Institute of Nephrology, Shaare Zedek Medical Center, Affiliated with the Hebrew University, P.O Box 3235, Jerusalem, 91031, Israel.
Department of Urology, Shaare Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel.
Urolithiasis. 2024 Jun 21;52(1):97. doi: 10.1007/s00240-024-01597-w.
An increased prevalence of vascular calcification (VC) has been reported in kidney stone formers (KSFs), along with an elevated cardiovascular risk. The aim of the current study is to assess whether VC in these patients develops at a younger age and is influenced by stone composition. This single-center, matched case-control study included KSFs with uric acid or calcium oxalate stones (diagnosed based on stone analysis) and age- and sex-matched controls without a history of nephrolithiasis. The prevalence and severity of abdominal aortic calcification (AAC) and bone mineral density (BMD) were compared between KSFs and non-KSFs. In total, 335 patients were investigated: 134 with calcium oxalate stones, 67 with uric acid stones, and 134 controls. Overall, the prevalence of AAC was significantly higher among calcium stone formers than among the controls (67.9% vs. 47%, p = 0.002). In patients under 60 years of age, those with calcium oxalate stones exhibited both a significantly elevated AAC prevalence (61.9% vs. 31.3%, p = 0.016) and severity (94.8 ± 15.4 vs. 30.3 ± 15.95, p = 0.001) compared to the controls. Within the age group of 40-49, osteoporosis was identified only in the KSFs. Multivariate analysis identified age, smoking, and the presence of calcium stones as independent predictors of AAC. This study highlights that VC and osteoporosis occur in KSFs at a younger age than in non-stone-formers, suggesting potential premature VC. Its pathogenesis is intriguing and needs to be elucidated. Early evaluation and intervention may be crucial for mitigating the cardiovascular risk in this population.
已有研究报道肾结石患者（KSFs）的血管钙化（VC）患病率增加，同时心血管风险也升高。本研究旨在评估这些患者的 VC 是否更早发生，以及是否受结石成分的影响。这项单中心、匹配病例对照研究纳入了尿酸或草酸钙结石患者（根据结石分析诊断）和无肾结石病史的年龄及性别匹配对照者。比较了 KSFs 和非 KSFs 的腹主动脉钙化（AAC）和骨密度（BMD）的患病率和严重程度。共纳入 335 例患者：134 例草酸钙结石患者、67 例尿酸结石患者和 134 例对照者。总体而言，钙结石患者的 AAC 患病率明显高于对照组（67.9% vs. 47%，p=0.002）。在年龄<60 岁的患者中，草酸钙结石患者的 AAC 患病率（61.9% vs. 31.3%，p=0.016）和严重程度（94.8±15.4 vs. 30.3±15.95，p=0.001）均显著高于对照组。在 40-49 岁年龄组中，仅 KSFs 中存在骨质疏松症。多变量分析确定年龄、吸烟和钙结石的存在是 AAC 的独立预测因子。本研究表明，VC 和骨质疏松症在 KSFs 中的发生年龄比非结石形成者更早，提示潜在的过早 VC。其发病机制很有趣，需要进一步阐明。早期评估和干预对于降低该人群的心血管风险可能至关重要。
