TY - JOUR
T1 - Nephrolithiasis as a risk factor for CKD
T2 - The atherosclerosis risk in communities study
AU - Kummer, Andrew E.
AU - Grams, Morgan
AU - Lutsey, Pamela
AU - Chen, Yuan
AU - Matsushita, Kunihiro
AU - Köttgen, Anna
AU - Folsom, Aaron R.
AU - Coresh, Josef
N1 - Publisher Copyright:
© 2015 by the American Society of Nephrology.
PY - 2015/11/6
Y1 - 2015/11/6
N2 - Background and objectives Previous studies demonstrated a higher risk of CKD in persons with a history of kidney stones, but these studies examined mostly white populations and did not evaluate important potential interactions such as race and plasma uric acid. Design, setting, participants, & measurements In 10,678 Atherosclerosis Risk in Communities (ARIC) study participants free of CKD at baseline (ARIC visit 4 in 1996-1998), we assessed the association between a history of nephrolithiasis (a time-varying variable, defined by a combination of self-report and diagnostic codes) and incident CKD (defined by diagnostic codes from linkage to hospitalizations and US Centers for Medicare and Medicaid Services’ records). Results At baseline, 856 participants had a history of nephrolithiasis; 322 developed nephrolithiasis during follow-up. Over amean follow-up of 12 years, therewere 1037 incident CKD events.Nephrolithiasis historywas associated with a 29% (hazard ratio [HR], 1.29; 95%confidence interval [95% CI], 1.07 to 1.54) higher risk of CKD in demographic-adjusted analyses, but the association was no longer statistically significant after multivariable adjustment (HR, 1.09; 95% CI, 0.90 to 1.32). The multivariable-adjusted association was stronger among participants with plasma uric acid levels ≤6 mg/dl (HR, 1.34; 95% CI, 1.05 to 1.72) compared with those with levels >6 mg/dl (HR, 0.94; 95% CI, 0.70 to 1.28; Pinteraction=0.05). There was no interaction of stone disease and race with incident CKD. Conclusions In this community-based cohort, nephrolithiasis was not an independent risk factor for incident CKD overall. However, risk of CKD was unexpectedly elevated in participants with stone disease and lower plasma uric acid levels.
AB - Background and objectives Previous studies demonstrated a higher risk of CKD in persons with a history of kidney stones, but these studies examined mostly white populations and did not evaluate important potential interactions such as race and plasma uric acid. Design, setting, participants, & measurements In 10,678 Atherosclerosis Risk in Communities (ARIC) study participants free of CKD at baseline (ARIC visit 4 in 1996-1998), we assessed the association between a history of nephrolithiasis (a time-varying variable, defined by a combination of self-report and diagnostic codes) and incident CKD (defined by diagnostic codes from linkage to hospitalizations and US Centers for Medicare and Medicaid Services’ records). Results At baseline, 856 participants had a history of nephrolithiasis; 322 developed nephrolithiasis during follow-up. Over amean follow-up of 12 years, therewere 1037 incident CKD events.Nephrolithiasis historywas associated with a 29% (hazard ratio [HR], 1.29; 95%confidence interval [95% CI], 1.07 to 1.54) higher risk of CKD in demographic-adjusted analyses, but the association was no longer statistically significant after multivariable adjustment (HR, 1.09; 95% CI, 0.90 to 1.32). The multivariable-adjusted association was stronger among participants with plasma uric acid levels ≤6 mg/dl (HR, 1.34; 95% CI, 1.05 to 1.72) compared with those with levels >6 mg/dl (HR, 0.94; 95% CI, 0.70 to 1.28; Pinteraction=0.05). There was no interaction of stone disease and race with incident CKD. Conclusions In this community-based cohort, nephrolithiasis was not an independent risk factor for incident CKD overall. However, risk of CKD was unexpectedly elevated in participants with stone disease and lower plasma uric acid levels.
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U2 - 10.2215/CJN.10111014
DO - 10.2215/CJN.10111014
M3 - Article
C2 - 26342045
AN - SCOPUS:84946719784
SN - 1555-9041
VL - 10
SP - 2023
EP - 2029
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 11
ER -