Assessment of Metabolic, Clinical and Radiological Risk Factors for Nephrolithiasis in Autosomal Dominant Polycystic Kidney Disease: A Single-Center Retrospective Study

Yıl 2025, Cilt: 51 Sayı: 2, 247 - 253, 28.08.2025

Mehmet Sezen , Suat Akgür

https://doi.org/10.32708/uutfd.1694098

Öz

Autosomal dominant polycystic kidney disease (ADPKD) is a common monogenic disorder associated with an increased risk of nephrolithiasis. This study aimed to evaluate the clinical, metabolic, and radiological risk factors contributing to kidney stone formation in patients with ADPKD. A total of 55 patients followed in the nephrology outpatient setting at Bursa City Hospital between January 2022 and January 2025, with available non-contrast abdominopelvic CT scans, were retrospectively analyzed. Demographic data, laboratory values, radiological characteristics, and 24-hour urine analyses were recorded. Kidney stones were detected in 58.2% of patients based on CT reports. Macroscopic hematuria was observed exclusively in the stone-positive group. In multivariate logistic regression analysis, the presence of hepatic cysts (OR: 4.34) and increased 24-hour urinary calcium excretion (OR: 1.01) were identified as independent risk factors for nephrolithiasis. No significant association was found between stone formation and urinary citrate or oxalate levels. The number of patients receiving Tolvaptan therapy was equal between the two groups, limiting the assessment of its potential effect on stone formation. Although the prevalence of hypertension was higher in the stone-positive group, the difference was not statistically significant. The higher prevalence of nephrolithiasis observed in our cohort compared to the literature suggests that even asymptomatic ADPKD patients may benefit from non-contrast CT screening. Evaluating parameters such as hypercalciuria and hepatic cysts may aid in the development of individualized monitoring and management strategies.

Anahtar Kelimeler

Autosomal dominant polycystic kidney disease , Nephrolithiasis , Risk factors , Radiological assessment

Otozomal Dominant Polikistik Böbrek Hastalığında Nefrolitiazis İçin Metabolik, Klinik ve Radyolojik Risk Faktörlerinin Değerlendirilmesi: Tek Merkezli Retrospektif Bir Çalışma

Öz

Otozomal dominant polikistik böbrek hastalığı (ODPKBH), böbrek taşı gelişimi açısından artmış risk barındıran bir monogenik hastalıktır. Bu çalışmada, ODPKBH tanılı bireylerde böbrek taşı oluşumuna katkıda bulunabilecek klinik, metabolik ve radyolojik risk faktörlerinin değerlendirilmesi amaçlanmıştır. Ocak 2022 - Ocak 2025 tarihleri arasında Bursa Şehir Hastanesi Ayaktan Nefroloji Polikliniği’nde takip edilen ve non-kontrast batın BT görüntülemesi mevcut olan, 55 ODPKBH hastasının verileri retrospektif olarak incelendi. Demografik, laboratuvar ve radyolojik özellikler ile 24 saatlik idrar analizleri kaydedildi. Hastaların %58,2’sinde BT raporlarında taş varlığı tespit edildi. Makroskopik hematüri sadece taş saptanan grupta gözlendi. Çok değişkenli lojistik regresyon analizinde, karaciğer kisti varlığı (OR: 4,34) ve 24 saatlik idrarda artmış kalsiyum atılımı (OR: 1,01) bağımsız risk faktörleri olarak belirlendi. Sitrat ve oksalat düzeyleri ile taş varlığı arasında anlamlı ilişki saptanmadı. Tolvaptan tedavisi alan hasta sayısı eşit olduğundan bu ilacın taş üzerine etkisi değerlendirilemedi. Taş saptanan grupta hipertansiyon oranı yüksek olmakla birlikte istatistiksel anlamlılık izlenmedi. Çalışmamızda literatüre kıyasla daha yüksek taş prevalansı tespit edilmesi, asemptomatik ODPKBH hastalarında dahi non-kontrast BT ile taş taramasının değerli olabileceğini düşündürmektedir. Hiperkalsiüri ve karaciğer kisti varlığı gibi parametrelerin değerlendirilmesi, kişiye özgü takip ve tedavi planlarının oluşturulmasına katkı sağlayabilir.

