Hypertriglyceridemia and Low High-Density Lipoprotein Cholesterolemia Are Associated with Increased Hazard for Urolithiasis

The pathophysiology of nephrolithiasis is multifactorial. Obesity, diabetes mellitus and hypertension are implicated in its formation. Dyslipidemia (DLD) recently has received attention as well. Congruent with a vascular etiology in stone formation, DLD theoretically would predispose patients to nephrolithiasis. We investigated a possible association of DLD with nephrolithiasis. A random cohort of 60,000 patients was established by collecting the first 5,000 patient charts per month in the year 2000. After excluding pediatric patients, a retrospective study was performed by reviewing age, sex, comorbidities, and last patient follow-up. Median lipid laboratory levels also were reviewed. Descriptive statistics were performed as well as Cox proportional-hazards regression analysis, and univariate and multivariate analyses. 52,184 (22,717 women/29,467 men) patient charts were reviewed. The average age was 31.0 ± 15.2 years. On univariate analysis, DLD was associated with nephrolithiasis with a hazard ratio (HR) of 2.2 [Confidence Interval (CI), 1.9–2.5; p < 0.001] and on multivariate analysis HR = 1.2 (1.0–1.5; p = 0.033). Low-density lipoprotein and triglycerides had no association with stone disease. Patients with high-density lipoprotein (HDL) values <45 for men and <60 for women had an HR of 1.4 (1.1–1.7, 95% CI, p = 0.003) on univariate analysis and on multivariate analysis; HR = 1.27 (1.03–1.56; p = 0.024) for nephrolithiasis. DLD was associated with an increased risk of stone disease though the only specific lipid panel associated with lower nephrolithiasis was HDL. Clinicians should consider obtaining lipid levels with the intent that treatment could potentially not only mitigate atherosclerotic disease but also decrease nephrolithiasis risk.

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“…We were reassured by the results obtained by Kang et al [18] from South Korea. They showed that increased HDL was protective.…”

Section: Discussionsupporting

confidence: 62%

Dyslipidemia is associated with an increased risk of nephrolithiasis

et al. 2014

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“…The 11 selected studies contained 282 479 participants (ranging from 694 to 116 536) . They were published between 2008 and 2017.…”

Section: Resultsmentioning

confidence: 99%

“…The regional distribution of the studies included were as follows: nine from Asia, one from Europe and one from the USA. Eight studies reported the association between TG and urolithiasis, whereas nine studies reported the relationship between HDL and urolithiasis . Three studies showed the association of any dyslipidemia traits (not separately reported TG, HDL, TC, LDL) with urolithiasis .…”

Section: Resultsmentioning

confidence: 99%

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Association between blood lipid profile and urolithiasis: A systematic review and meta‐analysis of observational studies

Beşiroğlu

Özbek

2018

Int J of Urology

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The objective of this study was to pool individual studies regarding the association of blood lipid profiles with urolithiasis to carry out a systematic review and meta-analysis. We searched MEDLINE, PubMed, Embase and Cochrane Library to identify the relevant studies up to November 2017. Studies that met all inclusion criteria were chosen, and a pooled analysis of the odds ratio between urolithiasis and dyslipidemia traits was calculated. A total of 11 observational studies (seven cross-sectional, three cohort, one case-control) with a total of 282 479 participants were examined. The overall pooled analysis of eight studies showed that high triglyceride was associated with increased estimated risk of urolithiasis (odds ratio 1.287, 95% CI 1.073-1.544; P = 0.007). Estimates of the total effect size were consistent in the sensitivity analysis. No evidence of publication bias was detected. The overall pooled analysis of nine studies showed low high-density lipoprotein was weakly associated with increased estimated risk of urolithiasis (odds ratio 1.171, 95% CI 1.010-1.358; P = 0.032). The sensitivity analysis showed conflicting results. No evidence of publication bias was detected. Three studies on the association between any dyslipidemia traits and urolithiasis showed a significant association (odds ratio 1.309, 95% CI 1.202-1.425; P < 0.001). The present meta-analysis showed that patients with higher triglyceride and lower high-density lipoprotein had an increased estimated risk of urolithiasis. A triglyceride-urolithiasis association was found to be more coherent and consistent compared with the high-density lipoprotein-urolithiasis association. Although somewhat contradictory results have been found, the meta-analysis is encouraging for evaluating urolithiasis as a systemic disorder. Further well-designed prospective randomized controlled or cohort studies are necessary to better elucidate the causal association of dyslipidemia and urolithiasis.

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“…Kang et al. found that people with a tendency to develop kidney stones were more likely to have high triglycerides and low HDL cholesterol. Torricelli et al.…”

Section: Discussionmentioning

confidence: 99%

Dyslipidaemia in overweight children and adolescents is associated with an increased risk of kidney stones

et al. 2015

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Hypertriglyceridemia and Low High-Density Lipoprotein Cholesterolemia Are Associated with Increased Hazard for Urolithiasis

Abstract: Our study implies that dyslipidemia may play a crucial part in urinary stone risk.

Cited by 31 publications

References 26 publications

Dyslipidemia is associated with an increased risk of nephrolithiasis

Dyslipidemia is associated with an increased risk of nephrolithiasis

Association between blood lipid profile and urolithiasis: A systematic review and meta‐analysis of observational studies

Dyslipidaemia in overweight children and adolescents is associated with an increased risk of kidney stones

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