In the Journals

Kidney stones linked to atherosclerosis risk in children

Preliminary research indicates that children with kidney stones may have a higher risk for atherosclerosis, according to a study published in The Journal of Pediatrics.

“If the processes of kidney stone formation and hardening of the arteries are somehow linked in adults, it makes sense that a similar link may exist in children,” Kirsten Kusumi, MD, nephrology fellow, Nationwide Children’s Hospital, Columbus, Ohio, said in a press release. “We wanted to learn whether and why children who have kidney stones may already be showing damage to their arteries.”

Kirsten Kusumi, MD

Kirsten Kusumi

The researchers examined 15 children aged 12 to 17 years with kidney stone passage within 6 months of enrollment and 15 without kidney stones between February and November 2014 at the Nationwide Children’s Hospital. Children with a family history of kidney stones within one generation or who were diagnosed with existing morbidities were excluded to accurately assess the association, according to the researchers.

Children were matched by age, sex and BMI. Ultrasound was used to evaluate carotid artery intima-media thickness, a well-established marker for early atherosclerosis. Urine samples were examined for atherosclerosis-related proteins.

Children with kidney stones had higher carotid artery intima-media thickness for the right common carotid artery (mean, 0.46 mm vs. 0.41 mm; P = .01) and the overall median of all carotid artery intima-media thickness measurements (P = .03) compared with children without kidney stones. There were no differences in right common carotid artery bulb (P = .14), left common carotid artery (P = .88) and left common carotid artery (P = .08) measurements in children with kidney stones vs. controls.

The researchers also studied the correlation between urine proatherosclerotic proteins, carotid artery intima-media thickness and kidney stones. Results revealed a trend toward higher fibronectin 1 (P = .15) and vascular cell adhesion protein 1 (P = .2) levels in children with kidney stones vs. controls. According to multiple regression analysis, stone status (P = .03) and osteopontin (P = .006) were predictors of carotid artery intima-media thickness in both groups.

“The finding that urine [osteopontin] levels positively correlate with [carotid artery intima-media thickness] raises the possibility that renal production of [osteopontin] may be associated with atherosclerosis,” Kusumi and colleagues wrote.

“The implications may be very important [for] further studies to characterize this association and address [CV] risk at an early age for these high-risk patients,” Kusumi told Cardiology Today.

Because there was a clear association between kidney stones and atherosclerosis beginning in childhood, preventive measures could be implemented during childhood, the researchers wrote.

Future research should expand the number of participants, include kidney stone subtypes and potential molecular processes, and clarify the role of inflammation and innate immunity in stone pathogenesis, according to the researchers. – by Trish Shea, MA

Disclosure: The researchers report no relevant financial disclosures.

Preliminary research indicates that children with kidney stones may have a higher risk for atherosclerosis, according to a study published in The Journal of Pediatrics.

“If the processes of kidney stone formation and hardening of the arteries are somehow linked in adults, it makes sense that a similar link may exist in children,” Kirsten Kusumi, MD, nephrology fellow, Nationwide Children’s Hospital, Columbus, Ohio, said in a press release. “We wanted to learn whether and why children who have kidney stones may already be showing damage to their arteries.”

Kirsten Kusumi, MD

Kirsten Kusumi

The researchers examined 15 children aged 12 to 17 years with kidney stone passage within 6 months of enrollment and 15 without kidney stones between February and November 2014 at the Nationwide Children’s Hospital. Children with a family history of kidney stones within one generation or who were diagnosed with existing morbidities were excluded to accurately assess the association, according to the researchers.

Children were matched by age, sex and BMI. Ultrasound was used to evaluate carotid artery intima-media thickness, a well-established marker for early atherosclerosis. Urine samples were examined for atherosclerosis-related proteins.

Children with kidney stones had higher carotid artery intima-media thickness for the right common carotid artery (mean, 0.46 mm vs. 0.41 mm; P = .01) and the overall median of all carotid artery intima-media thickness measurements (P = .03) compared with children without kidney stones. There were no differences in right common carotid artery bulb (P = .14), left common carotid artery (P = .88) and left common carotid artery (P = .08) measurements in children with kidney stones vs. controls.

The researchers also studied the correlation between urine proatherosclerotic proteins, carotid artery intima-media thickness and kidney stones. Results revealed a trend toward higher fibronectin 1 (P = .15) and vascular cell adhesion protein 1 (P = .2) levels in children with kidney stones vs. controls. According to multiple regression analysis, stone status (P = .03) and osteopontin (P = .006) were predictors of carotid artery intima-media thickness in both groups.

“The finding that urine [osteopontin] levels positively correlate with [carotid artery intima-media thickness] raises the possibility that renal production of [osteopontin] may be associated with atherosclerosis,” Kusumi and colleagues wrote.

“The implications may be very important [for] further studies to characterize this association and address [CV] risk at an early age for these high-risk patients,” Kusumi told Cardiology Today.

Because there was a clear association between kidney stones and atherosclerosis beginning in childhood, preventive measures could be implemented during childhood, the researchers wrote.

Future research should expand the number of participants, include kidney stone subtypes and potential molecular processes, and clarify the role of inflammation and innate immunity in stone pathogenesis, according to the researchers. – by Trish Shea, MA

Disclosure: The researchers report no relevant financial disclosures.