#1029 Factors associated with chronic kidney disease in patients with recurrent kidney stones: a case-control study
Authors: Coronado-Daza Jorge Antonio , Bustos-Salazar Diego , Pantoja-Espinosa Angélica 
Published: May 2024

Abstract

Background and Aims
Kidney stones have been described in multiple studies as an independent risk factor for chronic kidney disease (CKD). However, this relationship remains partially understood, and there is limited local, regional, and national information available. While common factors contribute to both kidney stones and CKD development, other factors favoring CKD occurrence in patients with recurrent renal lithiasis have been reported. This study aimed to identify factors associated with chronic kidney disease in patients with recurrent renal lithiasis in the city of Cartagena, Colombia.

Method
This was an observational nested case-control study within a cohort, where cases were patients diagnosed with recurrent kidney stones who developed CKD during follow-up, and controls were patients with recurrent kidney stones without CKD during follow-up. The cohort comprised all adult patients with recurrent kidney stones between 2010 and 2019, without an initial diagnosis of CKD, and with a minimum follow-up period of two years or more. Data on demographic variables (age, gender, type of insurance), clinical factors (overweight, history of hyperuricemia, diabetes mellitus, hypertension, dyslipidemia, alcohol consumption, smoking, exercise habits), and variables related to recurrent kidney stones (course of kidney stones, onset time of CKD, metabolic disorders, history of renal colic, stone localization, number, and size) were collected. Variables associated with the development of chronic kidney disease were identified using association measures via the chi-square test. Variables of clinical and statistical significance were further analyzed for association using multivariable logistic regression.

Results
The study included 31 cases and 39 controls, with mean ages of 65.2±11.5 and 51.8±14.6 years, respectively (p=0.00002). The duration of recurrent kidney stones was 174.7±148.6 and 163.3±129.5 months for cases and controls (p=0.738). The onset time of CKD was 61.1±35.4 months. Among cases, 93.5% were men, 77.4% were hypertensive, and 67.9% had dyslipidemia, significantly differing from the controls (see Table 1). There were no differences between cases and controls concerning the duration of recurrent kidney stones, type of health insurance, overweight status, hyperuricemia, diabetes mellitus, exercise habits, metabolic study alterations, history of renal colic, renal stone localization, number, and size. The difference was borderline for alcohol consumption and smoking habits.
Multivariable logistic regression, incorporating variables with statistical significance (age, gender, hypertension, alcohol consumption, smoking habit) into the model, revealed that higher age corresponds to a greater risk of CKD (Odds ratio 1.052; 95% CI, 1.003 to 1.103). Furthermore, the male gender exhibited a 5.5 times higher likelihood of suffering from CKD (Odds ratio 5.5; 95% CI, 1.2 to 26.5).

Conclusion
In patients with recurrent kidney stones, higher age, and male gender were identified as factors associated with the development of CKD.