Top

Published in:

Open Access 01-12-2017 | Research article

Clinical relevance of aortic calcification in urolithiasis patients

Authors: Toshikazu Tanaka, Shingo Hatakeyama, Hayato Yamamoto, Takuma Narita, Itsuto Hamano, Teppei Matsumoto, Osamu Soma, Yuki Tobisawa, Tohru Yoneyama, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, Ippei Takahashi, Shigeyuki Nakaji, Yuriko Terayama, Tomihisa Funyu, Chikara Ohyama

Published in: BMC Urology | Issue 1/2017

Abstract

Background

The aim of the present study is to investigate the clinical relevance of aortic calcification in urolithiasis patients.

Methods

Between January 2010 and September 2014, 1221 patients with urolithiasis were treated in Oyokyo Kidney Research Institute and Hirosaki University Hospital. Among these, 287 patients (Stone group) on whom adequate data were available were included in this retrospective study. We also selected 148 subjects with early stage (pT1N0M0) renal cell carcinoma from 607 renal cell carcinoma patients who underwent radical nephrectomy at Hirosaki University Hospital (Non-stone group) as control subjects. Validity of the Non-stone group was evaluated by comparison with pair-matched 296 volunteers from 1166 subjects who participated in the Iwaki Health Promotion Project in 2014. Thereafter, age, body mass index, aortic calcification index (ACI), renal function, serum uric acid concentrations, and comorbidities (diabetes, hypertension, or cardiovascular disease) were compared between the Non-stone and Stone groups. Independent factors for higher ACI and impaired renal function were assessed using multivariate logistic regression analysis.

Results

We confirmed relevance of Non-stone group patients as a control subject by comparing the pair-matched community-dwelling volunteers. Backgrounds of patients between the Non-stone and Stone groups were not significantly different except for the presence of hypertension in the Stone group. ACI was not significantly high in the Stone group compared with the Non-stone group. However, age-adjusted ACI was greater in the Stone group than the Non-stone group. Among urolithiasis patients, ACI was significantly higher in uric acid containing stone patients. The number of patients with stage 3B chronic kidney disease (CKD) was significantly higher in the Stone group than in the Non-stone group (12% vs. 4%, P = 0.008). Multivariate logistic regression analysis showed higher aortic calcification index (>13%), and being a stone former were independent factors for stage 3B CKD at the time of diagnosis.

Conclusion

Aortic calcification and being a stone former had harmful influence on renal function. This study was registered as a clinical trial: UMIN: UMIN000022962.

Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC. Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int. 2003;63(5):1817–23.CrossRefPubMed

Yasui T, Iguchi M, Suzuki S, Kohri K. Prevalence and epidemiological characteristics of urolithiasis in Japan: national trends between 1965 and 2005. Urology. 2008;71(2):209–13.CrossRefPubMed

Yasui T, Okada A, Hamamoto S, Hirose M, Ando R, Kubota Y, Tozawa K, Hayashi Y, Gao B, Suzuki S, et al. The association between the incidence of urolithiasis and nutrition based on Japanese National Health and Nutrition Surveys. Urolithiasis. 2013;41(3):217–24.CrossRefPubMed

Esposito K, Chiodini P, Colao A, Lenzi A, Giugliano D. Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care. 2012;35(11):2402–11.CrossRefPubMedPubMedCentral

Kawamoto R, Kohara K, Tabara Y, Miki T. An association between metabolic syndrome and the estimated glomerular filtration rate. Internal medicine (Tokyo, Japan). 2008;47(15):1399–406.CrossRef

Rule AD, Krambeck AE, Lieske JC. Chronic kidney disease in kidney stone formers. Clin J Am Soc Nephrol . 2011;6(8):2069–75.CrossRefPubMedPubMedCentral

Thomas G, Sehgal AR, Kashyap SR, Srinivas TR, Kirwan JP, Navaneethan SD. Metabolic syndrome and kidney disease: a systematic review and meta-analysis. Clin J Am Soc Nephrol. 2011;6(10):2364–73.CrossRefPubMedPubMedCentral

Bahous SA, Blacher J, Safar ME. Aortic stiffness, kidney disease, and renal transplantation. Curr Hypertens Rep. 2009;11(2):98–103.CrossRefPubMed

Walsh CR, Cupples LA, Levy D, Kiel DP, Hannan M, Wilson PW, O'Donnell CJ. Abdominal aortic calcific deposits are associated with increased risk for congestive heart failure: the Framingham Heart Study. Am Heart J. 2002;144(4):733–9.CrossRefPubMed

10.

