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Nephrolithiasis associated with renal insufficiency: factors predicting outcome
Rajesh Kukreja1, Mihir Desai, Snehal H Patel
1Department of Urology, Muljibhai Patel Urological Hospital, Dr. V.V. Desai Road, Nadiad, Gujarat 387001, India.
Journal of Endourology
|January 28, 2004
Summary
Patients with kidney stones and renal insufficiency need aggressive treatment to prevent further kidney damage. Factors like high creatinine, proteinuria, and recurrent infections predict worse outcomes.
Area of Science:
- Nephrology
- Urology
- Nephrolithiasis Research
Background:
- Renal calculous disease can lead to renal insufficiency due to obstruction, infection, and surgery.
- Understanding factors predicting renal function in these patients is crucial.
Purpose of the Study:
- To analyze renal function progression in patients with kidney stones and renal insufficiency.
- To identify predictors of postoperative renal function deterioration.
Main Methods:
- Retrospective analysis of 4400 patients treated for calculous disease since 1991.
- Identified 84 patients (1.9%) with renal insufficiency (serum creatinine >1.5 mg/dL).
- Evaluated preoperative, intraoperative, and postoperative factors for predicting renal function changes.
Main Results:
- Over 2.2 years, 39.3% improved, 28.6% stabilized, and 32.1% deteriorated in renal function.
- Predictors of deterioration included higher baseline creatinine, proteinuria (>300 mg/day), cortical atrophy, large stone burden (>1500 mm²), recurrent UTIs, and age <15.
Conclusions:
- Aggressive treatment for complete stone clearance and recurrence prevention is vital for patients with nephrolithiasis and renal insufficiency.
- Specific factors significantly increase the risk of renal function decline post-treatment.