Evaluation of the Effectiveness of Interventions on Nephrolithiasis in Transplanted Kidney

Boissier, R.; Rodríguez-Faba, Óscar; Zakri, Rhana Hassan; Hevia, Vital; Budde, Klemens; Figueiredo, Arnaldo; García, E. Lledó; Olsburgh, Jonathon; Regele, Heinz; Yuan, Cathy; Breda, Alberto

doi:10.1016/j.euf.2022.11.019

Cited by 10 publications

(8 citation statements)

References 35 publications

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“…[ 53 ] demonstrated that diagnosis was incidental in 34% of kidney transplant recipients with nephrolithiasis, while 17% of the patients presented with a rise in creatinine, 10% with gross hematuria, 9% with urinary tract infection and only 3% with pain. The mean (minimum–maximum) age at diagnosis was 44 ( 11–72 ) years, and the mean time interval from transplant to nephrolithiasis was 28 (3–387) months [ 53 ]. Due to denervation of the transplanted kidney, the rate of asymptomatic cases may be higher in transplant recipients than in the general population.…”

Section: Nephrolithiasis Among Kidney Transplant Recipientsmentioning

confidence: 99%

“…A recent meta-analysis of interventions in transplanted kidneys reported stone-free rates (SFR) at 3 months as 96% with open surgery, 95% with antegrade ureteroscopy, 86% with PNL, 81% with retrograde ureteroscopy, 75% with SWL and 62% with medical treatment. Overall, 52% of the patients required a surgical intervention including open surgery (4%), ureteroscopy (29%) and PNL (19%), which is higher than in patients with native kidneys [ 53 , 78 ]. Although the most common treatments include retrograde URS and SWL for large stones, these findings suggest that anterograde approaches such as antegrade ureteroscopy, percutaneous nephrolithotomy and open surgery are more effective and may be considered more in allograft nephrolithiasis than in native kidneys.…”

Section: Chronic Kidney Disease–mineral Bone Disordermentioning

confidence: 99%

“…Urinary alkalinization and increased hydration can cause complete resolution of uric acid stones [ 79 , 84 ]. However, conservative management has a low SFR, and laboratory, as well as radiological, follow-up is highly recommended [ 53 , 76 ].…”

Section: Chronic Kidney Disease–mineral Bone Disordermentioning

confidence: 99%

“…For smaller stones in the transplant kidney, an endoscopic approach is also favoured [ 98 ]. While the retrograde approach (transurethral) is more commonly employed, the antegrade approach (percutaneous access) yields a higher SFR [ 53 ]. Despite the complex anatomy of the transplanted kidney, the development of thinner, flexible ureteroscopes and laser technology makes ureteroscopy a valid therapeutic option for calculi in transplant recipients.…”

Section: Chronic Kidney Disease–mineral Bone Disordermentioning

confidence: 99%

See 3 more Smart Citations

Management of de novo nephrolithiasis after kidney transplantation: a comprehensive review from the European Renal Association CKD-MBD working group

Kanbay,

Copur,

Bakir

et al. 2024

Clinical Kidney Journal

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The lifetime incidence of kidney stones is 6-12% in the general population. Nephrolithiasis is a known cause of acute and chronic kidney injury, mediated via obstructive uropathy or crystal-induced nephropathy, and several modifiable and non-modifiable genetic and lifestyle causes have been described. Evidence for epidemiology and management of nephrolithiasis after kidney transplantation is limited by low number of publications, small study sizes, and short observational periods. Denervation of the kidney and ureter graft greatly reduces symptomatology of kidney stones in transplant recipients, which may contribute to a considerable underdiagnosis. Thus, reported prevalence rates of 1-2% after kidney transplantation and the lack of adverse effects on allograft function and survival should be interpreted with caution. In this narrative review we summarize current state-of-the-art knowledge regarding epidemiology, clinical presentation, diagnosis, prevention, and therapy of nephrolithiasis after kidney transplantation, including management of asymptomatic stone disease in kidney donors. Our aim is to strengthen clinical nephrologists who treat kidney transplant recipients in informed decision-making regarding management of kidney stones. Available evidence, supporting both surgical and medical treatment and prevention of kidney stones, are presented and critically discussed. The specific anatomy of the transplanted kidney and urinary tract requires deviation from established interventional approaches for nephrolithiasis in native kidneys. Also, pharmacological and lifestyle changes may need adaptation to the specific situation of kidney transplant recipients. Finally, we point out current knowledge gaps and the need for additional evidence from future studies.