Nakagami H, Osako MK, Morishita R. New concept of vascular calcification and metabolism. Curr Vasc Pharmacol. 2011;9(1):124–7.CrossRefPubMed

11.

Mizobuchi M, Towler D, Slatopolsky E. Vascular calcification: the killer of patients with chronic kidney disease. J Am Soc Nephrol. 2009;20(7):1453–64.CrossRefPubMed

12.

Tsushima M, Terayama Y, Momose A, Funyu T, Ohyama C, Hada R. Carotid intima media thickness and aortic calcification index closely relate to cerebro- and cardiovascular disorders in hemodialysis patients. Int J Urol. 2008;15(1):48–51.CrossRefPubMed

13.

Fujita N, Hatakeyama S, Yamamoto H, Tobisawa Y, Yoneyama T, Yoneyama T, Hashimoto Y, Koie T, Nigawara T, Ohyama C. Implication of aortic calcification on persistent hypertension after laparoscopic adrenalectomy in patients with primary aldosteronism. Int J Urol. 2016;23(5):412–7.CrossRefPubMed

14.

Imanishi K, Hatakeyama S, Yamamoto H, Okamoto A, Imai A, Yoneyama T, Hashimoto Y, Koie T, Fujita T, Murakami R, et al. Post-transplant renal function and cardiovascular events are closely associated with the aortic calcification index in renal transplant recipients. Transplant Proc. 2014;46(2):484–8.CrossRefPubMed

15.

Yasui T, Itoh Y, Bing G, Okada A, Tozawa K, Kohri K. Aortic calcification in urolithiasis patients. Scand J Urol Nephrol. 2007;41(5):419–21.CrossRefPubMed

16.

Imai E, Horio M, Iseki K, Yamagata K, Watanabe T, Hara S, Ura N, Kiyohara Y, Hirakata H, Moriyama T, et al. Prevalence of chronic kidney disease (CKD) in the Japanese general population predicted by the MDRD equation modified by a Japanese coefficient. Clin Exp Nephrol. 2007;11(2):156–63.CrossRefPubMed

17.

Satake R, Sugawara N, Sato K, Takahashi I, Nakaji S, Yasui-Furukori N, Fukuda S. Prevalence and Predictive Factors of Irritable Bowel Syndrome in a Community-dwelling Population in Japan. Intern Med. 2015;54(24):3105–12.CrossRefPubMed

18.

Hatakeyama S, Koie T, Narita T, Hosogoe S, Yamamoto H, Tobisawa Y, Yoneyama T, Yoneyama T, Hashimoto Y, Ohyama C. Renal Function Outcomes and Risk Factors for Risk Factors for Stage 3B Chronic Kidney Disease after Urinary Diversion in Patients with Muscle Invasive Bladder Cancer. PLoS One. 2016;11(2):e0149544.CrossRefPubMedPubMedCentral

19.

Akobeng AK. Understanding diagnostic tests 3: Receiver operating characteristic curves. Acta Paediatr. 2007;96(5):644–7.CrossRefPubMed

20.

Li LC, Lee YT, Lee YW, Chou CA, Lee CT. Aortic arch calcification predicts the renal function progression in patients with stage 3 to 5 chronic kidney disease. Biomed Res Int. 2015;2015:131263.PubMedPubMedCentral

21.

Thomas IC, Ratigan AR, Rifkin DE, Ix JH, Criqui MH, Budoff MJ, Allison MA. The association of renal artery calcification with hypertension in community-living individuals: the multiethnic study of atherosclerosis. J Am Soc Hypertens. 2016;10(2):167–74.CrossRefPubMed

22.

