Association between kidney stones and future risk of kidney cancer: A systematic review and meta-analysis

Despite increasing interest in the potential associations between kidney stones and kidney cancer, their relationship remains incompletely characterized. This systematic review and meta-analysis evaluated the association between a history of kidney stones and the future risk of kidney cancer.

We systematically searched Medline, Embase, and the Cochrane Central Register of Controlled Trials for observational studies of renal cell carcinoma risk in adults with kidney stones. A random-effects meta-analysis was performed to calculate the pooled risk ratio and 95% confidence interval (CI). Subgroup analyses and meta-regression were conducted to assess the associations with study design, data sources, risk of bias, control group type, and sex.

Thirteen studies (five cohort, eight case-control) were included in the meta-analysis. A history of kidney stones was associated with a significantly higher risk of developing kidney cancer (risk ratio 2.36; 95% CI 1.74, 2.98, p<0.001, I²=94%). Subgroup analysis showed a consistently elevated risk of kidney cancer in stone formers across all subgroups. No significant differences were observed between subgroups, except that more recent studies demonstrated significantly stronger associations between stone disease and risk of kidney cancer (p<0.001).

This meta-analysis demonstrates a significant association between kidney stones and increased risk of kidney cancer, with affected individuals having approximately twice the risk of developing kidney cancer. These findings highlight the importance of enhanced cancer surveillance in patients with a history of kidney stones and suggest the need for further research into shared pathophysiologic mechanisms and potential preventative strategies.