Association between hypertension and kidney stones: a cross-sectional analysis from NHANES and Mendelian randomization

The association between hypertension and kidney stones remains inconsistent. This research investigated the relationship between hypertension and the risk and progression of kidney stones.
A cross-sectional analysis was performed using data from the National Health and Nutrition Examination Survey (NHANES). The association was assessed with a multivariable logistic regression model. Furthermore, a two-sample Mendelian randomization (MR) analysis was conducted to evaluate causality. Methods included inverse-variance weighted (IVW), weighted median, and sensitivity analyses. Summary-level data for kidney stones were obtained from the UK Biobank, and for hypertension from a genome-wide association study (GWAS)analysis.
The NHANES analysis included 21,740 participants. After full adjustment, hypertension was significantly associated with a higher prevalence of kidney stones (odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.19−1.56, p < 0.001). In the MR analysis, the IVW method indicated a causal effect of hypertension on kidney stones (OR = 1.01, 95% CI: 1.00−1.01, p = 0.013), supported by the weighted median method (OR = 1.01, 95% CI: 1.00−1.02, p = 0.002). Sensitivity analyses revealed no significant heterogeneity or pleiotropy.
Our investigation revealed a heightened risk of kidney stones linked to hypertension, which necessitates validation through further large-scale prospective cohort studies.

高血压与肾结石之间的关联迄今尚未达成共识。本研究旨在探讨高血压与肾结石发病风险及病情进展之间的关联。
本研究借助美国国家健康与营养检查调查（National Health and Nutrition Examination Survey, NHANES）的数据开展横断面分析，采用多变量logistic回归模型评估二者的关联。此外，本研究还开展了两样本孟德尔随机化（Mendelian randomization, MR）分析以验证因果关系，所用方法包括逆方差加权（inverse-variance weighted, IVW）、加权中位数法以及敏感性分析。肾结石的汇总级数据来源于英国生物样本库（UK Biobank），高血压的汇总级数据则取自一项全基因组关联研究（genome-wide association study, GWAS）。
NHANES分析共纳入21740名研究对象。经全面校正后，高血压与肾结石的高患病率呈显著关联（比值比[OR]=1.36，95%置信区间[CI]：1.19~1.56，P<0.001）。在MR分析中，IVW法提示高血压对肾结石存在因果效应（OR=1.01，95%CI：1.00~1.01，P=0.013），加权中位数法也验证了这一结果（OR=1.01，95%CI：1.00~1.02，P=0.002）。敏感性分析未发现显著的异质性或多效性。
本研究证实高血压与肾结石的发病风险升高存在关联，该结论仍需通过后续大规模前瞻性队列研究进一步验证。