Published: Oct 24, 2014
By Kristina Fiore, Staff Writer, MedPage Today
Patients who have kidney stones may be at increased risk of fracture, researchers found.
In a retrospective cohort study, men who’d had kidney stones had a higher risk of fracture than men who didn’t have urolithiasis (HR 1.13, 95% CI 1.08-1.18), according to Michelle Denburg, MD, of Children’s Hospital of Philadelphia, and colleagues.
Risk was also elevated among women ages 30 to 79 (HR 1.55, 95% CI 1.261.90), they reported online in the Clinical Journal of the American Society of Nephrology.
“Our data cannot establish a causal mechanism, but clearly confirm the association between urolithiasis and risk of subsequent fracture,” they wrote. “Current evidence points to an association between hypercalciuria and diminished bone mineral density.”
A large portion of patients with recurrent kidney stones have hypercalciuria, which can lead to negative calcium balance and compromised bone remodeling. However, it remains unclear whether kidney stones and fracture are linked.
Denburg and colleagues reviewed data from the electronic medical records of 553 general practices in the U.K., assessing 51,785 patients with kidney stones and 517,267 matched controls. Their median age was 53 years, and 67% were male.
The researchers found that the median time from kidney stone diagnosis to first fracture was 10 years.
They also saw a higher risk of fracture in men who’d had kidney stones (HR 1.13, 95% CI 1.08-1.18), with the strongest relationship among those ages 10 to 19 (HR 1.55, 95% CI 1.07-2.25). It was also significant in those ages 40 to 49, 50 to 59, and 80 to 89.
Among women who’d had a kidney stone, the risk of fracture was elevated in those ages 30 to 79, with the greatest risk in women ages 30 to 39, they found (HR 1.52, 95% CI 1.23-1.87).
“The significantly higher risk at certain ages in males and females has profound public health implications,” Denburg said in a statement. “Given that the median time from diagnosis of urolithiasis to fracture was a decade, we might be able to intervene during this interval to reduce the burden of future fracture.”