Risk of hypertension among first-time symptomatic kidney stone formers

Wonngarm Kittanamongkolchai, Kristin C. Mara, Ramila A. Mehta, Lisa E. Vaughan, Aleksandar Denic, John J. Knoedler, Felicity T. Enders, John C. Lieske, Andrew D. Rule

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and objectives Prior work has suggested a higher risk of hypertension in kidney stone formers but lacked disease validation and adjustment for potential confounders. Certain types of stone formers may also be at higher risk of hypertension. Design, setting, participants, & measurements In our study, incident symptomatic stone formers in Olmsted County from 2000 to 2011 were manually validated by chart review and age and sex matched to Olmsted County controls. We followed up patients through November 20, 2015. Hypertension was also validated by manual chart review, and the risk of hypertension in stone formers compared with controls was assessed both univariately and after adjusting for comorbidities. The risk of hypertension among different subtypes of stone formers was also evaluated. Results Among 3023 coded stone formers from 2000 to 2011, a total of 1515 were validated and matched to 1515 controls (mean age was 45 years old, and 56% were men). After excluding those with baseline hypertension (20% of stone formers and 18% of controls), 154 stone formers and 110 controls developed hypertension. Median follow-up time was 7.8 years in stone formers and 9.6 years in controls. Stone formers were found to have a higher risk of hypertension compared with controls (hazard ratio, 1.50; 95% confidence interval, 1.18 to 1.92), even after adjusting for age, sex, body mass index, serum creatinine, CKD, diabetes, gout, coronary artery disease, dyslipidemia, tobacco use, and alcohol abuse (hazard ratio, 1.58; 95% confidence interval, 1.12 to 2.21). Results were similar after excluding patients who were ever on a thiazide diuretic (hazard ratio, 1.65; 95% confidence interval, 1.16 to 2.38). Stone composition, radiographic stone burden, number of subsequent stone events, and stone removal surgeries were not associated with hypertension (P.0.05 for all). Conclusions The risk of hypertension was higher after the first symptomatic kidney stone event. However, kidney stone severity, type, and treatment did not associate with hypertension.

Original languageEnglish (US)
Pages (from-to)476-482
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume12
Issue number3
DOIs
StatePublished - Jan 1 2017

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Kidney Calculi
Hypertension
Confidence Intervals
Sodium Chloride Symporter Inhibitors
Safety Management
Gout
Tobacco Use
Dyslipidemias
Alcoholism
Comorbidity
Coronary Artery Disease
Creatinine
Body Mass Index

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Kittanamongkolchai, W., Mara, K. C., Mehta, R. A., Vaughan, L. E., Denic, A., Knoedler, J. J., ... Rule, A. D. (2017). Risk of hypertension among first-time symptomatic kidney stone formers. Clinical Journal of the American Society of Nephrology, 12(3), 476-482. https://doi.org/10.2215/CJN.06600616
Kittanamongkolchai, Wonngarm ; Mara, Kristin C. ; Mehta, Ramila A. ; Vaughan, Lisa E. ; Denic, Aleksandar ; Knoedler, John J. ; Enders, Felicity T. ; Lieske, John C. ; Rule, Andrew D. / Risk of hypertension among first-time symptomatic kidney stone formers. In: Clinical Journal of the American Society of Nephrology. 2017 ; Vol. 12, No. 3. pp. 476-482.
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abstract = "Background and objectives Prior work has suggested a higher risk of hypertension in kidney stone formers but lacked disease validation and adjustment for potential confounders. Certain types of stone formers may also be at higher risk of hypertension. Design, setting, participants, & measurements In our study, incident symptomatic stone formers in Olmsted County from 2000 to 2011 were manually validated by chart review and age and sex matched to Olmsted County controls. We followed up patients through November 20, 2015. Hypertension was also validated by manual chart review, and the risk of hypertension in stone formers compared with controls was assessed both univariately and after adjusting for comorbidities. The risk of hypertension among different subtypes of stone formers was also evaluated. Results Among 3023 coded stone formers from 2000 to 2011, a total of 1515 were validated and matched to 1515 controls (mean age was 45 years old, and 56{\%} were men). After excluding those with baseline hypertension (20{\%} of stone formers and 18{\%} of controls), 154 stone formers and 110 controls developed hypertension. Median follow-up time was 7.8 years in stone formers and 9.6 years in controls. Stone formers were found to have a higher risk of hypertension compared with controls (hazard ratio, 1.50; 95{\%} confidence interval, 1.18 to 1.92), even after adjusting for age, sex, body mass index, serum creatinine, CKD, diabetes, gout, coronary artery disease, dyslipidemia, tobacco use, and alcohol abuse (hazard ratio, 1.58; 95{\%} confidence interval, 1.12 to 2.21). Results were similar after excluding patients who were ever on a thiazide diuretic (hazard ratio, 1.65; 95{\%} confidence interval, 1.16 to 2.38). Stone composition, radiographic stone burden, number of subsequent stone events, and stone removal surgeries were not associated with hypertension (P.0.05 for all). Conclusions The risk of hypertension was higher after the first symptomatic kidney stone event. However, kidney stone severity, type, and treatment did not associate with hypertension.",
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Kittanamongkolchai, W, Mara, KC, Mehta, RA, Vaughan, LE, Denic, A, Knoedler, JJ, Enders, FT, Lieske, JC & Rule, AD 2017, 'Risk of hypertension among first-time symptomatic kidney stone formers', Clinical Journal of the American Society of Nephrology, vol. 12, no. 3, pp. 476-482. https://doi.org/10.2215/CJN.06600616

