Kidney Stones (Nephrolithiasis): Complications

The following are the most important diseases or complications that may be contributed to by nephrolithiasis (kidney stones):

Neoplasms (C00-D48)

• Renal cell carcinoma – significantly higher likelihood of papillary renal cell carcinoma than in patients without kidney stones (3.08-fold increased risk); no association with development of clear cell renal carcinoma
• Urothelial carcinoma (malignant (malignant) tumors of the urothelium (transitional tissue) lining the urinary tract) of the upper urinary tract (1.76-fold increased risk)

Symptoms and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)

• Dysuria – difficult (painful) urination; caused by injury to the wall of the urethra from the migrating stone.

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

• Bleeding
• Urinary stone recurrence (see prognostic factors below).
• Renal insufficiency (in case of recurrent/recurrent nephrolithiasis).
• Congestive kidney due to urinary retention with the formation of renal insufficiency (kidney weakness).
• Strictures (scar strands) in ureters (ureters) or urethra (urethra).
• Urethritis (inflammation of the urethra)
• Urosepsis – blood poisoning due to infection in the urinary tract.

Prognostic factors

High-risk group of urinary stone formers:

• Biographic causes
  • Genetic burden – genetically determined stone formation (e.g., cystinuria, primary hyperoxaluria, renal tubular acidosis (RTA), xanthinuria, 2,8-dihydroxyadeninuria).
  • Positive family history
  • Children and adolescents
• Diseases
  • Urinary transport disorder
  • Uric acid and urate stone formation (gout).
  • Hyperparathyroidism (parathyroid hyperfunction).
  • Infection stone formation
  • Gastrointestinal diseases (Crohn’s disease, ulcerative colitis, fat malabsorption syndrome, Z. n. bariatric surgery, sprue).
  • Nephrocalcinosis (deposition of calcium salts in the renal vessels and connective tissue of the kidney).
• Further
  • Frequent recurrent stone formation (≥ 3 stones within 3 years).
  • Brushite and carbonate apatite stone formation.
  • Bilateral (“on both sides”) large stone mass.
  • Residual stones (“residual stones”) after previous therapy.
  • Single kidney situation

Risk factors for stone growth

• Age > 60 years
• Diabetes mellitus
• Hyperuricemia (uric acid metabolism disorder)
• Stones >5 mm and those that were not at the lower pole posed a greater risk for stone-related symptoms:
  • Stones at the inferior pole of the kidney and those that were >5 mm were less likely to resolve spontaneously.
  • Stones that were not located at the bottom of a calyx.