Skip to main content
Top
Published in: Urolithiasis 1/2015

01-02-2015 | Original Paper

Dyslipidemia is associated with an increased risk of nephrolithiasis

Authors: James H. Masterson, Jason R. Woo, David C. Chang, Thomas Chi, James O. L’Esperance, Marshall L. Stoller, Roger L. Sur

Published in: Urolithiasis | Issue 1/2015

Login to get access

Abstract

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.
Literature
1.
go back to reference Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63(5):1817–1823PubMedCrossRef Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63(5):1817–1823PubMedCrossRef
2.
go back to reference Saigal CS, Joyce G, Timilsina AR (2005) Urologic Diseases in America Project. Direct and indirect costs of nephrolithiasis in an employed population: opportunity for disease management? Kidney Int 68(4):1808–1814PubMedCrossRef Saigal CS, Joyce G, Timilsina AR (2005) Urologic Diseases in America Project. Direct and indirect costs of nephrolithiasis in an employed population: opportunity for disease management? Kidney Int 68(4):1808–1814PubMedCrossRef
3.
go back to reference Taylor EN, Stampfer MJ, Curhan GC (2005) Obesity, weight gain, and the risk of kidney stones. JAMA 293(4):455–462PubMedCrossRef Taylor EN, Stampfer MJ, Curhan GC (2005) Obesity, weight gain, and the risk of kidney stones. JAMA 293(4):455–462PubMedCrossRef
4.
go back to reference Rendina D, Mossetti G, De Filippo G, Benvenuto D, Vivona CL, Imbroinise A et al (2009) Association between metabolic syndrome and nephrolithiasis in an inpatient population in southern Italy: role of gender, hypertension and abdominal obesity. Nephrol Dial Transplant 24(3):900–906PubMedCrossRef Rendina D, Mossetti G, De Filippo G, Benvenuto D, Vivona CL, Imbroinise A et al (2009) Association between metabolic syndrome and nephrolithiasis in an inpatient population in southern Italy: role of gender, hypertension and abdominal obesity. Nephrol Dial Transplant 24(3):900–906PubMedCrossRef
6.
go back to reference Inci M, Demirtas A, Sarli B, Akinsal E, Baydilli N (2012) Association between body mass index, lipid profiles, and types of urinary stones. Ren Fail 34(9):1140–1143PubMedCrossRef Inci M, Demirtas A, Sarli B, Akinsal E, Baydilli N (2012) Association between body mass index, lipid profiles, and types of urinary stones. Ren Fail 34(9):1140–1143PubMedCrossRef
7.
go back to reference Itoh Y, Yoshimura M, Niimi K, Usami M, Hamamoto S, Kobayashi T et al (2011) The role of long-term loading of cholesterol in renal crystal formation. Arch Ital Urol Androl 83(1):23–25PubMed Itoh Y, Yoshimura M, Niimi K, Usami M, Hamamoto S, Kobayashi T et al (2011) The role of long-term loading of cholesterol in renal crystal formation. Arch Ital Urol Androl 83(1):23–25PubMed
8.
go back to reference Program National Cholesterol Education (2002) (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Third report of the national cholesterol education program (ncep) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation 106(25):3143–3421 Program National Cholesterol Education (2002) (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Third report of the national cholesterol education program (ncep) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation 106(25):3143–3421
9.
go back to reference Torricelli FC, De SK, Gebreselassie S, Li I, Sarkissian C, Monga M (2014) Dyslipidemia and kidney stone risk. J Urol 191(3):667–672PubMedCrossRef Torricelli FC, De SK, Gebreselassie S, Li I, Sarkissian C, Monga M (2014) Dyslipidemia and kidney stone risk. J Urol 191(3):667–672PubMedCrossRef
10.
go back to reference Lipid Metabolism-Atherogenesis Branch, National Heart, Lung, and Blood Institute (1984) The lipid research clinics coronary primary prevention trial results. I. Reduction in incidence of coronary heart disease. JAMA 251(3):351–364 Lipid Metabolism-Atherogenesis Branch, National Heart, Lung, and Blood Institute (1984) The lipid research clinics coronary primary prevention trial results. I. Reduction in incidence of coronary heart disease. JAMA 251(3):351–364
11.
go back to reference Barter P, Gotto AM, LaRosa JC, Maroni J, Szarek M, Grundy SM et al (2007) HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med 357(13):1301–1310PubMedCrossRef Barter P, Gotto AM, LaRosa JC, Maroni J, Szarek M, Grundy SM et al (2007) HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med 357(13):1301–1310PubMedCrossRef
12.
go back to reference Eisner BH, Porten SP, Bechis SK, Stoller ML (2010) Diabetic kidney stone formers excrete more oxalate and have lower urine pH than nondiabetic stone formers. J Urol 183(6):2244–2248PubMedCrossRef Eisner BH, Porten SP, Bechis SK, Stoller ML (2010) Diabetic kidney stone formers excrete more oxalate and have lower urine pH than nondiabetic stone formers. J Urol 183(6):2244–2248PubMedCrossRef
13.
