Both the prevalence of cardiovascular risk factors and event rate are increased in patients with
urolithiasis. Screening is recommended to all patients who have high cardiovascular risk. The aim of this study was to document 10-year risk of
cardiovascular disease and mortality in asymptomatic patients with
urolithiasis. Consecutive 200 patients with
calcium oxalate urolithiasis were compared with 200 age- and sex-matched healthy controls. Ten-year
cardiovascular disease risk was calculated with the Framingham Risk Score and mortality risk with SCORE risk score.
Calcium, oxalate, and
citrate excretion were studied as
urinary stone risk factors. The results indicate that patients with
urolithiasis had higher total
cholesterol (p < 0.0001), lower
HDL-cholesterol (p < 0.0001), and higher systolic blood pressure (p < 0.0001) and
hsCRP (p < 0.0001) compared with controls. Patients with
urolithiasis had a higher Framingham Risk Scores [OR 8.36 (95% CI 3.81-18.65), p = 0.0001] and SCORE risk score [OR 3.02 (95% CI 1.30-7.02), p = 0.0006] compared with controls. The Framingham and SCORE risk score were significantly correlated with urinary
calcium (p = 0.0001, r = 0.460, and p = 0.005, r = 0.223, respectively) and
oxalate excretion (p = 0.0001, r = 0.516, p = 0.001, r = 0.290, respectively). In multiple linear regression analysis, urinary
calcium and
oxalate excretion, age, sex, total
cholesterol, HDL-
cholesterol,
hsCRP and smoking were the independent predictors of 10-year
cardiovascular disease risk and urinary
calcium and
oxalate excretion, age, sex, total
cholesterol, fasting
blood glucose for 10-year cardiovascular mortality. In conclusion, patients with
calcium oxalate urolithiasis carry high risk of
cardiovascular disease and mortality. All patients should be screened at the initial diagnosis of
urolithiasis for the risk factors.