Risk of Hypertension among First-Time Symptomatic Kidney Stone Formers.
OBJECTIVE
Prior work has suggested a higher risk of hypertension in kidney stone formers but lacked disease validation and adjustment for potential confounders. Certain types of stone formers may also be at higher risk of hypertension.


METHODS
In our study, incident symptomatic stone formers in Olmsted County from 2000 to 2011 were manually validated by chart review and age and sex matched to Olmsted County controls. We followed up patients through November 20, 2015. Hypertension was also validated by manual chart review, and the risk of hypertension in stone formers compared with controls was assessed both univariately and after adjusting for comorbidities. The risk of hypertension among different subtypes of stone formers was also evaluated.


RESULTS
Among 3023 coded stone formers from 2000 to 2011, a total of 1515 were validated and matched to 1515 controls (mean age was 45 years old, and 56% were men). After excluding those with baseline hypertension (20% of stone formers and 18% of controls), 154 stone formers and 110 controls developed hypertension. Median follow-up time was 7.8 years in stone formers and 9.6 years in controls. Stone formers were found to have a higher risk of hypertension compared with controls (hazard ratio, 1.50; 95% confidence interval, 1.18 to 1.92), even after adjusting for age, sex, body mass index, serum creatinine, CKD, diabetes, gout, coronary artery disease, dyslipidemia, tobacco use, and alcohol abuse (hazard ratio, 1.58; 95% confidence interval, 1.12 to 2.21). Results were similar after excluding patients who were ever on a thiazide diuretic (hazard ratio, 1.65; 95% confidence interval, 1.16 to 2.38). Stone composition, radiographic stone burden, number of subsequent stone events, and stone removal surgeries were not associated with hypertension (P>0.05 for all).


CONCLUSIONS
The risk of hypertension was higher after the first symptomatic kidney stone event. However, kidney stone severity, type, and treatment did not associate with hypertension.
Divisions of Nephrology and Hypertension, and.
Wonngarm
W
Kittanamongkolchai
Biomedical Statistic and Informatics, and.
Kristin C
KC
Mara
Biomedical Statistic and Informatics, and.
Ramila A
RA
Mehta
Biomedical Statistic and Informatics, and.
Lisa E
LE
Vaughan
Divisions of Nephrology and Hypertension, and.
Aleksandar
A
Denic
Department of Urology, Mayo Clinic, Rochester, Minnesota.
John J
JJ
Knoedler
Biomedical Statistic and Informatics, and.
Felicity T
FT
Enders
Divisions of Nephrology and Hypertension, and.
John C
JC
Lieske
Divisions of Nephrology and Hypertension, and.
Andrew D
AD
Rule
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D007669:Kidney Calculi / Q000737:chemistry / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D016016:Proportional Hazards Models; D012307:Risk Factors
Alcoholism; Body Mass Index; Comorbidity; Dyslipidemias; Epidemiology; Follow-Up Studies; Gout; Humans; Kidney Calculi; Male; Renal Insufficiency, Chronic; Sodium Chloride Symporter Inhibitors; Thiazide diuretics; Tobacco Use; chronic kidney disease; coronary artery disease; creatinine; diabetes mellitus; hypertension; kidney stones