Kidney stones and the risk for chronic kidney disease.
OBJECTIVE
Kidney stones lead to chronic kidney disease (CKD) in people with rare hereditary disorders (e.g., primary hyperoxaluria, cystinuria), but it is unknown whether kidney stones are an important risk factor for CKD in the general population.


METHODS
Among Olmsted County, MN, residents, all stone formers (n = 4774) whose condition was diagnosed in 1986 through 2003 were matched 1:3 to control subjects (n = 12,975). Cox proportional hazards models adjusted for age, gender, and comorbidities (hypertension, diabetes, obesity, dyslipidemia, gout, alcohol abuse, tobacco use, coronary artery disease, heart failure, cerebral infarct, and peripheral vascular disease) were used to assess the risk for incident CKD defined as a clinical diagnosis (diagnostic codes), ESRD or death with CKD, sustained (>90 d) elevated serum creatinine (>1.3 mg/dl in men, >1.1 mg/dl in women), or sustained estimated GFR <60 ml/min per 1.73 m(2).


RESULTS
During a mean of 8.6 yr of follow-up, stone formers were at increased risk for a clinical diagnosis of CKD, but an increased risk for ESRD or death with CKD was NS. Among patients with follow-up serum creatinine levels, stone formers were at increased risk for a sustained elevated serum creatinine and a sustained reduced GFR.


CONCLUSIONS
Kidney stones are a risk factor for CKD, and studies are warranted to assess screening and preventive measures for CKD in stone formers.
Rule
Andrew D
AD
Departments of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota 55905. rule.andrew@mayo.edu
Bergstralh
Eric J
EJ
Melton
L Joseph
LJ
Li
Xujian
X
Weaver
Amy L
AL
Lieske
John C
JC