Urolithiasis, Independent of Uric Acid, Increased Risk of Coronary Artery and Carotid Atherosclerosis: A Meta‐Analysis of Observational Studies

Abstract

Background and Aims. Recent epidemiological evidence indicates an association between urolithiasis and atherosclerosis; however, results are incongruous. Our aim is to summarize the association between urolithiasis and arteriosclerosis risk through a detailed meta-analysis. Methods. Relevant studies published before April 2019 were identified by searching OVID, EMBASE, PubMed, Web of Science database, and Cochrane Library. The relationship between urolithiasis and the risk of atherosclerosis was assessed by using odds ratio (OR) values and the corresponding 95% confidence intervals (CIs), and the selection of fixed- or random-effects model based on heterogeneity. Results. The meta-analysis includes 8 observational studies that contained 70,716 samples. Pooled results showed that urolithiasis was associated with an increased adjusted and unadjusted risk estimated for atherosclerosis (P=0.017 and P=0.014, respectively), especially in coronary artery and carotid atherosclerosis, which was associated with the outcome of CV disease. Interestingly, when we merged the data from the vast majority of these samples (n = 65,751/70,716) with serum uric acid levels less than 6.0 mg/dl, it still showed that urolithiasis was associated with a higher risk of atherosclerosis (P<0.001) and with no evidence of heterogeneity (I2 = 0.0%, P=0.697). Furthermore, we also found that renal calculi would increase the risk of moderate or severe atherosclerosis (P<0.001) and recurrent renal calculi were associated with the incidence of atherosclerosis (P=0.007). Conclusions. Urolithiasis is associated with an increased risk for atherosclerosis, especially in coronary artery and carotid atherosclerosis. Urolithiasis may be another potential risk factor of atherosclerosis, which is independent of serum uric acid levels.

Nephrolithiasis and the risk of myocardial infarction and stroke.

“…Прежде чем эти общие патофизиологические механизмы и факторы риска реализуются в ИБС и инсульт, должен наблюдаться повышенный риск атеросклеротического поражения артерий у больных МКБ. Такие исследования есть -они обобщены в мета-анализе W. Luo и соавт., и подтверждают, что МКБ связана с повышенным риском атеросклероза, особенно коронарных и каротидных артерий [54]. Для коронарного атеросклероза ОШ=1,59, (95% ДИ=1,44-1,75), для каротидного атеросклероза ОШ=1,68, (95% ДИ=1, 29).…”

“…Примечательно, что риск атеросклероза у больных МКБ не зависел от уровня мочевой кислоты, а также от уровня дислипидемии и артериального давления. Авторы мета-анализа делают вывод, что МКБ может быть независимым фактором риска атеросклероза [54].…”

Mineral Characterization in Human Body: A Dual Energy Approach

“…Even though kidney stones are not fatal, they may provoke cardiovascular diseases that are among the diseases with the highest mortality rates [72,73]. Several studies investigated the association between urolithiasis/nephrolithiasis and cardiovascular diseases including atherosclerotic plaques [72][73][74][75][76][77][78]. Aydin et al investigated data from two hundred patients with kidney stones composed of calcium oxalate and two hundred controls to estimate the ten-year risk of cardiovascular disease and mortality.…”

“…The assessment of all the studies' results revealed that the possibility of atherosclerotic plaque formation when ureteric stones were found in the samples was higher [79]. Although the association between ureteric/kidney stones and atherosclerotic plaques requires more investigation, the screening for cardiovascular diseases in patients with ureteric/kidney stones shall be taken into consideration [77,78].…”