Revista de Nefrología, Diálisis y Trasplante (Jul 2019)
Nephrolithiasis and cardiovascular risk
Abstract
Renal lithiasis is a frequent disease whose prevalence has increased in recent years. Nowadays it is considered as a systemic pathology, not limited to the kidney and the urinary tract, but largely related to diabetes mellitus, obesity, hypertension, hyperuricemia, hypercholesterolemia and chronic kidney disease; all cardiovascular risk factors that are usually linked to severe events such as stroke, coronary heart disease or acute myocardial infarction. Numerous cross-sectional studies and meta-analyzes have proved the association between renal lithiasis and cardiovascular disease. In this review we will try to demonstrate the mechanisms involved in the pathophysiology of these two entities. Three associations are mentioned. The first one refers to oxidative stress and inflammation. The second association refers to the presence of lithogenetic mechanisms contributing to vascular calcification. The last theory is the already known correlation with obesity, metabolic syndrome, diabetes and hypertension; all risk factors for the development of renal lithiasis as well as cardiovascular disease. Let us remember that renal lithiasis is the cause, in 8% of cases, of the development of chronic kidney disease, another risk factor for cardiovascular disease and death. In conclusion, the theory that renal lithiasis is not a disease limited to the kidney and the urinary tract is confirmed; it is rather a systemic disease, with a risk of cardiovascular events so severe that they can lead to death.