Kidney stones linked to heart disease risk in women

An analysis of data from three studies that involved a total of more than 240,000 participants found that a self-reported history of kidney stones was associated with a statistically significant increased risk of coronary heart disease among women.

No significant association was evident for men, according to the findings, which were published in JAMA (2013; 310:408-15).

First author Pietro Manuel Ferraro, MD, of Columbus-Gemelli Hospital, Rome, and co-authors analyzed the relationship between kidney stones and risk of incident coronary heart disease (CHD) for individuals with a history of kidney stones. The analysis included 45,748 men and 196,357 women in the United States without a history of CHD at baseline who were participants in the Health Professionals Follow-up Study, Nurses’ Health Study I (NHS I), and Nurses’ Health Study II (NHS II). The diagnoses of kidney stones and CHD were updated biennially during follow-up. Coronary heart disease was defined as fatal or nonfatal myocardial infarction or coronary revascularization.

Of a total of 242,105 participants, 19,678 reported a history of kidney stones. After up to 24 years of follow-up in men and 18 years in women, 16,838 incident cases of CHD occurred.

“Multivariable-adjusted analysis of individual outcomes confirmed an association in NHS I and NHS II participants between history of kidney stones and myocardial infarction and revascularization. After pooling the NHS I and NHS II cohorts, women with a history of kidney stones had an increased risk of CHD, fatal and nonfatal myocardial infarction, and revascularization,” the authors wrote.

After multivariable adjustment, there was no significant association between history of kidney stones and CHD in the men’s cohort.

“Our finding of no significant association between history of kidney stones and risk of CHD in men but an increased risk in women is difficult to explain, even though we could not determine whether this was due to sex or some other difference between the male and female cohorts. However, differences by sex are not infrequent in studies analyzing the association between nephrolithiasis and either CHD or risk factors for CHD,” the authors added.

“Further research is needed to determine whether the association is sex-specific and to establish the pathophysiological basis of this association.”

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