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Urolithiasis

, Volume 43, Issue 1, pp 49–53 | Cite as

Dyslipidemia is associated with an increased risk of nephrolithiasis

  • James H. Masterson
  • Jason R. Woo
  • David C. Chang
  • Thomas Chi
  • James O. L’Esperance
  • Marshall L. Stoller
  • Roger L. SurEmail author
Original Paper

Abstract

The pathophysiology of nephrolithiasis is multifactorial. Obesity, diabetes mellitus and hypertension are implicated in its formation. Dyslipidemia (DLD) recently has received attention as well. Congruent with a vascular etiology in stone formation, DLD theoretically would predispose patients to nephrolithiasis. We investigated a possible association of DLD with nephrolithiasis. A random cohort of 60,000 patients was established by collecting the first 5,000 patient charts per month in the year 2000. After excluding pediatric patients, a retrospective study was performed by reviewing age, sex, comorbidities, and last patient follow-up. Median lipid laboratory levels also were reviewed. Descriptive statistics were performed as well as Cox proportional-hazards regression analysis, and univariate and multivariate analyses. 52,184 (22,717 women/29,467 men) patient charts were reviewed. The average age was 31.0 ± 15.2 years. On univariate analysis, DLD was associated with nephrolithiasis with a hazard ratio (HR) of 2.2 [Confidence Interval (CI), 1.9–2.5; p < 0.001] and on multivariate analysis HR = 1.2 (1.0–1.5; p = 0.033). Low-density lipoprotein and triglycerides had no association with stone disease. Patients with high-density lipoprotein (HDL) values <45 for men and <60 for women had an HR of 1.4 (1.1–1.7, 95% CI, p = 0.003) on univariate analysis and on multivariate analysis; HR = 1.27 (1.03–1.56; p = 0.024) for nephrolithiasis. DLD was associated with an increased risk of stone disease though the only specific lipid panel associated with lower nephrolithiasis was HDL. Clinicians should consider obtaining lipid levels with the intent that treatment could potentially not only mitigate atherosclerotic disease but also decrease nephrolithiasis risk.

Keywords

Urolithiasis Dyslipidemia High-density lipoprotein 

Notes

Acknowledgments

We especially thank Sean Malloy for his diligence and hard work in creating a data set for analysis for this project.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • James H. Masterson
    • 1
  • Jason R. Woo
    • 2
  • David C. Chang
    • 3
  • Thomas Chi
    • 4
  • James O. L’Esperance
    • 1
  • Marshall L. Stoller
    • 4
  • Roger L. Sur
    • 2
    Email author
  1. 1.Department of UrologyNaval Medical Center San DiegoSan DiegoUSA
  2. 2.Department of Urology, UC San Diego Health SystemVA San Diego Healthcare System, UC San Diego Comprehensive Kidney Stone CenterSan DiegoUSA
  3. 3.Department of SurgeryUC San Diego School of MedicineSan DiegoUSA
  4. 4.Department of UrologyUC San Francisco Medical CenterSan FranciscoUSA

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