cox proportional hazard models were employed to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).

Main Results:

• An increased risk of ischemic stroke was observed in the nephrolithiasis group (adjusted HR = 1.13; 95% CI = 1.06-1.21; P < 0.001).
• This association persisted in subgroup analyses, including young women and middle-aged men, and for follow-up periods of ≤ 1 year.
• No statistically significant association was found between nephrolithiasis and hemorrhagic stroke.

Conclusions:

• Nephrolithiasis is significantly associated with an elevated risk of ischemic stroke.
• The findings suggest a need for increased awareness and potential preventative strategies for stroke in patients with kidney stones.
• Further research may explore the underlying mechanisms linking nephrolithiasis to ischemic stroke.