Recent Literatures and Updated Guidelines on Kidney Stones
Charat Thongprayoon, Wisit Cheungpasitporn
Division of Nephrology and Hypertension, Department of Medicine,
are very common urological problems. The incidence of kidney stones is rising
with an estimated global prevalence of 10% to 15%. In the
Kidney Stones | Meta-analysis | Nephrolithiasis | Urolithiasis
stones are very common urological problems. The incidence of kidney stones is
rising with an estimated global prevalence of 10% to 15%.1-4 In the
Clinical Effectiveness of Shock Wave Lithotripsy, Retrograde Intrarenal Surgery, and Percutaneous Nephrolithotomy for Lower-pole Renal Stones.
A recent meta-analysis demonstrated that percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) were superior to shock wave lithotripsy (SWL) in clearing the Lower-pole stones within 3 months.7 Lee et. al.8 showed that, for stones <10mm, shockwave lithotripsy with adjuvant therapy such as inversion, hydration and forced diuresis appears to have better stone clearance, lower risk of adverse events and need for further treatment for Lower-pole Renal Stones. De et. al.9 performed meta-analysis comparing Percutaneous nephrolithotomy (PCNL) Versus Retrograde Intrarenal Surgery and found that PCNL is associated with higher stone-free rates at the expense of higher complication rates, blood loss, and admission times.
The Risk of Kidney Cancer in Patients with Kidney Stones
We performed a meta-analysis of seven studies and found a significant increased risk of renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) in patients with prior kidney stones. However, the increased risk of RCC was noted only in male patients.10 The finding may impact clinical management and cancer surveillance.
Kidney Stones and Cardiovascular Risk:
Meta-analyses11, 12 have shown that kidney stones are linked to increased cardiovascular risk, including the risk for incident CHD or stroke. The risk may be higher in women than men. Further studies are required to determine whether the association is sex specific.
Goldfarb, DS: Increasing prevalence of kidney stones in the
6. Pearle, MS, Goldfarb, DS, Assimos, DG, Curhan, G, Denu-Ciocca, CJ, Matlaga, BR, Monga, M, Penniston, KL, Preminger, GM, Turk, TM, White, JR: Medical management of kidney stones: AUA guideline. J Urol, 192: 316-324, 2014.
7. Donaldson, JF, Lardas, M, Scrimgeour, D, Stewart, F, MacLennan, S, Lam, TB, McClinton, S: Systematic Review and Meta-analysis of the Clinical Effectiveness of Shock Wave Lithotripsy, Retrograde Intrarenal Surgery, and Percutaneous Nephrolithotomy for Lower-pole Renal Stones. Eur Urol, 2014.
8. Lee, SW, Chaiyakunapruk, N, Chong, HY, Liong, ML: Comparative efficacy and safety of various treatment procedures for lower pole renal calculi: a systematic review and network meta-analysis. BJU Int, 2014.
9. De, S, Autorino, R, Kim, FJ, Zargar, H, Laydner, H, Balsamo, R, Torricelli, FC, Di Palma, C, Molina, WR, Monga, M, De Sio, M: Percutaneous Nephrolithotomy Versus Retrograde Intrarenal Surgery: A Systematic Review and Meta-analysis. Eur Urol, 67: 125-137, 2015.
Cheungpasitporn, W, Thongprayoon, C, O'Corragain, OA,
Cheungpasitporn, W, Thongprayoon, C,
Conflict of interest: No conflicts declared.
Department of Medicine, Division of Nephrology and Hypertension
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