Association between kidney stones and risk of developing stroke: a meta-analysis

Abstract

Background Many studies have described the relationship between kidney stones and stroke, but the results are controversial, so we conducted this meta-analysis to estimate the relationship between kidney stones and the risk of developing stroke. Methods Studies were marked with a comprehensive search of PubMed, EMBASE, Google, and ISI Web of Science databases through 25 March 2020. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and a random-effects model or fix-effects model was used to compute the pooled combined risk estimate. Heterogeneity was reported as I2. We performed subgroup and sensitivity analysis to assess potential sources of heterogeneity. Results Eight studies of seven articles involving 3,526,808 participants were included in the meta-analysis. Overall, kidney stones were associated with a moderate risk of stroke incidence (HR, 1.24; 95% CI, 1.11–1.40; I2=79.6%; p=0.000). We conducted a sensitivity analysis by removing the studies that had a high risk of bias. Heterogeneity subsequently decreased significantly, while an increased risk of stroke in patient with kidney stones was again demonstrated (HR, 1.16; 95% CI, 1.11–1.23; I2=28.7%; p=0.000). Stratifying analysis showed that the results were more pronounced for ischemic stroke (HR, 1.14; 95% CI, 1.08–1.22; I2=15.6%; p=0.00) and the follow-up duration ≥10 years (HR, 1.18; 95% CI, 1.10–1.27; I2=31.6%; p=0.003). Conclusions Our meta-analysis suggests that patients with kidney stones may have a modestly increased risk of developing stroke, especially in ischemic stroke. More large-scaled and clinical trials should be done to identify the relative impact of kidney stones on stroke outcomes in the future.

Association of total pre-existing comorbidities with stroke risk: a large-scale community-based cohort study from China

“…First, among non-ischemic stroke category, a large percentage of undetermined stroke is likely to be undiagnosed ischemic stroke, which may lead to the dilution bias in the results. Second, many comorbidities, such as psychiatric disorders [ 21 – 23 ], gouty arthritis [ 44 ], kidney stones [ 45 ], and rheumatoid arthritis [ 46 ], have been shown to be important factors associated with stroke risk. However, due to the specific study design, mental conditions such as dementia [ 47 ] were not included in our study.…”

Nephrolithiasis and the risk of myocardial infarction and stroke.

“…Два из 4-х мета-анализов [19,20] изучали в качестве исходов ИБС и инсульт, в одном мета-анализе [21] исходом был только инсульт, в другом -только ИБС [18].…”

“…Дефиниция инсульта в двух мета-анализах не включала в себя разделения на виды инсульта. Только в мета-анализе M. Yuan ишемический и геморрагический инсульты анализировались раздельно [21].…”

“…Результаты всех 4-х мета-анализов показали, что МКБ связана с повышенным риском ИБС, ИМ и инсульта [18][19][20][21] (табл. 2).…”

“…Нет никаких данных (результатов исследований или известных патофизиологических механизмов), указывающих на то, что меры метафилактики МКБ могут повышать риск ССЗ. Напротив, многие авторы считают, что метафилактика МКБ может снижать риск ССЗ [21,26,32,41]. Основанием этому служит, в том числе тот факт, что многие меры метафилактики совпадают с мерами профилактики ИБС и инсульта.…”