Association Between Sonographically Diagnosed Nephrolithiasis and Subclinical Coronary Artery Calcification in Adults

Background: Although recent studies suggest an association between nephrolithiasis and clinical cardiovascular events, this association has been underexplored. Study Design: Cross-sectional study. Setting & Participants: 62,091 asymptomatic adults without known coronary heart disease who underwent a screening health examination that included cardiac tomography. Predictor: Nephrolithiasis. Outcome: Coronary artery calcification (CAC). Measurements: Nephrolithiasis assessed using ultrasonography of the abdomen. CAC scoring assessed using cardiac computed tomography. Results: The prevalence of CAC scores >0 was 13.1% overall. Participants with nephrolithiasis had a higher prevalence of coronary calcification than those without (19.1% vs 12.8%). In Tobit models adjusted for age and sex, the CAC score ratio comparing participants with nephrolithiasis with those without nephrolithiasis was 1.56 (95% CI, 1.19-2.05). After further adjustment for screening center, year of screening examination, physical activity, alcohol intake, smoking status, education level, body mass index, family history of cardiovascular disease, total energy intake, glucose concentration, systolic blood pressure, triglyceride concentration, high-density lipoprotein cholesterol concentration, uric acid concentration, and estimated glomerular filtration rate, the CAC score ratio was attenuated, but remained significant (CAC score ratio, 1.31; 95% CI, 1.00-1.71). Limitations: Computed tomographic diagnosis of nephrolithiasis was unavailable. Conclusions: Nephrolithiasis was associated with the presence of CAC in adults without known coronary heart disease, supporting the hypothesis that these 2 health conditions share a common pathophysiology.