Vascular calcification and bone mineral density in recurrent kidney stone formers

• Published in: Clinical journal of the American Society of Nephrology 2015-02, Vol.10 (2), p.278-285
• Main Authors: Shavit, Linda, Girfoglio, Daniela, Vijay, Vivek, Goldsmith, David, Ferraro, Pietro Manuel, Moochhala, Shabbir H, Unwin, Robert
• Format: Article
• Language: English
• Subjects: Adult; Aorta, Abdominal - diagnostic imaging; Aortic Diseases - diagnosis; Aortic Diseases - epidemiology; Aortography - methods; Bone Density; Chi-Square Distribution; Female; Humans; Hypercalciuria - diagnosis; Hypercalciuria - epidemiology; Kidney Calculi - diagnosis; Kidney Calculi - epidemiology; Linear Models; London - epidemiology; Male; Middle Aged; Multivariate Analysis; Original; Osteoporosis - diagnosis; Osteoporosis - epidemiology; Outpatient Clinics, Hospital; Prevalence; Recurrence; Retrospective Studies; Risk Factors; Severity of Illness Index; Spine - diagnostic imaging; Tomography, X-Ray Computed; Vascular Calcification - diagnosis; Vascular Calcification - epidemiology
• ISSN: 1555-9041; 1555-905X
• DOI: 10.2215/cjn.06030614

Recent epidemiologic studies have provided evidence for an association between nephrolithiasis and cardiovascular disease, although the underlying mechanism is still unclear. Vascular calcification (VC) is a strong predictor of cardiovascular morbidity and the hypothesis explored in this study is that VC is more prevalent in calcium kidney stone formers (KSFs). The aims of this study were to determine (1) whether recurrent calcium KSFs have more VC and osteoporosis compared with controls and (2) whether hypercalciuria is related to VC in KSFs. This is a retrospective, matched case-control study that included KSFs attending an outpatient nephrology clinic of the Royal Free Hospital (London, UK) from 2011 to 2014. Age- and sex-matched non-stone formers were drawn from a list of potential living kidney donors from the same hospital. A total of 111 patients were investigated, of which 57 were KSFs and 54 were healthy controls. Abdominal aortic calcification (AAC) and vertebral bone mineral density (BMD) were assessed using available computed tomography (CT) imaging. The prevalence, severity, and associations of AAC and CT BMD between KSFs and non-stone formers were compared. Mean age was 47±14 years in KSFs and 47±13 in non-stone formers. Men represented 56% and 57% of KSFs and non-stone formers, respectively. The prevalence of AAC was similar in both groups (38% in KSFs versus 35% in controls, P=0.69). However, the AAC severity score (median [25th percentile, 75th percentile]) was significantly higher in KSFs compared with the control group (0 [0, 43] versus 0 [0, 10], P