Anahtar Kelimeler

Otozomal dominant polikistik böbrek hastalığı , Nefrolitiyazis , Risk faktörleri , Radyolojik değerlendi

Kaynakça

• 1. Torres VE, Harris PC, Pirson Y. Autosomal dominant polycystic kidney disease. Lancet. 2007;369(9569):1287-301.
• 2. Grantham JJ. Clinical practice. Autosomal dominant polycystic kidney disease. N Engl J Med. 2008;359(14):1477-85.
• 3. Chapman AB, Devuyst O, Eckardt KU, et al. Autosomal-dominant polycystic kidney disease (ADPKD): Executive summary from a KDIGO Controversies Conference. Kidney Int. 2015;88(1):17–27.
• 4. Torres VE, Erickson SB, Smith LH, Wilson DM, Hattery RR, Segura JW. The association of nephrolithiasis and autosomal dominant polycystic kidney disease. Am J Kidney Dis. 1988 Apr;11(4):318-25.
• 5. Levine E, Grantham JJ. Calcified renal stones and cyst calcifications in autosomal dominant polycystic kidney disease: clinical and CT study in 84 patients. AJR Am J Roentgenol. 1992 Jul;159(1):77-81.
• 6. Grampsas SA, Chandhoke PS, Fan J, Glass MA, Townsend R, Johnson AM, Gabow P. Anatomic and metabolic risk factors for nephrolithiasis in patients with autosomal dominant polycystic kidney disease. Am J Kidney Dis. 2000 Jul;36(1):53-7.
• 7. Romero V, Akpinar H, Assimos DG. "Kidney stones: a global picture of prevalence, incidence, and associated risk factors." Rev Urol. 2010;12(2-3):e86–e96.
• 8. Shastri S, Patel J, Sambandam KK, Lederer ED. Kidney Stone Pathophysiology, Evaluation and Management: Core Curriculum 2023. Am J Kidney Dis. 2023 Nov;82(5):617-634.
• 9. Torres VE, Harris PC. Autosomal dominant polycystic kidney disease (ADPKD): Kidney manifestations. UpToDate. Waltham, MA: UpToDate Inc.; Accessed April 30, 2025. Available from: https://www.uptodate.com/contents/autosomal-dominant-polycystic-kidney-disease-adpkd-kidney-manifestations
• 10. Kaygısız O, Coşkun B, Oruç A, Gedik CC, Ersoy A, Kordan Y, Kılıçarslan H, Yıldız A. Evaluation of nephrolithiasis risk factors in autosomal dominant polycystic kidney disease (ADPKD): a single center experience. Okmeydanı Tıp Dergisi. 2018;34(2):87-91.
• 11. Pak CY, Sakhaee K, Moe OW, Poindexter JR, Adams-Huet B, Pearle MS. Biochemical profile of stone-forming patients with diabetes mellitus. Urology. 2003;61(3):523–527.
• 12. Sakhaee K, Capolongo G, Maalouf NM, Pasch A, Moe OW, Poindexter J, Adams-Huet B. Metabolic syndrome and the risk of calcium stones. Nephrol Dial Transplant. 2012 Aug;27(8):3201-9.
• 13. Worcester EM, Coe FL. Clinical practice. Calcium kidney stones. N Engl J Med. 2010 Sep 2;363(10):954-63.
• 14.Taylor EN, Curhan GC. Oxalate intake and the risk fornephrolithiasis. J Am Soc Nephrol. 2007 Jul;18(7):2198-204.
• 15.Coe FL, Evan A, Worcester E. Kidney stone disease. J ClinInvest. 2005;115(10):2598–2608.
• 16.Nishiura JL, Neves RF, Eloi SR, Cintra SM, Ajzen SA,Heilberg IP. Evaluation of nephrolithiasis in autosomaldominant polycystic kidney disease patients. Clin J Am SocNephrol. 2009 Apr;4(4):838-44.
• 17.Resnick MI, Munday D, Boyce WH. Magnesium excretion andcalcium oxalate urolithiasis. Urology. 1982 Oct;20(4):385-9. Ettinger B, Citron JT, Livermore B, Dolman LI. Chronicpotassium-magnesium citrate therapy for calcium oxalatenephrolithiasis. J Urol. 1997;158(6):2069–2073.
• 18.Ferraro PM, Taylor EN, Curhan GC. 24-Hour UrinaryChemistries and Kidney Stone Risk. Am J Kidney Dis. 2024Aug;84(2):164-169.
• 19.Chasan O, Mirioglu S, Artan AS, Gursu M, Kazancioglu R,Elcioglu OC. Assessment of metabolic risk factors fornephrolithiasis in patients with autosomal dominant polycystickidney disease: a cross-sectional study. Clin Exp Nephrol. 2023Nov;27(11):912-918.
• 20.Torres VE, Chapman AB, Devuyst O, Gansevoort RT,Grantham JJ, Higashihara E, Perrone RD, Krasa HB, Ouyang J,Czerwiec FS. Tolvaptan in Patients with Autosomal DominantPolycystic Kidney Disease. N Engl J Med. 2012 Dec20;367(25):2407-18.
• 21.Borghi L, Meschi T, Guerra A, Briganti A, Schianchi T, AllegriF, Novarini A. Essential arterial hypertension and stone disease. Kidney Int. 1999 Jun;55(6):2397-406
• 22.Madore F, Stampfer MJ, Rimm EB, Curhan GC. Nephrolithiasis and risk of hypertension. Am J Hypertens. 1998Jan;11(1 Pt 1):46-53.