Dataset Information

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.

SUBMITTER: Yuan M

PROVIDER: S-EPMC8519881 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Publications

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

Yuan Min M Zhou Huang-Yan HY Hu Fan F Liu Shi-Ying SY Rao Wei W Wu Ling-Feng LF Nie Hong-Bing HB Cao Wen-Feng WF

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology 20210219 11

<h4>Background</h4>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.<h4>Methods</h4>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 ...[more]

PMID: 33606128

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Project description:ObjectivesNephrolithiasis, with a prevalence of 9% and increasing worldwide, has a recurrence rate close to 50%. Urinary stones significantly impact quality of life and impose substantial economic burdens on patients and healthcare systems. Systemic inflammation is postulated as a risk factor for urinary stones. Previous studies have identified associations between inflammatory markers and kidney stones, but these often rely on patient recall, introducing potential recall bias. This study investigates whether inflammatory markers vary according to the presence of nephrolithiasis using health check-up data from a large cohort in South Korea.Materials and methodsData were collected from participants in health checkups at a university hospital in Seoul between 2010 and 2020. The study included 18,243 males and 12,919 females who underwent blood tests, KUB (Kidneys, Ureters, and Bladder) radiography, and ultrasound examinations. Only stones larger than 5 mm were counted, enrolling 328 males and 99 females with kidney stones. Exclusion criteria included pyuria, congenital renal deformities, renal cancer, kidney transplant, and diuretic use. Inflammatory markers assessed included the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammatory index (SII). The primary outcome was the presence of nephrolithiasis, detected using combined ultrasonography and KUB radiography. Logistic regression analyses determined the association between inflammatory markers and nephrolithiasis, adjusting for confounders such as age, BMI, blood pressure, triglycerides, LDL, HDL, creatinine, BUN, uric acid, fasting glucose, calcium, and medical history.ResultsIn females, an LMR ≤ 5.02 (OR: 2.30, 95% CI: 1.47-3.61, p < 0.001), NLR > 1.94 (OR: 1.97, 95% CI: 1.24-3.12, p = 0.004), and SII > 484.05 (OR: 2.12, 95% CI: 1.38-3.24, p < 0.001) were significantly associated with kidney stones after adjusting for confounders. In males, an LMR ≤ 7.79 (OR: 1.82, 95% CI: 1.33-2.49, p < 0.001) and NLR > 1.32 (OR: 1.55, 95% CI: 1.12-2.15, p = 0.009) were significantly associated with kidney stones, but SII > 560.11 was not (OR: 1.21, 95% CI: 0.87-1.68, p = 0.255), after adjusting. The significant relationships between these inflammatory markers and kidney stones were maintained only in participants aged ≥ 50 years. Specifically, in females aged ≥ 50 years, LMR ≤ 5.02 (OR: 2.38, 95% CI: 1.52-3.74, p < 0.001), NLR > 1.94 (OR: 2.05, 95% CI: 1.30-3.24, p = 0.002), and SII > 484.05 (OR: 2.18, 95% CI: 1.43-3.32, p < 0.001) were significant predictors of nephrolithiasis. In males aged ≥ 50 years, LMR ≤ 7.79 (OR: 1.90, 95% CI: 1.38-2.62, p < 0.001) and NLR > 1.32 (OR: 1.62, 95% CI: 1.17-2.25, p = 0.004) were significant predictors.ConclusionElevated inflammatory markers are significantly associated with the presence of kidney stones, particularly in individuals aged 50 years or older. These findings suggest that systemic inflammation plays a crucial role in the pathogenesis of nephrolithiasis, especially in the older population. The results imply that inflammation contributes to the increasing prevalence of urinary stones with age, highlighting the importance of managing systemic inflammation in preventing nephrolithiasis. Future research would be needed to explore causal relationships and investigate whether anti-inflammatory interventions can reduce the risk of kidney stones.

Dataset Information

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

Background

Methods

Results

Conclusions

Publications

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

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