Cholelithiasis and the risk of nephrolithiasis

Abstract

Purpose: Existing data on the relation between gallstones and kidney stones are provocative but limited. Therefore, we determined whether symptomatic radiographically confirmed gallstones (and/or cholecystectomy) and symptomatic kidney stone disease are independently associated.

Materials and methods: We conducted cross-sectional and prospective analyses in the Nurses' Health Studies I and II (older and younger women, respectively) and the Health Professionals Follow-Up Study (men) that included more than 240,000 participants followed for 14 to 24 years. Regression models adjusted for age, body size, thiazide use, diet and other factors.

Results: At baseline the multivariate odds ratio of kidney stone history in individuals with gallstone history compared to those without was 1.65 (95% CI 1.46-1.86) in older women, 1.85 (95% CI 1.65-2.07) in younger women and 1.61 (95% CI 1.41-1.85) in men. Prospectively, the multivariate relative risk of incident kidney stones in participants with gallstone history compared to those without was 1.26 (95% CI 1.09-1.44) in older women, 1.32 (95% CI 1.14-1.52) in younger women and 1.28 (95% CI 1.03-1.57) in men. The multivariate relative risk of incident gallstones in participants with kidney stone history compared to those without was 1.17 (95% CI 1.06-1.29) in older women, 1.31 (95% CI 1.19-1.45) in younger women and 1.51 (95% CI 1.35-1.68) in men. Prospective lag analyses instituting a delay of 4 years between the diagnoses of gallstones and kidney stones yielded similar results.

Conclusions: Gallstones and kidney stones are independently associated. Additional studies are needed to identify shared mechanisms underlying both diseases.