Long-term Follow-up of Patients Undergoing Nephrectomy for Urolithiasis
Thiago Augusto Cunha Ferreira1, Alexandre Danilovic1, Samirah Abreu Gomes2
1Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - HCFMUSP, SP, Brasil.
Summary
Type 2 diabetes and older age increase chronic kidney disease (CKD) risk after nephrectomy. Contralateral kidney stones and hypercalciuria elevate the risk of new or growing stones.
Area of Science:
- Nephrology
- Urology
- Endocrinology
Background:
- Nephrectomy for urolithiasis can impact renal function and stone recurrence.
- Identifying risk factors post-surgery is crucial for patient management.
Purpose of the Study:
- To determine risk factors for stage 3 chronic kidney disease (CKD) progression.
- To identify predictors of kidney stone formation or growth after nephrectomy for urolithiasis.
Main Methods:
- Prospective study of 107 patients undergoing nephrectomy for urolithiasis (2006-2013).
- Renal function assessed by estimated glomerular filtration rate (eGFR).
- Kidney stone events evaluated using computed tomography.
Main Results:
- Type 2 diabetes mellitus (T2DM) increased CKD progression risk 34.79-fold (p=0.004).
- Age and T2DM predicted CKD progression; higher preoperative eGFR was protective (OR=0.84, p<0.01).
- Contralateral kidney stones (p<0.01) and hypercalciuria (p=0.03) were risk factors for stone events.
Conclusions:
- T2DM and age are key predictors of CKD progression post-nephrectomy.
- Higher preoperative eGFR offers protection against CKD progression.
- Hypercalciuria and contralateral stones increase the likelihood of post-nephrectomy stone events.
