HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: CJN.05811108v1 4/4/804    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Rule, A. D. Articles by Lieske, J. C. Search for Related Content PubMed PubMed Citation Articles by Rule, A. D. Articles by Lieske, J. C.

Kidney Stones and the Risk for Chronic Kidney Disease

Andrew D. Rule^*,, Eric J. Bergstralh, L. Joseph Melton, III, Xujian Li, Amy L. Weaver, and John C. Lieske^*,

Departments of ^* Nephrology and Hypertension, Epidemiology, Biostatistics, and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota

Correspondence: Dr. Andrew D. Rule, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905. Phone: 507-284-8045; Fax: 507-284-1161; E-mail: rule.andrew{at}mayo.edu

Background and objectives: Kidney stones lead to chronic kidney disease (CKD) in people with rare hereditary disorders (e.g., primary hyperoxaluria, cystinuria), but it is unknown whether kidney stones are an important risk factor for CKD in the general population.

Design, setting, participants, & measurements: Among Olmsted County, MN, residents, all stone formers (n = 4774) whose condition was diagnosed in 1986 through 2003 were matched 1:3 to control subjects (n = 12,975). Cox proportional hazards models adjusted for age, gender, and comorbidities (hypertension, diabetes, obesity, dyslipidemia, gout, alcohol abuse, tobacco use, coronary artery disease, heart failure, cerebral infarct, and peripheral vascular disease) were used to assess the risk for incident CKD defined as a clinical diagnosis (diagnostic codes), ESRD or death with CKD, sustained (>90 d) elevated serum creatinine (>1.3 mg/dl in men, >1.1 mg/dl in women), or sustained estimated GFR <60 ml/min per 1.73 m².

Results: During a mean of 8.6 yr of follow-up, stone formers were at increased risk for a clinical diagnosis of CKD, but an increased risk for ESRD or death with CKD was NS. Among patients with follow-up serum creatinine levels, stone formers were at increased risk for a sustained elevated serum creatinine and a sustained reduced GFR.

Conclusions: Kidney stones are a risk factor for CKD, and studies are warranted to assess screening and preventive measures for CKD in stone formers.