The Risk of Chronic Kidney Disease Associated With Urolithiasis and its Urological Treatments: a Review

PURPOSE: Urolithiasis can impair kidney function. This literature review focuses on the risk of kidney impairment in stone formers, the specific conditions associated with this risk and the impact of urological surgery. MATERIALS AND METHODS: The PubMed and Embase databases were searched for publications on urolithiasis, its treatment, and the risk of chronic kidney disease (CKD), end-stage renal disease (ESRD) and nephrectomy in stone formers. RESULTS: In general, renal stone formers carry twice the risk of CKD or ESRD, and for female and overweight stone formers the risk is even higher. Patients with frequent urinary tract infections, struvite stones, urinary malformations and diversions, malabsorptive bowel conditions, and some monogenic disorders are at high risk of CKD/ESRD. Shock wave lithotripsy or minimally-invasive urological interventions for stones do not adversely affect renal function. Declines in renal function generally occur in patients with pre-existing CKD or with a large stone burden requiring repeated and/or complex surgery. CONCLUSIONS: Although the effect size is modest, urolithiasis may cause CKD thus it is mandatory to assess patients with renal stones for their risk of developing CKD/ESRD. We suggest that all guidelines dealing with renal stone disease should include assessing this risk.