Johnson RC, Leopold JA, Loscalzo J. Vascular calcification: pathobiological mechanisms and clinical implications. Circ Res. 2006;99(10):1044–59.CrossRefPubMed

23.

Watson KE, Bostrom K, Ravindranath R, Lam T, Norton B, Demer LL. TGF-beta 1 and 25-hydroxycholesterol stimulate osteoblast-like vascular cells to calcify. J Clin Invest. 1994;93(5):2106–13.CrossRefPubMedPubMedCentral

24.

Sodek J, Ganss B, McKee MD. Osteopontin. Critical Reviews in Oral Biology and Medicine. 2000;11(3):279–303.CrossRefPubMed

25.

Gravallese EM. Osteopontin: a bridge between bone and the immune system. J Clin Invest. 2003;112(2):147–9.CrossRefPubMedPubMedCentral

26.

Kohri K, Suzuki Y, Yoshida K, Yamamoto K, Amasaki N, Yamate T, Umekawa T, Iguchi M, Sinohara H, Kurita T. Molecular cloning and sequencing of cDNA encoding urinary stone protein, which is identical to osteopontin. Biochem Biophys Res Commun. 1992;184(2):859–64.CrossRefPubMed

27.

Kohri K, Nomura S, Kitamura Y, Nagata T, Yoshioka K, Iguchi M, Yamate T, Umekawa T, Suzuki Y, Sinohara H, et al. Structure and expression of the mRNA encoding urinary stone protein (osteopontin). J Biol Chem. 1993;268(20):15180–4.PubMed

28.

Okada A, Yasui T, Hamamoto S, Hirose M, Kubota Y, Itoh Y, Tozawa K, Hayashi Y, Kohri K. Genome-wide analysis of genes related to kidney stone formation and elimination in the calcium oxalate nephrolithiasis model mouse: detection of stone-preventive factors and involvement of macrophage activity. J Bone Miner Res. 2009;24(5):908–24.CrossRefPubMed

29.

Buendia P, Montes de Oca A, Madueno JA, Merino A, Martin-Malo A, Aljama P, Ramirez R, Rodriguez M, Carracedo J. Endothelial microparticles mediate inflammation-induced vascular calcification. FASEB J. 2015;29(1):173–81.CrossRefPubMed

30.

Byon CH, Chen Y. Molecular Mechanisms of Vascular Calcification in Chronic Kidney Disease: The Link between Bone and the Vasculature. Curr Osteoporos Rep. 2015;13(4):206–15.CrossRefPubMedPubMedCentral

31.

Nishimura S, Manabe I, Nagasaki M, Eto K, Yamashita H, Ohsugi M, Otsu M, Hara K, Ueki K, Sugiura S, et al. CD8+ effector T cells contribute to macrophage recruitment and adipose tissue inflammation in obesity. Nat Med. 2009;15(8):914–20.CrossRefPubMed

Title: Clinical relevance of aortic calcification in urolithiasis patients
Authors: Toshikazu Tanaka
Shingo Hatakeyama
Hayato Yamamoto
Takuma Narita
Itsuto Hamano
Teppei Matsumoto
Osamu Soma
Yuki Tobisawa
Tohru Yoneyama
Takahiro Yoneyama
Yasuhiro Hashimoto
Takuya Koie
Ippei Takahashi
Shigeyuki Nakaji
Yuriko Terayama
Tomihisa Funyu
Chikara Ohyama
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Urology / Issue 1/2017
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-017-0218-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical relevance of aortic calcification in urolithiasis patients

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2017

Emerging concepts and spectrum of renal injury following Intravesical BCG for non-muscle invasive bladder cancer

Simultaneous antegrade and retrograde endoscopic treatment of non-malignant ureterointestinal anastomotic strictures following urinary diversion

Toileting behaviors and overactive bladder in patients with type 2 diabetes: a cross-sectional study in China

Should manual detorsion be a routine part of treatment in testicular torsion?

The neutrophil-to-lymphocyte ratio (NLR) predicts adrenocortical carcinoma and is correlated with the prognosis

Can Randall’s plug composed of calcium oxalate form via the free particle mechanism?