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Hypertension in kidney stone patients
Insights
Arterial hypertension (HT) prevalence in kidney stone patients mirrors the general population, especially for calcium stones. Uric acid and struvite stone formers show a higher HT risk, linked to age and metabolic factors, not hypercalciuria.
Area of Science:
- Nephrology
- Cardiology
- Urology
Background:
- Arterial hypertension (HT) is a significant health concern.
- Kidney stone disease affects a substantial portion of the population.
- The relationship between kidney stones and HT requires further investigation.
Purpose of the Study:
- To investigate the prevalence of arterial hypertension in patients with a history of primary stone disease.
- To identify factors associated with HT in kidney stone formers.
- To compare HT prevalence across different types of kidney stones.
Main Methods:
- Cross-sectional study of 258 patients (171 male, 87 female) with primary stone disease.
- Prevalence of HT assessed and compared across stone types (calcium, uric acid, struvite).
- Discriminant analysis used to identify factors associated with HT, including stone composition, age, and body weight.
Main Results:
- Overall HT prevalence was 24.8%, with no significant gender difference.
- HT prevalence was significantly higher in uric acid (45.9%) and struvite (40.7%) stone formers compared to calcium stone formers (18.6%).
- Stone composition, rather than age or weight, was the primary factor associated with HT. Hypercalciuria was more prevalent in calcium stone formers but its link to HT was uncertain.
Conclusions:
- HT prevalence in kidney stone patients, particularly calcium stone formers, is similar to the general population.
- Uric acid and struvite stone formers exhibit a higher risk of HT, likely due to older age and associated metabolic abnormalities.
- Hypercalciuria's role as a direct link between HT and urolithiasis remains uncertain.
Abstract:
The prevalence of arterial hypertension (HT) was investigated in 258 patients (171 m, 87 f, 22-68 years) with a history of primary stone disease. HT was detected in 64 patients (24.8%), with no difference between males (25.7%) and females (23.0%). The prevalence of HT by age was very similar to that of a general population, especially in the calcium stone group. The discriminant analysis demonstrated that the composition of stones, other than the age and body weight of the patients, were the main factors associated with HT. As far as the different kind of stone is concerned, the prevalence of HT was higher in patients with uric acid (17/37, 45.9%) and struvite stones (11/27, 40.7%) than in calcium stone formers (35/188, 18.6%) (chi 2 16.31, p < 0.001). The prevalence of hypercalciuria was higher in the calcium stone group than in uric acid or struvite stone patients (36.4 vs. 9.7 vs. 13.7%; chi 2 10.35, p < 0.01). Furthermore, the hypercalciuria showed a trend to be more prevalent in the untreated (47.0%) than in the treated (31.2%) hypertensives, or normotensives (35.1%). Uric acid stone formers were older, heavier and with higher triglycerides and uric acid plasma levels than calcium or struvite patients. Also the struvite stone formers were older than the calcium stone ones. Our data suggest that the prevalence of HT in kidney stone patients and particularly in calcium stone formers is similar to that of a general population. The role of hypercalciuria as the link for HT-urolithiasis association seems quite uncertain. Struvite and uric acid stone formers have higher risk for HT than calcium stone formers, probably due to the old age or to the associated metabolic abnormalities.