Endothelial Dysfunction: An Intermediate Clinical Feature between Urolithiasis and Cardiovascular Diseases

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.