Urolithiasis can impair kidney function. This literature review focuses on the risk of kidney impairment in stone formers, the specific conditions associated with this risk and the impact of urological surgery.
The PubMed® and Embase® databases were searched for publications on urolithiasis, its treatment, and the risk of chronic kidney disease, end stage renal disease and nephrectomy in stone formers.
In general, renal stone formers have twice the risk of chronic kidney disease or end stage renal disease, and for female and overweight stone formers the risk is even higher. Patients with frequent urinary tract infections, struvite stones, urinary malformations and diversions, malabsorptive bowel conditions and some monogenic disorders are at high risk for chronic kidney disease/end stage renal disease. Shock wave lithotripsy or minimally invasive urological interventions for stones do not adversely affect renal function. Declines in renal function generally occur in patients with preexisting chronic kidney disease or a large stone burden requiring repeated and/or complex surgery.
Although the effect size is modest, urolithiasis may cause chronic kidney disease and, thus, it is mandatory to assess patients with renal stones for the risk of chronic kidney disease/end stage renal disease. We suggest that all guidelines dealing with renal stone disease should include assessment of this risk.
The Journal of urology. 2017 Mar 10 [Epub ahead of print]
Giovanni Gambaro, Emanuele Croppi, David Bushinsky, Philippe Jaeger, Adamasco Cupisti, Andrea Ticinesi, Sandro Mazzaferro, Alessandro D'Addessi, Pietro Manuel Ferraro
Division of Nephrology, Fondazione Policlinico Universitario A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: ., Division of Nephrology, Fondazione Policlinico Universitario A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy., Nephrology Division, Department of Medicine and of Pharmacology and Physiology, University of Rochester School of Medicine, Rochester, New York., UCL Centre for Nephrology, Royal Free Campus and Hospital, University College London, London, United Kingdom., Department of Clinical and Experimental Medicine, University of Pisa; Nephrology, Transplantation and Dialysis Unit, AOUP Pisa, Pisa, Italy., Department of Clinical and Experimental Medicine, University of Parma and Geriatric-Medicine Rehabilitation Department, Azienda Ospedaliero-Universitario di Parma, Parma, Italy., Department. of Cardiovascular Respiratory Nephrologic Anesthetic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy., Division of Urology, Fondazione Policlinico Universitario A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy.