Related Experiment Video
Updated: Oct 6, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Endothelial Dysfunction: An Intermediate Clinical Feature between Urolithiasis and Cardiovascular Diseases
Javier Saenz-Medina1,2, Mercedes Muñoz3, Claudia Rodriguez3
1Department of Urology, Puerta de Hierro-Majadahonda University Hospital, 28222 Majadahonda, Spain.
Insights
Kidney stones (urolithiasis) are linked to increased cardiovascular disease risk. Endothelial dysfunction appears to be a key factor connecting kidney stones and heart conditions, potentially influenced by oxidative stress.
Area of Science:
- Nephrology
- Cardiology
- Pathophysiology
Background:
- Urolithiasis and cardiovascular diseases share an established epidemiological link.
- Endothelial dysfunction, a precursor to cardiovascular issues, is associated with oxidative stress and inflammation seen in conditions like hypertension and diabetes.
- Understanding the pathogenic link between urolithiasis and cardiovascular morbidities is crucial.
Purpose of the Study:
- To review the pathogenic mechanisms linking urolithiasis to endothelial dysfunction.
- To summarize the current knowledge on how kidney stones may contribute to cardiovascular diseases.
Main Methods:
- A non-systematic review was conducted.
- Literature search combined terms for urolithiasis (kidney stone, nephrolithiasis) with cardiovascular disease indicators (myocardial infarction, stroke, endothelial dysfunction).
Main Results:
- Nephrolithiasis patients exhibit a 1.20-1.24 relative risk for cardiovascular disease and higher vascular risk scores.
- Endothelial dysfunction is strongly associated with urolithiasis, though specific systemic markers remain unclear.
- Experimental models show elevated endothelial dysfunction markers in hyperoxaluria.
Conclusions:
- Endothelial dysfunction is a significant, modifiable link between urolithiasis and cardiovascular disease.
- Oxidative stress plays a role in both lithogenesis and endothelial dysfunction.
- Cardiovascular monitoring in urolithiasis patients is essential, considering potential benefits from medications like statins and allopurinol.
Abstract:
An epidemiological relationship between urolithiasis and cardiovascular diseases has extensively been reported. Endothelial dysfunction is an early pathogenic event in cardiovascular diseases and has been associated with oxidative stress and low chronic inflammation in hypertension, coronary heart disease, stroke or the vascular complications of diabetes and obesity. The aim of this study is to summarize the current knowledge about the pathogenic mechanisms of urolithiasis in relation to the development of endothelial dysfunction and cardiovascular morbidities.
Methods:
A non-systematic review has been performed mixing the terms "urolithiasis", "kidney stone" or "nephrolithiasis" with "cardiovascular disease", "myocardial infarction", "stroke", or "endothelial dysfunction".
Results:
Patients with nephrolithiasis develop a higher incidence of cardiovascular disease with a relative risk estimated between 1.20 and 1.24 and also develop a higher vascular disease risk scores. Analyses of subgroups have rendered inconclusive results regarding gender or age. Endothelial dysfunction has also been strongly associated with urolithiasis in clinical studies, although no systemic serum markers of endothelial dysfunction, inflammation or oxidative stress could be clearly related. Analysis of urine composition of lithiasic patients also detected a higher expression of proteins related to cardiovascular disease. Experimental models of hyperoxaluria have also found elevation of serum endothelial dysfunction markers.
Conclusions:
Endothelial dysfunction has been strongly associated with urolithiasis and based on the experimental evidence, should be considered as an intermediate and changeable feature between urolithiasis and cardiovascular diseases. Oxidative stress, a key pathogenic factor in the development of endothelial dysfunction has been also pointed out as an important factor of lithogenesis. Special attention must be paid to cardiovascular morbidities associated with urolithiasis in order to take advantage of pleiotropic effects of statins, angiotensin receptor blockers and allopurinol.
More Related Videos
Related Concept Videos
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
01:24Chronic Kidney Disease II: Clinical Manifestations
01:26Coronary Artery Disease II: Pathophysiology
01:25Chronic Kidney Disease I: Introduction
01:28Urinary Tract Calculi I: Introduction
01:30Coronary Artery Disease I: Introduction