EAU 2017: State-of-the-art Lecture – Stones And Cardiovascular Disease: More Than A Coincidence?

London, England (UroToday.com) Initial reports linking cardiovascular diseases (CVD) and stone disease date back to the 1970’s. Most reports however are small cohort studies and used surrogate endpoints. For hypertension (HTN) and chronic kidney stone disease, relations have been indicated, but the mechanism has not yet been fully elucidated. All three diseases (AHT, CVD and CKD) are probably realated to stone disease, but: “relation is not necessarily causation”.

In the past 10 years stones have been correlated to more CV events and atherosclerosis. The largest database to date shows that after adjusting for confounding factors, this effect may be largest for women. With an increase in DM, BMI and stones in kids, should we be concerned to see more CVD in the future? Indeed, study published by Kusumi and colleagues in Journal of Pediatrics showed a correlation between carotid thickness and urinary stone disease in a pediatric population4. He also showed a correlation with osteopontin, which appears to be enhancer of atherosclerosis. Summarizing the data so far, there seems to be a consistent association of stone disease with CVD risk. BUT? Is the CV risk related to the presence of randalls plaques? There may be a link between calciprotein particles, which are pro-inflammatory. They may have a causal role in both calcifications in the papilla and in the vascular wall.

In conclusion, there is a significant correlation of stone disease and risk of CVD and future studies are needed to elucidate the root causes, mechanism of impacts, diagnosis and most importantly prevention methods in high risk patients.

Presenter: Beat Roth, MD; Department of Urology, University of Bern, Bern, Switzerland

Written By: Zhamshid Okhunov, MD, University of California, Irvine

at the #EAU17 - March 24-28, 2017- London, England

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