Association of cardiovascular-kidney-metabolic syndrome stages with kidney stone prevalence: a population-based analysis of NHANES 2007–2020

Background The prevalence of kidney stones (KSs) has been increasing globally, and their association with cardiovascular disease and metabolic syndrome suggests a shared underlying pathophysiology. However, the impact of different stages of cardiovascular-kidney-metabolic (CKM) syndrome on KS prevalence remains unclear. Objective This study aimed to investigate the association between the stages of CKM syndrome and the prevalence of KS in a nationally representative sample of adults in the USA. Methods A total of 15 568 participants aged ≥20 years were included in the National Health and Nutrition Examination Survey 2007–2020 fasting subsample. CKM syndrome stages (0–4) were defined based on the 2023 American Heart Association Presidential Advisory on CKM Health. The KS history was determined using self-reported data. Multivariable logistic regression models were used to assess the association between the CKM syndrome stage and KS prevalence. Results Of the 15 568 participants, 1501 (9.64%) reported a history of KS. The KS prevalence increased progressively with advancing CKM stage, rising from 5.10% in stage 0 to 16.55% in stage 4 (p<0.001). In the fully adjusted model, the ORs for KS were 1.18 (95% CI 0.83–1.68) for stage 1, 1.72 (95% CI 1.28 to 2.32) for stage 2, 2.00 (95% CI 1.29 to 3.10) for stage 3 and 2.36 (95% CI 1.64 to 3.40) for stage 4, compared with stage 0 ( P for trend <0.001). Stratified analyses revealed no significant interactions between age, sex, race/ethnicity or other subgroups. Conclusion This study demonstrated a significant stepwise increase in KS prevalence with the advancing stages of CKM syndrome. These findings highlight the importance of monitoring and managing CKM syndromes to mitigate the risks of KS.