Association Between Kidney Stone History and Cardiovascular Event Risk in US Adults.

Objective: To determine the association between kidney stone history and predicted 10-year risk of atherosclerotic cardiovascular disease (CVD) events in a nationally representative US adult sample without existing CVD.

Methods: This was a cross-sectional study of the 2017-2020 National Health and Nutrition Examination Survey that included a nationally representative sample of 3842 adults aged 40-79 free from CVD. Kidney stone history was assessed through self-reporting. The 10-year risk of an atherosclerotic CVD event was predicted using the American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort Equations.

Results: The weighted prevalence of kidney stones was 12.2% (95% CI: 10.5% to 14.1%). In unadjusted analysis, the odds of borderline or higher (≥5%) atherosclerotic CVD risk were higher in stone formers (odds ratio=1.56; 95% CI 1.01-2.40; P = .046). This association persisted after adjustment for demographics and clinical covariates (adjusted odds ratio=1.57; 95% CI=1.02 to 2.43; P = .04). A significant interaction by biological sex was identified (P = .002), with excess risk conferred by kidney stones in males but not females.

Conclusion: Kidney stone history was independently associated with increased 10-year predicted atherosclerotic CVD event risk, with excess risk observed among males but not females. Intensified CVD screening may be warranted among stone formers given their increased cardiovascular risk.