Correlates of kidney stone disease differ by race in a multi-ethnic middle-aged population: The ARIC study
Introduction
In the US, lifetime risk for kidney stone formation exceeds 12% in males and 6% in females (Johnson et al., 1979, Stamatelou et al., 2003, Gillen et al., 2005b). Increasing prevalence of kidney stones over time has partly been attributed to the increasing prevalence of obesity and type 2 diabetes (Stamatelou et al., 2003, Taylor et al., 2005a, Taylor et al., 2005b; Stamatelou et al., 2003, Taylor et al., 2005a, Taylor et al., 2005b). The high prevalence of kidney stones and recurrence rates of 30–40% (Coe et al., 1977) resulted in annual costs of 2 billion dollars in the US in 2000.
Known risk factors for kidney stones include diabetes (Taylor et al., 2005a, Daudon et al., 2006) and other cardiovascular disease risk factors such as hypertension, hypercholesterolemia and excess weight (Taylor et al., 2005b, Ramey et al., 2004). Individual components of the metabolic syndrome may be independent risk factors for kidney stone disease, and recent evidence suggests that it may be a systemic disorder (Ramey et al., 2004, West et al., 2008, Sakhaee, 2008). Dietary factors are also known to influence risk of stone formation (Curhan et al., 1993, Siener, 2006). Known hereditary syndromes and recent population-based studies additionally support a genetic component to kidney stone disease (Thorleifsson et al., 2009). Men and individuals of white race seem to be at a higher risk for kidney stone disease than women and African Americans, respectively (Stamatelou et al., 2003, Gillen et al., 2005b, Daudon et al., 2006, Ramey et al., 2004, Borghi et al., 1999, Curhan et al., 2005, Gillen et al., 2005a, Hiatt et al., 1982, Siener et al., 2004, Soucie et al., 1996), but many previous studies have focused on only one ethnic group or gender.
We aimed to identify correlates of a history of kidney stone disease in a cohort study among 9,541 white and 2,620 African American middle-aged participants of the Atherosclerosis Risk in Communities (ARIC) Study, and to assess the importance of these correlates across races and both cross-sectionally and prospectively.
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Study population
The ARIC Study is an ongoing prospective population-based cohort study of 15,792 adults aged 45–64 years at enrolment. Between 1987 and 1989 (Visit 1), approximately 4,000 individuals were recruited from each of four participating US communities (Forsyth County, North Carolina; Jackson, Mississippi; suburban Minneapolis, Minnesota; Washington County, Maryland). In-home interviews, laboratory measurements and clinical examinations were conducted after informed consent was obtained. Three
Results
Of 12,161 study participants, 8.0%, 12.0% of men and 4.8% of women, reported a history of physician-diagnosed kidney stones. Individuals reporting kidney stones were more likely to be male, to have higher concentrations of serum triglycerides and uric acid and to have lower HDL cholesterol compared to those not reporting kidney stones (Table 1). Co-morbidities such as diabetes, gout and gallstone disease were found more frequently in those reporting kidney stone disease. Mean BMI, waist
Discussion
Our study in a large biracial population provides estimates of kidney stone disease prevalence and of the incidence of kidney stone disease-related hospitalizations. We identify novel correlates of prevalent kidney stone disease, serum triglycerides and gallstone disease, as well as confirm known correlates, male gender, white race, region of residence, and diabetes. Significant interactions with race were observed, with older age, higher triglycerides and gallbladder disease showing stronger
Conflict of interest statement
The authors declare that there are no conflicts of interest.
Acknowledgments
The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by the National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021 and N01-HC-55022. The authors thank the staff and participants of the ARIC study for their important contributions. We thank Dr. Gary Curhan for helpful discussions and critical review of the manuscript. Some of the data in this abstract has been presented at
References (30)
- et al.
Essential arterial hypertension and stone disease
Kidney Int.
(1999) - et al.
Regional variation in nephrolithiasis incidence and prevalence among United States men
J. Urol.
(1994) - et al.
Nephrolithiasis and increased blood pressure among females with high body mass index
Am. J. Kidney Dis.
(2005) - et al.
Decreased renal function among adults with a history of nephrolithiasis: a study of NHANES III
Kidney Int.
(2005) - et al.
Renal stone epidemiology: a 25-year study in Rochester, Minnesota
Kidney Int.
(1979) - et al.
Nephrolithiasis and risk of hypertension
Am. J. Hypertens.
(1998) - et al.
Nephrolithiasis and risk of hypertension in women
Am. J. Kidney Dis.
(1998) - et al.
Metabolic syndrome and uric acid nephrolithiasis
Semin. Nephrol.
(2008) - et al.
Demographic and geographic variability of kidney stones in the United States
Kidney Int.
(1994) - et al.
Time trends in reported prevalence of kidney stones in the United States: 1976-1994
Kidney Int.
(2003)
Diabetes mellitus and the risk of nephrolithiasis
Kidney Int.
Metabolic syndrome and self-reported history of kidney stones: the National Health and Nutrition Examination Survey (NHANES III) 1988–1994
Am. J. Kidney Dis.
The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives
Am. J. Epidemiol.
Kidney stones and hypertension: population based study of an independent clinical association
BMJ
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