Ms. Yasmeen Al Sadek
Final Year Student at Cardiff University
Title: Prevalence of chronic kidney disease in patients with kidney stones from the metabolic stone perspective: is there an association? (Literature Review)
Biography
Abstract
Background: Previous literature has established a strong link between urolithiasis and the consequent development of impaired renal function and ultimately chronic kidney disease . The research, however, is still in its infancy in terms of identifying the predictive factors, from the metabolic stone perspective, that predispose certain stone formers to adverse renal outcomes. This literature review was therefore conducted to critically analyse the existing literature and offer suggestions on how to improve research efforts and patient care in the future. Methods: An Ovid Medline search was performed (year 2000 to current day) to locate suitable articles. All selected publications were reviewed using the title and abstract and the appropriate articles were fully read. Cohort studies and case control studies were considered in this review. Results: Multiple studies have identified urolithiasis as an independent predictor of CKD . There is a heterogeneity however, that exists in the risk of CKD in stone formers, with certain factors like stone composition, stone burden and the presence of underlying monogenic disorders being found to be predictive of the risk of adverse renal outcomes . The impact of urological interventions on the risk of CKD was shown to be small, with more than 80% of the articles that were reviewed showing a weak association between stone removal techniques (like ESWL and PCNL) and subsequent renal damage. Conclusions: By investigating the contribution of different factors in stone formers towards development of renal damage and CKD, we can then more easily identify patients who are at highest risk of adverse renal outcomes. This ultimately allows health interventions to be introduced early on, thus preventing development of irreversible renal damage. Large scale prospective studies with thorough analysis of stone episodes are therefore needed to better characterise the association between urolithiasis and CKD.