Chou PS, et al. - The specialists explored the available literature work to determine whether urolithiasis was associated with an increased risk of stroke. They found an increased risk of both ischemic and hemorrhagic stroke in patients with urolithiasis, particularly in those older than 40 years old.

Methods

• The nationwide population database was applied and a matched cohort study was conducted to investigate the association between urolithiasis and longitudinal risks of ischemic and hemorrhagic stroke.

Results

• A total of 12,979 and 64,895 patients were included in the urolithiasis and nonurolithiasis cohorts, respectively.
• Of these, 728 (5.6%) and 2,802 (4.3%) patients in the urolithiasis and nonurolithiasis cohorts, respectively, had a stroke during the 5-year follow-up period.
• After adjustment for potential confounders, the hazard ratio (HR) for stroke was 1.19-times higher (95% confidence interval [CI] = 1.10–1.29; P < 0.001) in the urolithiasis cohort than in the nonurolithiasis cohort.
• In the urolithiasis cohort, the risk of both ischemic (adjusted HR = 1.16; 95% CI = 1.05–1.29) and hemorrhagic stroke (adjusted HR = 1.30; 95% CI = 1.03–1.64) remained significant. 
• Moreover, the risk of stroke was significant in both men (adjusted HR = 1.16; 95% CI = 1.05–1.28) and women (adjusted HR = 1.26; 95% CI = 1.10–1.45).
• Middle-aged (40–59 years; adjusted HR = 1.26; 95% CI = 1.10–1.45) and older ( ≥60 years; adjusted HR = 1.14; 95% CI = 1.03–1.27) patients had a particularly high risk of stroke.