Increased risk of nephrolithiasis is associated with treatment of hematologic malignancies, "Beyond the Abstract," by Hossein S. Mirheydar, MD and Roger L. Sur, MD

BERKELEY, CA ( - The findings from this study, which spanned 10 years, support the hypothesis that metabolic derangements during chemotherapy are associated with an increased risk of nephrolithiasis. Until this study, as well as a few other pediatric studies, the claim of increased nephrolithiasis risk with hematologic malignancy had been substantiated by only case reports and the plausible pathophysiologic theory of endogenous nucleotide catabolism. The incidence of nephrolithiasis in a population of patients (over 1 300 patients with up to 10 years follow-up) with lymphoproliferative and myeloproliferative disorders was 5.5%.

In multivariate analysis, we report that diabetes mellitus, hyperuricemia, and hypercalcemia were independently associated with development of a future stone after chemotherapy. This study is important because it provides an opportunity for oncologists to promptly treat hyperuricemia in order to reduce the risk of nephrolithiasis. Increasing utilization of rasburicase (recombinant urate oxidase) rather than allopurinol may be one such strategy employed by oncologists in order to reduce incidence of nephrolithiasis. Our study also highlights the observation that urological consultations were infrequently obtained in this patient population, and as such, metabolic stone evaluations were rarely performed in these patients. While it would have been incredibly useful to have a 24-hour urine collection in every single stone former, the absence of this data provides an area of opportunity for urologists to improve the care of these patients. Urologists should be consulted in the care of such patients to appropriately work up the etiology of stone disease, and thereby prevent future stones from occurring.

Written by:
Hossein S. Mirheydar, MD and Roger L. Sur, MD* as part of Beyond the Abstract on This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

Department of Urology, UC San Diego Health System, San Diego, CA USA, *Corresponding Author:

What is the incidence of kidney stones after chemotherapy in patients with lymphoproliferative or myeloproliferative disorders? - Abstract

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