Glomerular Filtration Rate and Urolithiasis: Results from the UK Biobank

Abstract Introduction: To investigate the association of a decreased estimated glomerular filtration rate (eGFR) with urolithiasis risk. This study aimed to investigate the association between eGFR and the risk of urolithiasis formation in the general population. Methods This is a prospective cohort study. We included 426,866 community-dwelling participants (39 to 73 years old) from the UK Biobank. Participants joined the study from 2006 to 2010 and were followed up until 2021. We used the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula based on cystatin C to calculate eGFR. Cox proportional hazards regression models were used to evaluate the association between eGFR and the risk of urolithiasis formation. Results The mean age of all participants was 56 years, of which 231,509 were female (54%) and 403,214 (94%) were White. During a mean follow-up of 12.4 years, 5,176 participants (1%) developed incident urolithiasis. We found that participants were 3% (adjusted hazard ratio [HR] 1.03, 95% confidence interval [CI] 1.01–1.06, p = 0.01) more likely to develop urolithiasis for every 10 mL/min/1.73 m2 decrease in eGFR. Compared to those with eGFR between 90–104 mL/min/1.73 m2, the HRs (95% CIs) for the eGFR < 60, 60 ≤ eGFR < 75, 75 ≤ eGFR < 89 and eGFR ≥ 105 mL/min/1.73 m2 groups were 1.19 (1.02–1.38), 1.07 (0,96–1.18), 1.02 (0.94–1.11), and 0.93 (0.83–1.04), respectively. Conclusion A lower eGFR is associated with higher risk of urolithiasis formation in the general population.