Kidney stones may increase risk for chronic kidney disease

Kidney stones may damage the kidneys and lead to chronic kidney disease (CKD), according to a paper being presented at the American Society of Nephrology's 41st Annual Meeting and Scientific Exposition in Philadelphia, Pennsylvania.

In extreme cases, individuals with CKD caused by kidney stones may even need dialysis or kidney transplants.

Kidney stones lead to CKD in patients with rare genetic diseases, but it is unclear if they also are an important risk factor for CKD in the general population. In general, researchers have thought that complications of kidney stones can only rarely cause CKD, but studies that have looked at this potential link have been small or have had limited follow-up.

To get a better sense of the role that kidney stones may play in the development of CKD, John Lieske, MD, and his colleagues at the Mayo Clinic in Rochester, Minnesota, studied records of all residents of Olmsted County, MN, over a 20 year span (1984-2003). These data are available through the Rochester Epidemiology Project, a unique and extensive medical documentation system that combines clinical records from the Mayo Clinic and other community providers in the county.

The investigators compared residents diagnosed with kidney stones with individuals without stones, noting who went on to develop CKD as determined by diagnosis codes and laboratory tests. Those with kidney stones were matched 1:3 to controls in the general population so that a total of 4424 stone formers and 10995 controls were identified and followed up, on average, for more than eight years.

The researchers discovered that individuals diagnosed with kidney stones were significantly more likely to subsequently develop CKD. Specifically, stone formers had a 60% greater risk of developing CKD and a 40% increased risk of developing end-stage renal disease (ESRD), the most severe form of CKD.

The study indicates that 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, said Lieske.

Additional studies are needed to determine why patients with kidney stones are at increased risk for CKD. Studies on potential treatment options also are needed, such as studies to determine whether treatments to prevent stone recurrence would reduce risk of further CKD progression.

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