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Published on: February 9, 2021
Chronic kidney disease in kidney stone formers
Andrew D Rule1, Amy E Krambeck, John C Lieske
1Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA. rule.andrew@mayo.edu
Summary
Symptomatic kidney stones increase chronic kidney disease (CKD) risk, particularly in those with specific hereditary conditions, infections, or comorbidities. Less invasive treatments may reduce this risk, but further research is needed.
Area of Science:
- Nephrology
- Urology
- Epidemiology
Background:
- Population studies link symptomatic kidney stones to increased chronic kidney disease (CKD) risk.
- Kidney stones may be contributing factors to end-stage renal disease (ESRD), despite not being the primary cause.
- CKD can paradoxically reduce kidney stone formation due to decreased urine calcium excretion.
Purpose of the Study:
- To investigate the association between kidney stones and the risk of developing chronic kidney disease (CKD).
- To identify specific patient groups and stone types associated with a higher risk of CKD.
- To explore potential mechanisms linking kidney stones to CKD and the impact of treatment modalities.
Main Methods:
- Review of population studies and clinical data.
- Analysis of risk factors for CKD among kidney stone formers, including hereditary diseases, infections, and comorbidities.
- Examination of potential mechanisms of kidney injury, such as obstructive uropathy, pyelonephritis, and parenchymal damage.
- Consideration of the impact of surgical management and diagnostic imaging on CKD risk.
Main Results:
- Symptomatic kidney stone formers are at increased risk for CKD.
- Individuals with rare hereditary stone diseases, recurrent urinary tract infections, struvite stones, hypertension, and diabetes face the highest CKD risk.
- Past symptomatic kidney stones, but not radiographic stones, are linked to albuminuria in potential kidney donors.
- Kidney stones detected by ultrasound are associated with CKD in the general population.
Conclusions:
- Kidney stones, especially symptomatic ones, represent a significant risk factor for CKD.
- Specific patient profiles and stone characteristics necessitate careful monitoring for CKD development.
- Further research is required to refine CKD classification, characterize stone formers, control for confounding factors, and minimize detection bias.
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