title: Nephrectomy as a cause of chronic kidney disease in the treatment of urolithiasis: a case-control study.
abstract: OBJECTIVE
  To analyze the clinical course of nephrectomized patients due to complications related to nephrolithiasis and ascertain the prevalence of chronic kidney disease (CKD) in this population.
  
  
  METHODS
  From 2005 to 2010, 658 patients were treated with urolithiasis. Among these, 30 (4.6%) were nephrectomized. For each case, a control was selected and matched to the case by age, sex and disease duration. All data were collected from medical records, which contained the clinical, laboratory evaluation and diagnostic imaging.
  
  
  RESULTS
  Age of the study group was 51.5 ± 10.4 years and the control group 47.1 ± 5.2 years. There were 17 (85%) women and three men in each group. Patients from the study group reported 3 (range, 1-5) episodes of acute renal colic before nephrectomy. Urinary tract infection and hematuria was detected in 70% of cases before surgery. In addition, half of the patients had at least one previous urological procedure. The control group showed higher urinary levels of calcium (216.1 ± 114.3 vs. 130.9 ± 72.2), uric acid (530.2 ± 197.4 vs. 424 ± 75.2) and citrate (755 ± 533 vs. 380.2 ± 260.7), p < 0.01, 0.03 and 0.01, respectively. The creatinine clearance was lower in the study group, 52.5 ± 18.8 ml/min vs. 92.9 ± 24.2 ml/min in the control group (p < 0.001).
  
  
  CONCLUSIONS
  There was a decrease in kidney function in nephrectomized patients compared to a control group of stone-forming patients with both kidneys. Prospective studies are needed to assess the incidence of CKD in patients with nephrolithiasis submitted to nephrectomy.
authors.affiliation: Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil, carvalho@mais.sul.com.br.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Carvalho
authors.forename: Rafael Luis Santos
authors.initials: RL
authors.lastname: Martin
authors.forename: Rodrigo Coutinho
authors.initials: RC
authors.lastname: Passos
authors.forename: Miguel Carlos
authors.initials: MC
authors.lastname: Riella
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D052878:Urolithiasis / Q000601:surgery*