[Urinary calculi and the single kidney]

The problems and interactions of urolithiasis and monorenality are presented in a survey covering four essential parameters: --Urolithiasis as an indication for nephrectomy: One nephrectomy in four is performed because of urolithiasis. This rate of nephrectomy has not changed in the last 50 years. --Recidive urolithiasis in the residual kidney: Around 37% of all monorenal persons have a diseased single or residual kidney. On average one in four cases of residual kidney disease is caused by urolithiasis. This recidive calculus quota has also not significantly changed in recent decades. --Lethality of operations on the residual kidney: Urolithiasis is becoming almost the only indication for operating on a residual kidney; due to postrenal anuria, uraemia and urosepsis a large percentage of such operations are emergency operations under extremely unfavourable initial conditions. Despite the use of modern methods of medical treatment the lethality rate is for this reason still relatively high (7-15%). --Life expectancy of monorenals with urolithiasis: The life expectancy of monorenals with urolithiasis is clearly limited due to further complications (chronic pyelonephritis, hypertonia, urinary stasis and uraemia). It is therefore absolutely necessary for monorenal persons with urolithiasis to have intensive observation and urological treatment.