title: Risk of chronic and end stage kidney disease in patients with nephrolithiasis.
abstract: OBJECTIVE
  We examine kidney stone disease as a potential risk factor for chronic kidney disease, end stage kidney disease and treatment with dialysis.
  
  
  METHODS
  The NHANES (National Health and Nutrition Examination Survey) 2007-2010 database was interrogated for patients with a history of kidney stones. Demographics and comorbid conditions including age, gender, body mass index, diabetes, hemoglobin A1c, hypertension, gout and smoking were also assessed. Multivariate analysis adjusting for patient demographics and comorbidities was performed to assess differences in the prevalence of chronic kidney disease and treatment with dialysis between the 2 groups. History of nephrolithiasis was assessed with the question, "Have you ever had kidney stones?" Chronic kidney disease was defined as an estimated glomerular filtration rate of less than 60 ml/minute/1.73 m(2) and/or a urinary albumin-to-creatinine ratio greater than 30 mg/gm. Statistical calculations were performed using Stata® software with determinations of p values and 95% CI where appropriate.
  
  
  RESULTS
  The study included an analysis of 5,971 NHANES participants for whom data on chronic kidney disease and kidney stones were available, of whom 521 reported a history of kidney stones. On multivariate analysis a history of kidney stones was associated with chronic kidney disease and treatment with dialysis (OR 1.50, 1.10-2.04, p = 0.013 and OR 2.37, 1.13-4.96, p = 0.025, respectively). This difference appeared to be driven by women, where a history of kidney stones was associated with a higher prevalence of chronic kidney disease (OR 1.76, 1.13-2.763, p = 0.016) and treatment with dialysis (OR 3.26, 1.48-7.16, p = 0.004). There was not a significant association between kidney stone history and chronic kidney disease or treatment with dialysis in men.
  
  
  CONCLUSIONS
  Kidney stone history is associated with an increased risk of chronic kidney disease and treatment with dialysis among women even after adjusting for comorbid conditions. Large scale prospective studies are needed to further characterize the relationship between nephrolithiasis and chronic kidney disease.
authors.affiliation: Department of Urology, Weill Cornell Medical College, New York, New York.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shoag
authors.affiliation: Department of Urology, Weill Cornell Medical College, New York, New York.
authors.forename: Joshua
authors.initials: J
authors.lastname: Halpern
authors.affiliation: New York Harbor VA Healthcare System, New York, New York; NYU School of Medicine, New York, New York.
authors.forename: David S
authors.initials: DS
authors.lastname: Goldfarb
authors.affiliation: Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: beisner@partners.org.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Eisner
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D053040:Nephrolithiasis / Q000150:complications* / Q000453:epidemiology; D009749:Nutrition Surveys / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
keywords: chronic; dialysis; epidemiology; kidney calculi; kidney failure; urolithiasis