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Nephrolithiasis-induced end stage renal disease.
[primary hyperoxaluria type 1]
Nephrolithiasis
still
remains
a
too
frequent
and
underappreciated
cause
of
end
stage
renal
disease
(
ESRD
)
.
Of
the
entire
cohort
of
7128
consecutive
patients
who
started
maintenance
dialysis
in
our
nephrology
department
between
January
1992
and
December
2006
,
a
total
of
45
patients
(
26
women
,
19
men
)
had
renal
stone
disease
as
the
cause
of
ESRD
.
The
type
of
nephrolithiasis
was
determined
in
45
cases
and
etiology
in
42
.
The
treatment
and
evolution
of
stone
disease
and
patient
's
survival
were
studied
.
The
overall
proportion
of
nephrolithiasis
related
ESRD
was
0
.
63
%
.
The
mean
age
was
48
.
4
years
.
Infection
stones
(
struvite
)
accounted
for
40
%
,
calcium
stones
,
26
.
67
%
(
primary
hyperparathyroidism
:
15
.
56
%
;
familial
hypercalciuria
:
4
.
44
%
,
unknown
etiology
:
6
.
66
%
)
,
primary
hyperoxaluria
type
1
,
17
.
78
%
and
uric
acid
lithiasis
in
15
.
56
%
of
cases
.
The
mean
delay
of
the
evolution
of
the
stone
renal
disease
to
chronic
renal
failure
was
85
.
8
months
.
The
feminine
gender
,
obesity
and
elevated
alkaline
phosphatases
>
128
IU
/
L
were
significantly
correlated
with
fast
evolution
of
ESRD
.
The
median
evolution
to
ESRD
was
12
months
.
The
normal
body
mass
index
(
BMI
)
,
medical
treatment
of
stone
and
primary
hyperoxaluria
type
1
were
correlated
with
fast
evolution
to
ESRD
.
All
patients
were
treated
by
hemodialysis
during
a
mean
evolution
of
60
months
.
Sixteen
patients
died
.
The
patient
's
survival
rate
at
1
,
3
and
5
years
was
97
.
6
,
92
.
8
and
69
%
respectively
.
Hypocalcemia
,
cardiopathy
and
normal
calcium
-phosphate
product
were
significantly
correlated
with
lower
survival
rate
.
Severe
forms
of
nephrolithiasis
remain
an
underestimated
cause
of
ESRD
.
These
findings
highlight
the
crucial
importance
of
accurate
stone
analysis
and
metabolic
evaluation
to
provide
early
diagnosis
and
efficient
treatment
for
conditions
leading
to
ESRD
.
Diseases
Validation
Diseases presenting
"nephrolithiasis"
symptom
adrenal incidentaloma
cushing syndrome
cystinuria
familial hypocalciuric hypercalcemia
primary hyperoxaluria type 1
This symptom has already been validated