Risk of hypertension among first-time symptomatic kidney stone formers. / Kittanamongkolchai, Wonngarm; Mara, Kristin C.; Mehta, Ramila A.; Vaughan, Lisa E.; Denic, Aleksandar; Knoedler, John J.; Enders, Felicity T.; Lieske, John C.; Rule, Andrew D.

In: Clinical Journal of the American Society of Nephrology, Vol. 12, No. 3, 01.01.2017, p. 476-482.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk of hypertension among first-time symptomatic kidney stone formers

AU - Kittanamongkolchai, Wonngarm

AU - Mara, Kristin C.

AU - Mehta, Ramila A.

AU - Vaughan, Lisa E.

AU - Denic, Aleksandar

AU - Knoedler, John J.

AU - Enders, Felicity T.

AU - Lieske, John C.

AU - Rule, Andrew D.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background and objectives Prior work has suggested a higher risk of hypertension in kidney stone formers but lacked disease validation and adjustment for potential confounders. Certain types of stone formers may also be at higher risk of hypertension. Design, setting, participants, & measurements In our study, incident symptomatic stone formers in Olmsted County from 2000 to 2011 were manually validated by chart review and age and sex matched to Olmsted County controls. We followed up patients through November 20, 2015. Hypertension was also validated by manual chart review, and the risk of hypertension in stone formers compared with controls was assessed both univariately and after adjusting for comorbidities. The risk of hypertension among different subtypes of stone formers was also evaluated. Results Among 3023 coded stone formers from 2000 to 2011, a total of 1515 were validated and matched to 1515 controls (mean age was 45 years old, and 56% were men). After excluding those with baseline hypertension (20% of stone formers and 18% of controls), 154 stone formers and 110 controls developed hypertension. Median follow-up time was 7.8 years in stone formers and 9.6 years in controls. Stone formers were found to have a higher risk of hypertension compared with controls (hazard ratio, 1.50; 95% confidence interval, 1.18 to 1.92), even after adjusting for age, sex, body mass index, serum creatinine, CKD, diabetes, gout, coronary artery disease, dyslipidemia, tobacco use, and alcohol abuse (hazard ratio, 1.58; 95% confidence interval, 1.12 to 2.21). Results were similar after excluding patients who were ever on a thiazide diuretic (hazard ratio, 1.65; 95% confidence interval, 1.16 to 2.38). Stone composition, radiographic stone burden, number of subsequent stone events, and stone removal surgeries were not associated with hypertension (P.0.05 for all). Conclusions The risk of hypertension was higher after the first symptomatic kidney stone event. However, kidney stone severity, type, and treatment did not associate with hypertension.

AB - Background and objectives Prior work has suggested a higher risk of hypertension in kidney stone formers but lacked disease validation and adjustment for potential confounders. Certain types of stone formers may also be at higher risk of hypertension. Design, setting, participants, & measurements In our study, incident symptomatic stone formers in Olmsted County from 2000 to 2011 were manually validated by chart review and age and sex matched to Olmsted County controls. We followed up patients through November 20, 2015. Hypertension was also validated by manual chart review, and the risk of hypertension in stone formers compared with controls was assessed both univariately and after adjusting for comorbidities. The risk of hypertension among different subtypes of stone formers was also evaluated. Results Among 3023 coded stone formers from 2000 to 2011, a total of 1515 were validated and matched to 1515 controls (mean age was 45 years old, and 56% were men). After excluding those with baseline hypertension (20% of stone formers and 18% of controls), 154 stone formers and 110 controls developed hypertension. Median follow-up time was 7.8 years in stone formers and 9.6 years in controls. Stone formers were found to have a higher risk of hypertension compared with controls (hazard ratio, 1.50; 95% confidence interval, 1.18 to 1.92), even after adjusting for age, sex, body mass index, serum creatinine, CKD, diabetes, gout, coronary artery disease, dyslipidemia, tobacco use, and alcohol abuse (hazard ratio, 1.58; 95% confidence interval, 1.12 to 2.21). Results were similar after excluding patients who were ever on a thiazide diuretic (hazard ratio, 1.65; 95% confidence interval, 1.16 to 2.38). Stone composition, radiographic stone burden, number of subsequent stone events, and stone removal surgeries were not associated with hypertension (P.0.05 for all). Conclusions The risk of hypertension was higher after the first symptomatic kidney stone event. However, kidney stone severity, type, and treatment did not associate with hypertension.

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