Vascular Disease and Kidney Stones: Abdominal Aortic Calcifications Are Associated with Low Urine pH and Hypocitraturia

Patel, Nishant; Ward, Ryan D.; Calle, Juan; Remer, Erick M.; Monga, Manoj

doi:10.1089/end.2017.0350

Cited by 20 publications

(17 citation statements)

References 26 publications

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“…In a longitudinal epidemiologic study (CARDIA) Reiner and associates [25] found that the kidney stone formers had greater carotid artery wall thickness. Patel and colleagues [26] demonstrated that the presence of abdominal aortic calcification found on CT was associated with uric acid stone formation, low urine pH, and hypocitraturia.…”

Section: Cardiovascular Disease and Urolithiasismentioning

confidence: 99%

The influence of metabolic syndrome and its components on the development of nephrolithiasis

Boyd

Wood

Whitaker

et al. 2018

Asian Journal of Urology

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The prevalence of kidney stone disease is increasing, afflicting 7%–11% of the United States population. Multiple systemic conditions, including obesity and diabetes, are also on the rise. Further, the literature has demonstrated a strong association between metabolic syndrome, its components, and kidney stone disease. In this article, we aim to review the associations of metabolic syndrome and nephrolithiasis, discussing the pathophysiology, urinary parameters, and clinical presentations. With this knowledge, urologists will have a more comprehensive understanding of this complex population of metabolic stone formers enabling improved patient management and treatment of stone disease.

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Section: Cardiovascular Disease and Urolithiasismentioning

confidence: 99%

The influence of metabolic syndrome and its components on the development of nephrolithiasis

Boyd

Wood

Whitaker

et al. 2018

Asian Journal of Urology

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“…Furthermore, a positive association between risk factors for coronary artery disease (smoking) was reported (33). Finally, abdominal aortic calcification found on CT have been associated with uric acid stone formation, low urine pH and hypocitraturia (34).…”

Section: Discussionmentioning

confidence: 96%

The new patterns of nephrolithiasis: What has been changing in the last millennium?

Cicerello

Ciaccia

Cova

et al. 2021

Arch Ital Urol Androl

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Nephrolithiasis has been increasing over the last millennium. Although early epidemiologic studies have shown that kidney stones were two to three times more frequent in males than in females, recent reports have suggested that this rate is decreasing. In parallel a dramatic increase of nephrolithiasis has also been observed among children and adolescents. Furthermore, epidemiologic studies have shown a strong association between metabolic syndrome (Mets) traits and kidney stone disease. Patients with hypertension have a higher risk of stone formation and stone formers are predisposed to develop hypertension compared to the general population. An incidence of nephrolithiasis greater than 75% has been shown in overweight and obese patients compared to those of normal weight. It has also been reported that a previous diagnosis of diabetes mellitus increases the risk of future nephrolithiasis. Additionally, an association between metabolic syndrome and uric acid stone formation has been clearly recognized. Furthermore, 24-h urinary metabolic abnormalities have been decreasing among patients with nephrolithiasis over the last decades. Finally, nephrolithiasis could cause chronic kidney disease (CKD) and end stage renal disease (ESRD), especially in women and overweight patients. According to these observations, a better understanding of these new features among stone former patients may be required. Hence, the recognition and the correction of metabolic disorders could help not only to reduce the primary disease, but also stone recurrence.

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“…Unlike prior studies, we used a standardized system working with our radiology colleagues to quantify the amount of calcifications at two anatomic sites. The semiautomated system was previously described by Patel et al, 9 who described an association between abdominal aortic calcifications and low urine pH and hypocitraturia. The significant correlation between calcifications and stone disease in this study, along with prior publications, supports a vascular theory of the development of kidney stones.…”

Section: Discussionmentioning

confidence: 99%

“…Noncontrast CT scans were evaluated and semiautomated CT software (Aquarius iNtuition version 4.4.5; TeraRecon, Inc., San Francisco, CA) were utilized to provide an abdominal aorta (AA), pancreas, and splenic artery (SA) calcification Agatston score, as per previously described methods. 9,10 A detection threshold of 130 HU was used on 3 mm slices. The calcification scores were categorized into four groups: none (score 0), mild (>0-100), intermediate (>100-400), and severe (>400).…”

Section: Methodsmentioning

confidence: 99%

Nonrenal Systemic Arterial Calcification Predicts the Formation of Kidney Stones

Stern

Ward

et al. 2019

Journal of Endourology

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Background: Recent data indicate that kidney stone formers (KSFs) may have increased biomineralization at anatomic sites throughout the body compared with nonstone formers (NSFs). The objective of this study is to compare the volume of nonrenal systemic calcifications between KSF and NSF by using a standardized system to analyze calcifications in the abdominal aorta (AA) and splenic artery (SA). Methods: The NSF cohort was obtained from a kidney donor's prospectively maintained database. One hundred ninety-seven NSF were matched to 197 KSF based on age, gender, and body mass index. Noncontrast CT scans were evaluated and semiautomated CT software was utilized to provide an AA and SA calcification Agatston score. Wilcoxon rank-sum test was used on continuous variables and chi-squared test or Fisher's exact test on categorical variables. Odds ratios (ORs) were given for a variable's influence on the formation of stones or calcifications. Results: AA and SA calcifications were more prevalent in the KSF group (p = 0.011 and p = 0.027, respectively). KSFs were 1.9 times more likely to have intermediate or severe AA calcification than NSFs (OR = 1.9, p = 0.004). Severe AA calcifications had even a greater association (OR = 3.1, p = 0.019). KSFs were also more likely to have SA, but this did not reach statistical significance (OR = 3.7, p = 0.103). Conclusion: Patients with increased systemic calcifications, specifically aortic or splenic calcifications, may be at an increased risk for future kidney stone formation. Patients with these imaging findings and additional risk factors for stone disease may be counseled on the future risk of stones.

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Vascular Disease and Kidney Stones: Abdominal Aortic Calcifications Are Associated with Low Urine pH and Hypocitraturia

Abstract: NCCT-based diagnosis of AAC is associated with low urine pH, hypocitraturia, and uric acid stone formation. The presence of AAC could be considered an additional prognosticator for the utility of alkalinization therapy.

Cited by 20 publications

References 26 publications

The influence of metabolic syndrome and its components on the development of nephrolithiasis

The influence of metabolic syndrome and its components on the development of nephrolithiasis

The new patterns of nephrolithiasis: What has been changing in the last millennium?

Nonrenal Systemic Arterial Calcification Predicts the Formation of Kidney Stones

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