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Cardiovascular and Cerebrovascular Morbidity in Patients with Urolithiasis: An Epidemiological Approach Based on
Javier Sáenz-Medina1,2, Victoria Gómez Dos Santos3, María Rodríguez-Monsalve1,2
1Department of Urology, Puerta de Hierro-Majadahonda University Hospital, Calle Manuel de Falla, 1, 28222 Majadahonda, Spain.
Insights
Patients with kidney stones face a significantly higher risk of coronary heart disease and stroke. Early intervention targeting cardiovascular risk factors in these patients is crucial for prevention.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Epidemiology
Background:
- Kidney stones (KSFs) are associated with an increased risk of coronary heart disease (CHD) and stroke.
- Understanding the long-term cardiovascular outcomes for patients hospitalized with kidney stones is essential.
Purpose of the Study:
- To analyze the natural history of coronary heart disease and stroke in patients hospitalized for kidney stones.
- To longitudinally assess cardiovascular complications in a Spanish nationwide cohort from 1997 to 2021.
Main Methods:
- Retrospective observational study using nationwide hospitalization data (minimum basic data base).
- Comparative analysis of coronary or cerebrovascular events in kidney stone hospitalizations versus the general population.
- Survival analysis (Kaplan-Meier) and Cox regression to identify risk factors for cardiovascular disease in kidney stone patients.
Main Results:
- Kidney stone patients showed significantly higher risks of CHD (OR=14.8) and stroke (OR=6.7) compared to the general population.
- 1.5% of kidney stone patients developed coronary events and 0.33% suffered strokes over the study period.
- Diabetes, hypertension, hyperlipidemia, and overweight were identified as key risk factors for cardiovascular events.
Conclusions:
- Kidney stones are confirmed as an independent risk factor for developing coronary heart disease and cerebrovascular disease.
- Preventive strategies should focus on managing traditional cardiovascular risk factors in patients with kidney stones.
- Early identification and mitigation of modifiable risk factors can reduce cardiovascular disease burden in kidney stone patients.
Abstract:
Background: Patients with kidney stones (KSFs) are known to have a heightened risk of coronary heart disease (CHD) or stroke. The objective of the present study was to describe the natural history of these complications through the longitudinal analysis of the hospitalizations due to kidney stones in Spain from 1997 to 2021. Methods: A retrospective longitudinal observational study was developed based on nationwide hospitalization data (minimum basic data base). Three different analyses were carried out. In the first step, the prevalence of coronary or cerebrovascular events in kidney stone hospitalizations was compared with the hospitalization burden of CHD or strokes related to the general population. In the second step, a survival analysis of the kidney stones-hospitalized patients using the Kaplan-Meier method was conducted. In the third step, a Cox regression was used to assess the influence of the classical comorbidities in the development of the lithiasic patients-cardiovascular disease. Results: Kidney stone-hospitalized patients exhibit a significantly higher risk of CHD (OR = 14.8 CI95%: 14.7-14.9) and stroke (OR = 6.7 CI95%: 6.6-6.8) compared to the general population across in all age groups, although they had less cardiovascular risk factors. A total of 9352 KSFs (1.5%) developed a coronary event within an average time of 78.8 months. A total of 2120 KSFs (0.33%) suffered a stroke in an average time of 71.1 months. Diabetes, hypertension, hyperlipidemia, and being overweight were identified as risk factors for developing CHD and stroke using a univariate and multivariate analysis. Conclusions: Our study confirms previous studies in which kidney stones must be considered as a risk factor for developing CHD or cerebrovascular disease. Preventive strategies should target patients with kidney stones and classical risk cardiovascular factors to mitigate modifiable conditions associated with cardiovascular diseases.
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