Kidney Stones Tied to Increased Risk of Chronic Kidney Disease

Kidney stones are an important risk factor for chronic kidney disease (CKD), researchers found when they studied the records of all residents of Olmstead County, Minn., over a 20-year span.

Kidney stones are known to lead to CKD in patients with rare genetic diseases, but their role as a risk factor for CKD in the general population had been less clear. Researchers generally thought that complications of kidney stones only rarely cause CKD; however, few long-term studies looked at the question.

John Lieske, MD, and his colleagues at the Mayo Clinic in Rochester, Minn., looked at the clinical records of the Olmstead County residents from 1984 to 2003. In total, 4424 stone formers and 10,995 controls were followed up, on average, for more than eight years. The data came from the Rochester Epidemiology Project, a medical documentation system that includes records from the Mayo Clinic and other community providers in the county.

Individuals diagnosed with kidney stones were significantly more likely to develop CKD, the researchers found. Those who formed kidney stones had a 60 percent greater risk of developing CKD and a 40 percent increased risk of developing end stage renal disease.

“This study strengthens the association of a diagnosis of kidney stones as a risk factor for the development of chronic kidney disease,” said Elaine Worcester, MD, professor of medicine in the nephrology section at the University of Chicago. “As yet unknown are the mechanisms by which stones may lead to CKD.” Possible factors associated with increased risk of CKD could be certain stone types, metabolic abnormalities such as severe hyperoxaluria, the need for multiple surgeries for stone removal, or complications such as urinary tract infection or repeated obstruction, Worcester said.

“Patients with kidney stones should be carefully evaluated for CKD and its risk factors, and they should be appropriately treated for any that are identified,” Lieske said. “Further studies on potential treatment options are needed, for example, whether treatments to prevent stone recurrence would reduce risk of further CKD progression.”

The study, “Kidney Stones Are Associated with an Increased Risk of Developing Chronic Kidney Disease” was part of the Renal Week session on “Chronic Kidney Disease: Its Prediction, Prevention, and Treatment.”