Correlates of kidney stone disease differ by race in a multi-ethnic middle-aged population: The ARIC study

Abstract

Objective-To identify correlates of kidney stone disease in white and African American men and women in a population-based longitudinal study starting in four US communities, and to assess differences in correlates across racial groups.Methods-12,161 middle-aged participants of the ARIC Study provided information on history of kidney stone disease between 1993-1995. Information on incident kidney stone-related hospitalizations was obtained from ICD-codes on hospital discharge records.Results-Kidney stone disease was reported by 12.0% of men and 4.8% of women. After multivariable adjustment, prevalent kidney stone disease was significantly (p<0.05) associated with male gender (PR=2.50), increased serum triglycerides (PR=1.07 per SD increase), diabetes (PR=1.27), gallstone disease (PR=1.54), white race (PR= 1.67), and region of residence. Male gender (HR=1.70), diabetes (HR=1.98) and hypertension (HR=1.69) were significantly associated (p<0.05) with incident kidney stone-related hospitalizations (n=94). Race-stratified analyses showed stronger associations of prevalent kidney stone disease with increased triglycerides, older age, and gallstone disease in African Americans compared to whites, whereas male gender showed stronger association in whites (all p-interaction<0.05).Conclusion-We identified novel correlates of kidney stone disease (triglycerides, gallstone disease) and risk factor interactions by race (age, male gender, triglycerides, gallstone disease).

Nephrolithiasis as a Risk Factor for CKD

“…Interaction analyses did not support differences in the nephrolithiasis-CKD association by race, but our power to test this interaction was limited. The prevalence of stones was much lower (3.5%) in AfricanAmerican persons than whites (9.2%) at baseline, as previously reported in the ARIC study (36).…”

Urolithiasis in male patients: A pilot study on the ethnic differences and clinical profile

“…Previous reports from the United States have documented that the prevalence of kidney stone disease to be highest among whites and lowest in African Americans after adjusting the age, gender and other variables 5,6 . In yet another cross-sectional study from the United States observed that the highest prevalence of kidney stones was among the white population, while Hispanic and Asians had an intermediate prevalence and lowest was noted among the black population 20 .…”

“…This may be attributed to the dietary pattern and changes in the climate and environment. In 2010, Akoudad et al reported that race and ethnicity are correlated with occurrence of kidney stones 5 . A survey carried out in the United States noted that the prevalence of ureteric stones among African Americans to be less than 50% in comparison to the Caucasians and the Mexican Americans 6 .…”

Epidemiology and Natural History of Nephrolithiasis

“…Increasing prevalence and incidence in recent years across differences of age, gender, and race has been observed in most developed countries for which data are available, including Japan and several European nations [6,7]. In the Atherosclerosis Risk in Communities (ARIC) study, a large (n = 12,161) population-based study of middle-aged adults, kidney stone prevalence was associated with white race and male gender, but the association of kidney stones with serum triglycerides and gallstones was stronger in African Americans than in whites [8]. Lifetime risk has been estimated at 12% in men and 6% in women [3].…”