Clinical relevance of aortic calcification in urolithiasis patients

Abstract Background The aim of the present study is to investigate the clinical relevance of aortic calcification in urolithiasis patients. Methods Between January 2010 and September 2014, 1221 patients with urolithiasis were treated in Oyokyo Kidney Research Institute and Hirosaki University Hospital. Among these, 287 patients (Stone group) on whom adequate data were available were included in this retrospective study. We also selected 148 subjects with early stage (pT1N0M0) renal cell carcinoma from 607 renal cell carcinoma patients who underwent radical nephrectomy at Hirosaki University Hospital (Non-stone group) as control subjects. Validity of the Non-stone group was evaluated by comparison with pair-matched 296 volunteers from 1166 subjects who participated in the Iwaki Health Promotion Project in 2014. Thereafter, age, body mass index, aortic calcification index (ACI), renal function, serum uric acid concentrations, and comorbidities (diabetes, hypertension, or cardiovascular disease) were compared between the Non-stone and Stone groups. Independent factors for higher ACI and impaired renal function were assessed using multivariate logistic regression analysis. Results We confirmed relevance of Non-stone group patients as a control subject by comparing the pair-matched community-dwelling volunteers. Backgrounds of patients between the Non-stone and Stone groups were not significantly different except for the presence of hypertension in the Stone group. ACI was not significantly high in the Stone group compared with the Non-stone group. However, age-adjusted ACI was greater in the Stone group than the Non-stone group. Among urolithiasis patients, ACI was significantly higher in uric acid containing stone patients. The number of patients with stage 3B chronic kidney disease (CKD) was significantly higher in the Stone group than in the Non-stone group (12% vs. 4%, P = 0.008). Multivariate logistic regression analysis showed higher aortic calcification index (>13%), and being a stone former were independent factors for stage 3B CKD at the time of diagnosis. Conclusion Aortic calcification and being a stone former had harmful influence on renal function. This study was registered as a clinical trial: UMIN: UMIN000022962

Patient selection and classification.

<p>Eligible patients with urinary stones and control subjects selected from the database. We excluded 629 patients without stone analysis, 42 patients without complete clinical data, and 46 struvite stones. The remaining 602 urinary stone patients included in the study. The subjects were divided into two groups according to UA levels: the UA-high group with hyperuricemia (UA ≥ 7.0 mg/dL) or the UA-low group with normal UA levels (UA < 7.0 mg/dL). The control subjects and stone patients were pair-matched according to age, sex, body mass index, comorbidities (HTN, DM and CVD), hyperlipidemia hemoglobin, serum Alb, and serum UA levels using propensity score matching.</p

The influence of serum uric acid on renal function in patients with calcium or uric acid stone: A population-based analysis

<div><p>Objectives</p><p>To determine the influence of serum uric acid (UA) levels on renal impairment in patients with UA stone.</p><p>Materials and methods</p><p>We retrospectively analyzed 463 patients with calcium oxalate and/or calcium phosphate stones (CaOx/CaP), and 139 patients with UA stones. The subjects were divided into the serum UA-high (UA ≥ 7.0 mg/dL) or the UA-low group (UA < 7.0 mg/dL). The control group comprised 3082 community-dwelling individuals that were pair-matched according to age, sex, body mass index, comorbidities, hemoglobin, serum albumin, and serum UA using propensity score matching. We compared renal function between controls and patients with UA stone (analysis 1), and between patients with CaOx/CaP and with UA stone (analysis 2). Logistic regression analysis was used to evaluate the impact of the hyperuricemia on the development of stage 3 and 3B chronic kidney disease (CKD) (analysis 3).</p><p>Results</p><p>The renal function was significantly associated with serum UA levels in the controls and patients with CaOx/CaP and UA stones. In pair-matched subgroups, patients with UA stone had significantly lower renal function than the control subjects (analysis 1) and patients with CaOx/CaP stones (analysis 2) regardless of hyperuricemia. Multivariate logistic regression analysis revealed that patients with UA stone, CaOx/CaP, hyperuricemia, presence of cardiovascular disease, higher body mass index, older age and lower hemoglobin had significantly higher risk of stage 3 and 3B CKD (analysis 3).</p><p>Conclusion</p><p>Patients with UA stones had significantly worse renal function than controls and CaOx/CaP patients regardless of hyperuricemia. Urolithiasis (CaOx/CaP and UA stone) and hyperuricemia had an association with impaired renal function. Our findings encourage clinicians to initiate intensive treatment and education approaches in patients with urolithiasis and/or hyperuricemia in order to prevent the progression of renal impairment.</p></div

Additional file 1: of Aortic calcification burden predicts deterioration of renal function after radical nephrectomy

Dataset-S1, Simple data set. Simple data set is available in supplemental file (Dataset S1, MS Excel). Mean (± standard deviation) and median (interquartile range) age were 63 ± 13 and 65 (55–73) years old, respectively. Median height (cm) and body weight (kg) were 161 (155–167) and 63 (54–72), respectively. (XLSX 32 kb