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Balancing Stone Prevention and Kidney Function: A Therapeutic Dilemma.
1State Institution "O.O. Shalimov National Scientific Center of Surgery and Transplantology of the National Academy of Medical Science of Ukraine", 03680 Kyiv, Ukraine.
Journal of Clinical Medicine
|June 13, 2025
Summary
Managing kidney stones in chronic kidney disease (CKD) requires careful balancing. This review integrates stone management and CKD care, offering tailored strategies to prevent recurrence while preserving kidney function.
Area of Science:
- Nephrology
- Urology
Background:
- Nephrolithiasis management in chronic kidney disease (CKD) is complex.
- Standard stone prevention strategies may be less effective or harmful in CKD patients.
- Current clinical guidance often fails to integrate nephrolithiasis and CKD care.
Purpose of the Study:
- To explore the bidirectional relationship between nephrolithiasis and CKD.
- To integrate pathophysiology and therapeutic strategies for managing kidney stones in CKD patients.
- To provide a practical, decision-oriented framework for clinicians.
Main Methods:
- Literature review integrating pathophysiology and therapeutic strategies.
- Framework development based on GFR category, stone type, and comorbidities.
- Identification of dual-purpose therapies and research gaps.
Main Results:
- Standard interventions for kidney stones carry risks in CKD (e.g., fluid overload, hyperkalemia).
- Tailored interventions are proposed based on CKD severity and stone characteristics.
- Dual-purpose therapies offer potential for simultaneous management of both conditions.
Conclusions:
- A unified approach is needed for managing nephrolithiasis in CKD.
- Tailored strategies can balance stone recurrence prevention and kidney function preservation.
- Further research is required to address existing gaps in clinical practice.
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