Kidney stone natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Overview

If left untreated, <30% of patients with nephrolithiasis may progress to develop renal colicky pain due to increase in rate of growth.Most of the stones pass spontaneously. about 10-20% of symptom-causing stones fail to pass. Lower poles stones were significantly less likely to cause symptoms or pass spontaneously. They can progress to hydronephrosis especially when combined or superimposed by urinary tract infection. Common complications of nephrolithiasis include hydronephrosis, chronic renal failure, hypertension, cardiovascular disease, and increased risk of fracture. Prognosis is generally excellent. Approximately 80-85% resolve spontaneously. Recurrence rates for calcium stones after the initial event is 40–50% at the end of 5 years and 50–60% at the end of 10 years.

Natural History, Complications, and Prognosis

Natural History

  • If left untreated, <30% of patients with nephrolithiasis may progress to develop renal colicky pain due to increase in rate of growth.[1]
  • Most of the stones pass spontaneously. about 10-20% of symptom causing stones fail to pass.[2]
  • Lower poles stones were significantly less likely to cause symptoms or pass spontaneously.
  • They can progress to hydronephrosis especially when combined or superimposed by urinary tract infection.

Complications

Prognosis

  • Prognosis is generally excellent.
  • Approximately 80-85% resolve spontaneously
  • Recurrence rates for calcium stones after the initial event is 40–50% at the end of 5 years and 50–60% at the end of 10 years.[6]

References

  1. Dropkin BM, Moses RA, Sharma D, Pais VM (April 2015). "The natural history of nonobstructing asymptomatic renal stones managed with active surveillance". J. Urol. 193 (4): 1265–9. doi:10.1016/j.juro.2014.11.056. PMID 25463995.
  2. Worcester EM, Coe FL (June 2008). "Nephrolithiasis". Prim. Care. 35 (2): 369–91, vii. doi:10.1016/j.pop.2008.01.005. PMC 2518455. PMID 18486720.
  3. Madore F, Stampfer MJ, Willett WC, Speizer FE, Curhan GC (November 1998). "Nephrolithiasis and risk of hypertension in women". Am. J. Kidney Dis. 32 (5): 802–7. PMID 9820450.
  4. Ferraro PM, Taylor EN, Eisner BH, Gambaro G, Rimm EB, Mukamal KJ, Curhan GC (July 2013). "History of kidney stones and the risk of coronary heart disease". JAMA. 310 (4): 408–15. doi:10.1001/jama.2013.8780. PMC 4019927. PMID 23917291.
  5. Denburg MR, Leonard MB, Haynes K, Tuchman S, Tasian G, Shults J, Copelovitch L (December 2014). "Risk of fracture in urolithiasis: a population-based cohort study using the health improvement network". Clin J Am Soc Nephrol. 9 (12): 2133–40. doi:10.2215/CJN.04340514. PMC 4255404. PMID 25341724.
  6. Worcester EM, Coe FL (June 2008). "Nephrolithiasis". Prim. Care. 35 (2): 369–91, vii. doi:10.1016/j.pop.2008.01.005. PMC 2518455. PMID 18486720.

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