Coronary Artery Calcium Score and Association with Recurrent Nephrolithiasis: The Multi-Ethnic Study of Atherosclerosis

J Urol. 2016 Apr;195(4 Pt 1):971-6. doi: 10.1016/j.juro.2015.10.001. Epub 2015 Oct 8.

Abstract

Purpose: Subclinical coronary artery calcification is an established predictor of cardiovascular events. While a history of kidney stones has been linked to subclinical carotid atherosclerosis, to our knowledge no study has examined its relationship with coronary artery calcification. We studied the association between kidney stone history and prevalent coronary artery calcification in MESA (Multi-Ethnic Study of Atherosclerosis).

Materials and methods: MESA is a multisite cohort study of participants 45 to 84 years old without known cardiovascular disease at baseline from 2000 to 2002. Computerized tomography was done in 3,282 participants at followup in 2010 to 2012 to determine coronary artery calcification and kidney stone history was assessed by self-report. Coronary artery calcification scores were categorized as none-0, mild-1 to 99, moderate-100 to 399 or severe-400 or greater. Cross-sectional analysis was performed adjusting for demographic and dietary factors related to kidney stones.

Results: The prevalence of kidney stone disease history was approximately 9%, mean ± SD participant age was 69.5 ± 9.3 years, 39% of participants were Caucasian, 47% were men and 69% had detectable coronary artery calcification (score greater than 0). No difference in the score was seen between single stone formers and nonstone formers. Recurrent kidney stone formation was associated with moderate or severe calcification on multivariable logistic regression vs none or mild calcification (OR 1.80, 95% CI 1.22-2.67). When coronary artery calcification scores were separated into none, mild, moderate and severe calcification, recurrent stone formation was associated with a higher score category on multivariable ordinal logistic regression (OR 1.44 per category, 95% CI 1.04-2.01).

Conclusions: Recurrent kidney stone formation is associated with subclinical coronary atherosclerosis. This association appeared stronger with coronary artery calcification severity than with coronary artery calcification presence.

Keywords: arteriosclerosis; coronary artery disease; kidney; recurrence; urolithiasis.

Publication types

  • Multicenter Study

MeSH terms

  • African Americans
  • Aged
  • Aged, 80 and over
  • Asian Americans
  • Atherosclerosis / complications*
  • Atherosclerosis / epidemiology*
  • Calcium / analysis*
  • Cohort Studies
  • Coronary Artery Disease / complications*
  • Coronary Artery Disease / epidemiology*
  • Coronary Vessels / chemistry*
  • Cross-Sectional Studies
  • European Continental Ancestry Group
  • Female
  • Hispanic Americans
  • Humans
  • Kidney Calculi / complications*
  • Male
  • Middle Aged
  • Prevalence
  • Recurrence
  • Vascular Calcification / complications*
  • Vascular Calcification / epidemiology*

Substances

  • Calcium