Renal function in patients with urinary stones of varying compositions

Abstract

Kidney stones are a potential risk factor for chronic kidney disease. The impact of different urinary stone components on renal function is unknown. In this study, we retrospectively reviewed 1,918 medical records of patients with urolithiasis. The renal function was evaluated as estimated glomerular filtration rate. All the stones were analyzed by Fourier transform infrared spectroscopy. The patients were divided into five groups according to the stone components. Statistical analysis was performed with analysis of variance. All the patients with stones had Stage 2-3 chronic kidney disease. The patients with uric acid and struvite stones had significantly lower estimated glomerular filtration rate compared with those having other stone components (p<0.01). Furthermore, the patients with calcium-containing stones (calcium oxalate and calcium phosphate) had significantly better renal function than those with non-calcium-containing stones (struvite and uric acid, p<0.01). Patients with urolithiasis had decreased renal function, and the impact of renal function varied depending on the stone components. We conclude that stone analysis is important in predicting the change in renal function in patients with urolithiasis. Moreover, the patients with non-calcium-containing stones, such as struvite and uric acid stones, should be carefully evaluated and treated to preserve their renal function.

Nephrolithiasis and loss of kidney function

“…This is indeed an intriguing observation and integrates the concept of hyperuricemia and its association with the metabolic syndrome with nephrolithiasis-associated CKD risk. It should be noted that these findings were consistent with another study from Taiwan that showed that patients with noncalcium-based nephrolithiasis (struvite and uric acid) were more likely to have eGFR less than 60 ml/min/1.73 m 2 [20]. The association with struvite stones has been attributed to recurrent urinary tract infections.…”

Effect of urinary stone disease and its treatment on renal function

“…There are many studies that associate stone disease with varying degrees of renal insufficiency, patients with CKD present 0.8% to 17.5% of those presenting with urinary stone disease [13] . DM and HT, well-defined risk factors, were considerably related with renal impairment in patients with urinary stone [4,12] .…”

“…Chronic kidney disease (CKD) is a significant health issue that affects 13% of the adults in the United States. The potential reasons of renal failure in patients with urolithiasis are multifactorial and enclose hydronephrosis, infection, DM, hypertension (HT), repeated stone surgeries, eating habits, environmental, and genetic factors [12] . There are many studies that associate stone disease with varying degrees of renal insufficiency, patients with CKD present 0.8% to 17.5% of those presenting with urinary stone disease [13] .…”

“…The existence of struvite stones in some patients can reason the improvement of kidney insufficiency on account of recrudescent urinary tract infection (UTI). Patients with uric acid stone are mostly related with diseases which end up with renal insufficiency such as diabetes and gout [12] .…”

In vitro evidence of the promoting effect of testosterone in kidney stone disease: A proteomics approach and functional validation

“…Among these, gender has been proven to be a crucial factor-proportion of kidney stone incidence in males compared to females is about 2-4:1 [5,6]. Testosterone has been proposed as the key factor responsible for the male preference of this disease [7].…”