Gallstone Disease Increases the Risk of Kidney Stone Disease: A Cross-Sectional and Longitudinal Cohort Study

Background: Gallstone disease (GSD) and kidney stone disease (KSD) may share metabolic pathways, however their association remains unclear. This study aimed to explore their relationship using cross-sectional and longitudinal analyses. Methods: The cross-sectional analysis included 121,550 participants in the Taiwan Biobank, and the association between self-reported GSD and KSD was examined using logistic regression. The longitudinal analysis included 25,208 participants without prior KSD, and the risk of incident KSD was assessed using Kaplan-Meier survival analysis and Cox proportional hazards models, adjusting for demographics, metabolic factors, lifestyle factors, and laboratory data. Results: In the cross-sectional cohort, the prevalence of KSD was higher in the participants with GSD (11% vs. 6%, p < 0.001). In adjusted analysis, GSD was associated with a 51% increased risk of KSD (odds ratio: 1.51, 95% CI: 1.38-1.65, p < 0.001). In the longitudinal analysis, the participants with GSD had a higher incidence of KSD (5% vs. 2%, p < 0.001), with an adjusted hazard ratio of 1.80 (95% CI: 1.36-2.38, p < 0.001). Subgroup analyses showed a significant interaction by sex but not by age, indicating a stronger association in women. Conclusion: Our results showed that GSD was an independent risk factor for KSD, suggesting shared metabolic mechanisms. Future studies should explore preventive strategies targeting the pathways underlying these mechanisms.