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Kidney Week

ASN / Education & Meetings / Kidney Week /

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Abstract: SA-PO097

Clinical Characteristics and Outcomes of Urolithiasis

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Kim, Sungyeon, Korea University, Seongbuk-gu, Korea (the Republic of)
  • Choi, Young Eun, Korea University, Seongbuk-gu, Korea (the Republic of)
  • Jang, Yookyung, Korea University, Seongbuk-gu, Korea (the Republic of)
  • Chung, Suk Min, Korea University, Seongbuk-gu, Korea (the Republic of)
  • Yoon Sook, Ko, Korea University, Seongbuk-gu, Korea (the Republic of)
  • Hee Young, Lee, Korea University, Seongbuk-gu, Korea (the Republic of)
  • Yang, Jihyun, Kangbuk Samsung Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Koo, Tai yeon, Korea University, Seongbuk-gu, Korea (the Republic of)
  • Oh, Sewon, Korea University, Seongbuk-gu, Korea (the Republic of)
  • Kim, Myung-Gyu, Korea University, Seongbuk-gu, Korea (the Republic of)
  • Jo, Sang-Kyung, Korea University, Seongbuk-gu, Korea (the Republic of)
Background

Recent studies have showed the incidence of urolithiasis is increasing and known to be associated with chronic kidney disease (CKD)/end stage kidney disease (ESKD). Although kidney and ureter stones are heterogenous in composition, it is usually considered as single entity. The aim of this study was to compare the different clinical characteristics and outcomes of kidney/ureter stone diseases according to compositions.

Methods

We performed a single center retrospective study of symptomatic stone formers with known stone compositions (n=758). Baseline characteristics, blood and urinary excretory profiles, prevalence of diverse comorbid conditions as well as acute kidney injury (AKI) and long-term outcomes including ESKD and death were compared.

Results

Mean age was 58.6 yrs with male predominance (64.5%). Calcium oxalate stone was the most common type (68%) followed by struvite stone (15.5%), uric acid stone (13%) and mixed stones. Uric acid stone formers were significantly older (68yrs) with male predominance (76.5%) and showed higher prevalence of diabetes mellitus, hypertension, ischemic heart disease/heart failure, dementia and cancer. Calcium oxalate stone formers excrete significantly higher levels of glucose and calcium while uric acid stone formers showed low urinary pH. Incidence of AKI was 36.3% and older age, hypertension, low total CO2, and uric acid stone were found to be independent risk factors of AKI. During the mean follow-up of 456 days, 33 (4.3%) progressed to ESKD and 35 (4.6%) died. AKI was found to be an independent risk factor for both ESKD and mortality regardless of stone composition.

Conclusion

Kidney stone disease is thought to be a heterogenous condition with different clinical characteristics and longterm outcomes. Occurrence of AKI regardless of stone composition is an important predictor for adverse longterm outcomes. Better understanding of epidemiology, risk factors and pathogenesis of this heterogenous conditions are needed.