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Sources of Funding: None

Introduction

Emerging data has revealed that patients with nephrolithiasis are at increased risk for atherosclerosis, coronary artery disease, and stroke. While nephrolithiasis occurs within a broad spectrum of human pathologic biomineralization, the overall association of nephrolithiasis with mineralization processes at non-renal, non-osseous sites is poorly understood. The objective of this study is to characterize the overall burden of systemic biomineralization in known kidney stone formers (SFs) compared to non stone formers (NSFs).

Methods

The presence and quantity of biomineralization at 9 non-renal anatomic locations (listed in results) was determined by a blinded, retrospective review of clinical non-contrast computed tomography (CT) scans of the abdomen/pelvis in known SFs (n = 71, mean age 52.3) and were compared to an age-matched control group of NSFs (renal transplant donors, n=86, mean age 51.6). Each anatomic site of interest was assigned a mineralization score based on calculated CT volume of visible calcification (0 = none)( 1 = less than 0.5cm^3) ( 2 = 0.5cm3 to 1.0cm^3)( 3 = greater than 1.0cm^3). Patients were also evaluated for age, gender, BMI, comorbidities, and stone type.

Results

The average systemic mineralization score was significantly higher in stone formers (4.14) compared to controls (2.16). SFs were more likely than NSFs to have mineral densities in the heart (19.7% vs 3.4%), aorta (46.5% vs 23.2%), iliac arteries (38.0% vs 14.0%),spleen/splenic artery (8.95% vs 4.7%), mesentery (15.5% vs 4.7%), uterus (48.34% vs 46.7%), prostate (62.2% vs 24.0%), and pancreas (8.45% vs 0.0%). The presence of pelvic phleboliths was similar in both groups (62.0% vs 62.8%). Site-specific mineralization scores were higher in SFs at all anatomic sites (Fig 1). SFs also had higher degree of obesity (BMI 29.73 vs 27.8) and higher rates of comorbidities including diabetes, hypertension, and hyperlipidemia.

Conclusions

SFs have increased mineralization at many anatomic sites compared to NSFs. Understanding nephrolithiasis within the context of systemic biomineralization may help to better elucidate underlying mechanisms of nephrolithiasis and other pathologic biomineralization processes.

Funding

None