Combined occurrence of cardiovascular and bone events in individuals with kidney stone disease.

BACKGROUND

Kidney stone disease (KSD) has been linked to increased risk of adverse cardiovascular (CV) and bone events, raising the hypothesis of a shared pathogenic pathway. However, it is unclear whether these events commonly occur in the same stone-forming individual. We examined the occurrence of CV and bone events in individuals with a history of KSD and analyzed their characteristics.

METHODS

We analyzed three large prospective cohorts, the Health Professionals Follow-up Study (HPFS, men) and the Nurses' Health Study (NHS, women) I and II. Individuals with a self-reported diagnosis of KSD during follow-up and no previous CV or bone events at the time of KSD diagnosis were included in the study and followed until the development of a CV event (fatal or non-fatal myocardial infarction, coronary revascularization) and a bone event (fracture, osteoporosis); individuals who developed cancer or died were censored. Characteristics of stone formers experiencing only one event (CV or bone), both events, or none were compared using multinomial logistic regression models.

RESULTS

Our study included data from 14 709 individuals with KSD. In HPFS, 28.7% of the participants experienced at least one event: 17.4% a CV event, 8.5% a bone event and 2.8% both. In NHS I, 46.0% of the participants experienced at least one event: 7.3% a CV event, 32.8% a bone event and 5.9% both. In NHS II, 27.1% of the participants experienced at least one event: 2.0% a CV event, 23.9% a bone event and 1.1% both. Across cohorts, age, BMI, thiazide use, calcium and vitamin D supplementation, and prevalence of hypertension and diabetes did not identify specific high-risk subgroups.

CONCLUSION

CV and bone events are common in KSD; however, their co-occurrence in the same stone-forming individual is relatively rare. CV disease and bone disease are unlikely to share major risk factors in individuals with KSD.