TY - JOUR AU - Hesswani, Charles AU - Iqbal, Sameena AU - Rafat Zand, Khashayar AU - Sun, Simon AU - Unikowsky, Bernard AU - Reinhold, Caroline AU - Andonian, Sero PY - 2019/11/29 Y2 - 2024/03/29 TI - Identifying risk factors for development of nephrolithiasis in endstage renal disease patients JF - Canadian Urological Association Journal JA - CUAJ VL - 14 IS - 5 SE - Original Research DO - 10.5489/cuaj.6017 UR - https://cuaj.ca/index.php/journal/article/view/6017 SP - E185-90 AB - <p><strong>Introduction:</strong> We sought to assess the incidence and risk factors for stone development in patients with end-stage renal disease (ESRD) on hemodialysis (HD).</p><p><strong>Methods:</strong> Medical records of patients receiving HD between 2007 and 2017 were retrospectively reviewed. Patients who had been on HD for at least three months and had imaging studies (computed tomography [CT] scans or ultrasound [US]) pre- and post-initiation of HD were included. Exclusion criterion was presence of stones pre-HD. De novo stones were defined as renal stones found on followup imaging. Demographics, laboratory data, comorbidities, and dialysis characteristics were compared between non-stone-formers and stone-formers using propensity score matching.</p><p><strong>Results:</strong> A total of 133 patients met the inclusion criteria. Their median age was 68.5 years, median body mass index 28.7 kg/m2, and median dialysis duration 59.5 months. After HD, 14 (10.5%) patients developed de novo stones and their median dialysis-to-stone duration was 23.5 months. When compared with non-stone-formers, stone-formers had significantly lower incidence of hypertension (48.2% vs. 14.3%; p=0.03), lower serum ionized calcium (1.16 vs. 1.07 mmol/L; p=0.01) and magnesium (0.95 vs. 0.81 mmol/L; p=0.01), and significantly higher serum uric acid (281.5 vs. 319.0 mmol/L; p=0.03). Multivariate analysis demonstrated that lower serum ionized calcium (adjusted odds ratio [OR] 0.00001; 95% confidence interval [CI] 0–0.18) and magnesium (adjusted OR 0.0003; 95% CI 0–0.59) were significantly associated with stone-formation.</p><p><strong>Conclusions:</strong> The incidence of de novo nephrolithiasis in ESRD patients on HD was 10.5%. Increased serum uric acid, decreased serum magnesium and ionized calcium, and absence of hypertension were associated with increased stone-formation in ESRD patients on HD.</p> ER -