Association between Metabolic Syndrome and Risk of Nephrolithiasis: A Cohort Study

Kidney stones are a prevalent urological issue globally, with risk factors like obesity, hypertension and metabolic disorders driving an increase in incidence rates. Metabolic syndrome (MetS), characterised by hypertension, obesity, hyperglycaemia and dyslipidaemia, has been increasingly linked to nephrolithiasis. This study investigates the association between metabolic syndrome and nephrolithiasis risk in a large Chinese cohort.

A cohort of 36,811 adults who underwent health screenings from 2018 to 2023 was analysed. Cox proportional hazards models assessed the influence of MetS and its components on nephrolithiasis risk. Stratified analyses examined variations by gender, age and renal function (glomerular filtration rate). Incidence density was calculated per 1000 person-years across follow-up.

During 93,966 person-years of follow-up, 573 participants developed kidney stones, with a higher incidence in males. Individuals with MetS had a 60.5% increased nephrolithiasis risk (hazard ratio = 1.61). Obesity and hypertension were identified as significant risk factors, whereas hyperglycaemia and dyslipidaemia showed no clear association. Higher glomerular filtration rate, older age and male gender were correlated with increased risk amongst those with MetS.

MetS, obesity and hypertension are independent predictors of nephrolithiasis, particularly in males. The findings underscore the importance of targeted interventions to reduce kidney stone incidence in populations with high MetS prevalence, highlighting public health benefits in addressing modifiable metabolic risks.