go back to reference Abate N, Chandalia M, Cabo-Chan AV Jr, Moe OW, Sakhaee K (2004) The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int 65(2):386–392PubMedCrossRef Abate N, Chandalia M, Cabo-Chan AV Jr, Moe OW, Sakhaee K (2004) The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int 65(2):386–392PubMedCrossRef
14.
go back to reference Selby JV, Austin MA, Newman B, Zhang D, Quesenberry CP Jr, Mayer EJ et al (1993) LDL subclass phenotypes and the insulin resistance syndrome in women. Circulation 88(2):381–387PubMedCrossRef Selby JV, Austin MA, Newman B, Zhang D, Quesenberry CP Jr, Mayer EJ et al (1993) LDL subclass phenotypes and the insulin resistance syndrome in women. Circulation 88(2):381–387PubMedCrossRef
15.
go back to reference Hoofnagle AN, Vaisar T, Mitra P, Chait A (2010) HDL lipids and insulin resistance. Curr Diabetes Rep 10(1):78–86CrossRef Hoofnagle AN, Vaisar T, Mitra P, Chait A (2010) HDL lipids and insulin resistance. Curr Diabetes Rep 10(1):78–86CrossRef
16.
go back to reference Stoller ML, Meng MV, Abrahams HM, Kane JP (2004) The primary stone event: a new hypothesis involving a vascular etiology. J Urol 171(5):1920–1924PubMedCrossRef Stoller ML, Meng MV, Abrahams HM, Kane JP (2004) The primary stone event: a new hypothesis involving a vascular etiology. J Urol 171(5):1920–1924PubMedCrossRef
17.
go back to reference Curhan GC, Willett WC, Speizer FE, Stampfer MJ (2001) Twenty-four-hour urine chemistries and the risk of kidney stones among women and men. Kidney Int 59(6):2290–2298PubMed Curhan GC, Willett WC, Speizer FE, Stampfer MJ (2001) Twenty-four-hour urine chemistries and the risk of kidney stones among women and men. Kidney Int 59(6):2290–2298PubMed
18.
go back to reference Kang HW, Lee SK, Kim WT, Kim YJ, Yun SJ, Lee SC, Kim WJ (2014) Hypertriglyceridemia and low high-density lipoprotein cholesterolemia are associated with increased hazard for urolithiasis. J Endourol 28(8):1001–1005PubMedCrossRef Kang HW, Lee SK, Kim WT, Kim YJ, Yun SJ, Lee SC, Kim WJ (2014) Hypertriglyceridemia and low high-density lipoprotein cholesterolemia are associated with increased hazard for urolithiasis. J Endourol 28(8):1001–1005PubMedCrossRef
19.
go back to reference Kurogi K, Sugiyama S, Sakamoto K, Tayama S, Nakamura S, Biwa T et al (2013) Comparison of pitavastatin with atorvastatin in increasing HDL-cholesterol and adiponectin in patients with dyslipidemia and coronary artery disease: The COMPACT-CAD study. J Cardiol 62:87–94PubMedCrossRef Kurogi K, Sugiyama S, Sakamoto K, Tayama S, Nakamura S, Biwa T et al (2013) Comparison of pitavastatin with atorvastatin in increasing HDL-cholesterol and adiponectin in patients with dyslipidemia and coronary artery disease: The COMPACT-CAD study. J Cardiol 62:87–94PubMedCrossRef
20.
go back to reference Sur RL, Masterson JH, Palazzi KL, L’esperance JO, Auge BK, Chang DC et al (2013) Impact of statins on nephrolithiasis in hyperlipidemic patients: a 10-year review of an equal access health care system. Clin Nephrol 79(5):351–355PubMedCrossRef Sur RL, Masterson JH, Palazzi KL, L’esperance JO, Auge BK, Chang DC et al (2013) Impact of statins on nephrolithiasis in hyperlipidemic patients: a 10-year review of an equal access health care system. Clin Nephrol 79(5):351–355PubMedCrossRef
21.
go back to reference Rendina D, De Filippo G, De Pascale F, Zampa G, Muscariello R, De Palma D et al (2013) The changing profile of patients with calcium nephrolithiasis: a comparison of two patient series observed 25 years apart. Nephrol Dial Transplant 28(Suppl 4):iv146–iv151PubMedCrossRef Rendina D, De Filippo G, De Pascale F, Zampa G, Muscariello R, De Palma D et al (2013) The changing profile of patients with calcium nephrolithiasis: a comparison of two patient series observed 25 years apart. Nephrol Dial Transplant 28(Suppl 4):iv146–iv151PubMedCrossRef
22.
go back to reference Ferrandino MN, Peitrow PK, Preminger GM (2011) Evaluation and medical management of urinary lithiasis. In: Wein AJ (ed) Campbell-Walsh urology, 10th edn. Saunders Elsevier, Philadelphia, p 46 Ferrandino MN, Peitrow PK, Preminger GM (2011) Evaluation and medical management of urinary lithiasis. In: Wein AJ (ed) Campbell-Walsh urology, 10th edn. Saunders Elsevier, Philadelphia, p 46
23.
go back to reference Cupisti A, D’Alessandro C, Samoni S, Meola M, Egidi MF (2014) Nephrolithiasis and hypertension: possible links and clinical implications. J Nephrol [Epub ahead of print] Cupisti A, D’Alessandro C, Samoni S, Meola M, Egidi MF (2014) Nephrolithiasis and hypertension: possible links and clinical implications. J Nephrol [Epub ahead of print]
Metadata
Title
Dyslipidemia is associated with an increased risk of nephrolithiasis
Authors
James H. Masterson
Jason R. Woo
David C. Chang
Thomas Chi
James O. L’Esperance
Marshall L. Stoller
Roger L. Sur
Publication date
01-02-2015
Publisher
Springer Berlin Heidelberg
Published in
Urolithiasis / Issue 1/2015
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI
https://doi.org/10.1007/s00240-014-0719-3

Other articles of this Issue 1/2015

Urolithiasis 1/2015 Go to the issue