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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
"obesity"
symptom
acute rheumatic fever
adrenal incidentaloma
aniridia
aromatase deficiency
carcinoma of the gallbladder
cohen syndrome
congenital adrenal hyperplasia
cushing syndrome
cystinuria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
heparin-induced thrombocytopenia
kabuki syndrome
monosomy 21
phenylketonuria
primary hyperoxaluria type 1
sneddon syndrome
werner syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated