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Section: Nephrolithiasis Among Kidney Transplant Recipientsmentioning

confidence: 99%

Section: Chronic Kidney Disease–mineral Bone Disordermentioning

confidence: 99%

Section: Chronic Kidney Disease–mineral Bone Disordermentioning

confidence: 99%

Section: Chronic Kidney Disease–mineral Bone Disordermentioning

confidence: 99%

See 2 more Smart Citations

Management of de novo nephrolithiasis after kidney transplantation: a comprehensive review from the European Renal Association CKD-MBD working group

Kanbay,

Copur,

Bakir

et al. 2024

Clinical Kidney Journal

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“…В 2021 г. R. Boissier et al выполнили ретроспективный анализ 37 исследований с участием 553 пациентов, которым было произведено 20 антеградных уретероскопий, 154 ретроградные уретероскопии, 118 ПНЛТ, 25 открытых оперативных вмешательств и 155 ДУВЛ; в 140 случаях проводилось консервативное ведение больных. Исследователями было отмечено, что частота отсутствия конкрементов в почечном трансплантате после процедуры составила: для открытых вмешательств -96%, для антеградной уретероскопии -95%, для ПНЛТ -86%, для ретроградной уретероскопии -81%, для ДУВЛ -75% [31].…”

Section: результатыunclassified

Efficacy of extracorporeal shock wave lithotripsy for post-transplant kidney stones. Hope or Disappointment?

Popov,

Huseynov,

Miloserdov

et al. 2023

RJTAO

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Nephrolithiasis in a transplanted kidney is an important medical and social problem. The presence of renal calculi may not manifest clinically for a long time due to the peculiarities of the surgical intervention during organ transplantation. Development of chronic urinary tract infection and deterioration of the functional ability of the renal transplant in the presence of kidney stones can lead to graft death, which is an immediate threat to the patient’s life. Existing Russian guidelines on the treatment of urolithiasis currently lack a clear strategy for the management of kidney transplant recipients.Objective: to systematize literature data on analysis of the outcomes of extracorporeal shock wave lithotripsy (ESWL) and other methods in patients with post-transplant kidney stones.Results. Thirty-five publications on the research topic were selected. We summarized the information on various therapy options for patients with stones in transplanted kidney: endourological approach, ESWL, percutaneous nephrolithotripsy (PCNL), open surgical treatment (nephrostomy, pyelolithotomy). A modern foreign algorithm for the management of patients with post-transplant kidney stones depending on the severity of obstruction with sepsis and the size of the renal calculi is presented.Conclusion. 1. The presence of stones in a kidney graft is a clinical situation that requires surgical treatment. 2. In clinical practice, different methods of treatment can be used, such as open intervention, ESWL, PCNL, retrograde transurethral manipulations. 3. In most cases, patient management tactics depend on the clinical picture (presence/absence of obstruction) and the size of the calculi. 4. The use of ESWL, as the most frequently used method, testifies to its efficiency and low-traumatic effect.

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Percutaneous nephrolithotomy for adult renal transplant de novo graft lithiasis: a single center analysis and systematic review of the literature

Lo,

Chong,

Sjariffudin

et al. 2024

World J Urol

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Evaluation of the Effectiveness of Interventions on Nephrolithiasis in Transplanted Kidney

Cited by 10 publications

References 35 publications

Management of de novo nephrolithiasis after kidney transplantation: a comprehensive review from the European Renal Association CKD-MBD working group

Management of de novo nephrolithiasis after kidney transplantation: a comprehensive review from the European Renal Association CKD-MBD working group

Efficacy of extracorporeal shock wave lithotripsy for post-transplant kidney stones. Hope or Disappointment?

Percutaneous nephrolithotomy for adult renal transplant de novo graft lithiasis: a single center analysis and systematic review of the literature

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