Search tips
Search criteria 


Logo of bmjThe BMJ
BMJ. 1990 May 12; 300(6734): 1234–1236.
PMCID: PMC1662841

Kidney stones and hypertension: population based study of an independent clinical association.


OBJECTIVE--To test the hypothesis that kidney stone disease is more frequent among hypertensive men when the effect of possible confounders is allowed for. DESIGN--Cross sectional study of a sample of the male working population conducted as part of the 10 year follow up of a nationwide survey of the prevalence of cardiovascular risk factors. SETTING--The Olivetti factory in Pozzuoli, a suburban area of Naples. POPULATION--688 Male workers (87.9% of the male workforce) aged 21-68. INTERVENTIONS--Anthropometric and blood pressure measurements, blood tests, and administration of a detailed questionnaire aimed at detecting a history of urolithiasis. MAIN OUTCOME MEASURES--Prevalence of a history of urolithiasis among normotensive and untreated and treated hypertensive men adjusted for the possible confounding effects of age, body mass index, renal function, and serum urate and total calcium concentrations. RESULTS--Of the 688 participants 509 were normotensive. Of the remainder, 118 had untreated and 61 treated hypertension. The overall prevalence of a history of urolithiasis was 16.3% (112/688). The relative risk of hypertensive subjects having a history of kidney stones was twice that of the normotensive group (odds ratio 2.11; 95% confidence interval 1.17 to 3.81), the risk being higher when only treated hypertensives were considered (odds ratio 3.16; 95% confidence interval 1.75 to 5.71). The prevalence of a history of urolithiasis was 13.4% (68/509) in the normotensive subjects, 20.3% (24/118) in the untreated hypertensives, and 32.8% (20/61) in the treated hypertensives (p less than 0.001). The age adjusted relative risk in treated hypertensive men was higher than that in the normotensive group (Mantel-Haenszel pooled estimate of odds ratio 2.63; 95% confidence interval 2.23 to 3.10). CONCLUSION--An independent clinical association exists between the occurrence of urolithiasis and hypertension. The increased urinary calcium excretion commonly detected in hypertension may be the pathogenetic link.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (688K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Wexler BC, McMurtry JP. Kidney and bladder calculi in spontaneously hypertensive rats. Br J Exp Pathol. 1981 Aug;62(4):369–374. [PubMed]
  • Ljunghall S, Hedstrand H. Epidemiology of renal stones in a middle-aged male population. Acta Med Scand. 1975 Jun;197(6):439–445. [PubMed]
  • Currie WJ, Turmer P. The frequency of renal stones within Great Britain in a gouty and non-gouty population. Br J Urol. 1979 Oct;51(5):337–341. [PubMed]
  • Johnson CM, Wilson DM, O'Fallon WM, Malek RS, Kurland LT. Renal stone epidemiology: a 25-year study in Rochester, Minnesota. Kidney Int. 1979 Nov;16(5):624–631. [PubMed]
  • Bengtsson C, Lennartsson J, Lindquist O, Noppa H. Renal stone disease--experience from a population study of women in Gothenburg, Sweden. Scand J Urol Nephrol Suppl. 1980;53:39–43. [PubMed]
  • Churchill DN, Maloney CM, Bear J, Bryant DG, Fodor G, Gault MH. Urolithiasis--a study of drinking water hardness and genetic factors. J Chronic Dis. 1980;33(11-12):727–731. [PubMed]
  • Hiatt RA, Dales LG, Friedman GD, Hunkeler EM. Frequency of urolithiasis in a prepaid medical care program. Am J Epidemiol. 1982 Feb;115(2):255–265. [PubMed]
  • Vahlensieck EW, Bach D, Hesse A. Incidence, Prevalence and mortality of urolithiasis in the German Federal Republic. Urol Res. 1982;10(4):161–164. [PubMed]
  • Robertson WG, Peacock M, Baker M, Marshall DH, Pearlman B, Speed R, Sergeant V, Smith A. Studies on the prevalence and epidemiology of urinary stone disease in men in Leeds. Br J Urol. 1983 Dec;55(6):595–598. [PubMed]
  • Strazzullo P, Nunziata V, Cirillo M, Giannattasio R, Ferrara LA, Mattioli PL, Mancini M. Abnormalities of calcium metabolism in essential hypertension. Clin Sci (Lond) 1983 Aug;65(2):137–141. [PubMed]
  • Lewis B, Chait A, Sigurdsson G. Serum lipoprotiens in four European communities: a quantitative comparison. Eur J Clin Invest. 1978 Jun;8(3):165–173. [PubMed]
  • Strazzullo P, Trevisan M, Farinaro E, Cappuccio FP, Ferrara LA, de Campora E, Mancini M. Characteristics of the association between salt intake and blood pressure in a sample of male working population in southern Italy. Eur Heart J. 1983 Sep;4(9):608–613. [PubMed]
  • Morris JA, Gardner MJ. Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. Br Med J (Clin Res Ed) 1988 May 7;296(6632):1313–1316. [PMC free article] [PubMed]
  • DOLLERY CT, DUNCAN H, SCHUMER B. Hyperuricaemia related to treatment of hypertension. Br Med J. 1960 Sep 17;2(5202):832–835. [PMC free article] [PubMed]
  • Breckenridge A. Hypertension and hyperuricaemia. Lancet. 1966 Jan 1;1(7427):15–18. [PubMed]
  • Strazzullo P, Cappuccio FP, Trevisan M, Iacoviello L, Iacone R, Barba G, De Leo A, Farinaro E, Mancini M. Red blood cell sodium-lithium countertransport, blood pressure, and uric acid metabolism in untreated healthy men. Am J Hypertens. 1989 Aug;2(8):634–636. [PubMed]
  • McCarron DA, Pingree PA, Rubin RJ, Gaucher SM, Molitch M, Krutzik S. Enhanced parathyroid function in essential hypertension: a homeostatic response to a urinary calcium leak. Hypertension. 1980 Mar-Apr;2(2):162–168. [PubMed]
  • Cirillo M, Siani A, Nunziata V, Cappuccio FP, Mattioli PL, Strazzullo P. Ridotto rapporto Mg/Ca nelle urine e rischio di nefrolitiasi nell'ipertensione essenziale. Minerva Nefrol. 1983 Oct-Dec;30(4):213–216. [PubMed]

Articles from The BMJ are provided here courtesy of BMJ Publishing Group