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Updated: May 26, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Combined occurrence of cardiovascular and bone events in individuals with kidney stone disease
Pietro Manuel Ferraro1, Eric N Taylor2,3, Giovanni Gambaro1
1Section of Nephrology, Department of Medicine, Università degli Studi di Verona, Verona, Italy.
Insights
Kidney stone disease (KSD) is linked to cardiovascular (CV) and bone events. While these events are common in individuals with KSD, they rarely occur together, suggesting distinct risk factors.
Area of Science:
- Nephrology
- Cardiology
- Orthopedics
- Epidemiology
Background:
- Kidney stone disease (KSD) is associated with increased risks of cardiovascular (CV) and bone-related adverse events.
- A shared pathogenic pathway is hypothesized, but it remains unclear if these events occur concurrently in the same KSD patients.
- This study investigates the occurrence and characteristics of CV and bone events in individuals with a history of KSD.
Purpose of the Study:
- To examine the incidence of cardiovascular and bone events in individuals diagnosed with kidney stones.
- To determine if cardiovascular and bone events commonly co-occur in the same kidney stone patients.
- To analyze the characteristics of kidney stone formers experiencing single, multiple, or no adverse CV or bone events.
Main Methods:
- Analysis of three large prospective cohorts: Health Professionals Follow-up Study (HPFS) and Nurses' Health Study (NHS) I and II.
- Inclusion criteria: self-reported KSD diagnosis, no prior CV or bone events at KSD diagnosis.
- Follow-up until CV event (myocardial infarction, revascularization), bone event (fracture, osteoporosis), cancer diagnosis, or death; multinomial logistic regression used for comparisons.
Main Results:
- Data from 14,709 individuals with KSD were analyzed.
- In HPFS, 28.7% experienced at least one event (17.4% CV, 8.5% bone, 2.8% both).
- In NHS I, 46.0% experienced at least one event (7.3% CV, 32.8% bone, 5.9% both); in NHS II, 27.1% experienced at least one event (2.0% CV, 23.9% bone, 1.1% both).
- Common risk factors like age, BMI, thiazide use, supplements, hypertension, and diabetes did not identify specific high-risk subgroups.
Conclusions:
- Cardiovascular and bone events are frequent in individuals with kidney stone disease.
- However, the co-occurrence of both cardiovascular and bone events within the same individual with KSD is infrequent.
- Major shared risk factors for cardiovascular disease and bone disease are unlikely in patients with kidney stone disease.
Background:
Kidney stone disease (KSD) has been linked to increased risk of adverse cardiovascular (CV) and bone events, raising the hypothesis of a shared pathogenic pathway. However, it is unclear whether these events commonly occur in the same stone-forming individual. We examined the occurrence of CV and bone events in individuals with a history of KSD and analyzed their characteristics.
Methods:
We analyzed three large prospective cohorts, the Health Professionals Follow-up Study (HPFS, men) and the Nurses' Health Study (NHS, women) I and II. Individuals with a self-reported diagnosis of KSD during follow-up and no previous CV or bone events at the time of KSD diagnosis were included in the study and followed until the development of a CV event (fatal or non-fatal myocardial infarction, coronary revascularization) and a bone event (fracture, osteoporosis); individuals who developed cancer or died were censored. Characteristics of stone formers experiencing only one event (CV or bone), both events, or none were compared using multinomial logistic regression models.
Results:
Our study included data from 14 709 individuals with KSD. In HPFS, 28.7% of the participants experienced at least one event: 17.4% a CV event, 8.5% a bone event and 2.8% both. In NHS I, 46.0% of the participants experienced at least one event: 7.3% a CV event, 32.8% a bone event and 5.9% both. In NHS II, 27.1% of the participants experienced at least one event: 2.0% a CV event, 23.9% a bone event and 1.1% both. Across cohorts, age, BMI, thiazide use, calcium and vitamin D supplementation, and prevalence of hypertension and diabetes did not identify specific high-risk subgroups.
Conclusion:
CV and bone events are common in KSD; however, their co-occurrence in the same stone-forming individual is relatively rare. CV disease and bone disease are unlikely to share major risk factors in individuals with KSD.
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