title: What is the incidence of kidney stones after chemotherapy in patients with lymphoproliferative or myeloproliferative disorders?
abstract: BACKGROUND
  This study describes the incidence and risk factors of de novo nephrolithiasis among patients with lymphoproliferative or myeloproliferative diseases who have undergone chemotherapy.
  
  
  METHODS
  From 2001 to 2011, patients with lymphoproliferative or myeloproliferative disorders treated with chemotherapy were retrospectively identified. The incidence of image proven nephrolithiasis after chemotherapy was determined. Demographic and clinical variables were recorded. Patients with a history of nephrolithiasis prior to chemotherapy were excluded. The primary outcome was incidence of nephrolithiasis, and secondary outcomes were risk factors predictive of de novo stone. Comparative statistics were used to compare demographic and disease specific variables for patients who developed de novo stones versus those who did not.
  
  
  RESULTS
  A total of 1,316 patients were identified and the incidence of de novo nephrolithiasis was 5.5% (72/1316; symptomatic stones 1.8% 24/1316). Among patients with nephrolithiasis, 72.2% had lymphoproliferative disorders, 27.8% had myeloproliferative disorders, and 25% utilized allopurinol. The median urinary pH was 5.5, and the mean serum uric acid, calcium, potassium and phosphorus levels were 7.5, 9.6, 4.3, and 3.8 mg/dL, respectively. In univariate analysis, mean uric acid (p=0.013), calcium (p<0.001)), and potassium (p=0.039) levels were higher in stone formers. Diabetes mellitus (p<0.001), hypertension (p=0.003), and hyperlipidemia (p<0.001) were more common in stone formers. In multivariate analysis, diabetes mellitus, hyperuricemia, and hypercalcemia predicted stone.
  
  
  CONCLUSIONS
  We report the incidence of de novo nephrolithiasis in patients who have undergone chemotherapy. Diabetes mellitus, hyperuricemia, and hypercalcemia are patient-specific risk factors that increase the odds of developing an upper tract stone following chemotherapy.
authors.affiliation: Department of Urology, UC San Diego Health System, San Diego CA, USA.
authors.forename: Hossein S
authors.initials: HS
authors.lastname: Mirheydar
authors.affiliation: UC San Diego School of Medicine, La Jolla, CA, USA.
authors.forename: Pooya
authors.initials: P
authors.lastname: Banapour
authors.affiliation: UC San Diego School of Medicine, La Jolla, CA, USA.
authors.forename: Rustin
authors.initials: R
authors.lastname: Massoudi
authors.affiliation: Department of Urology, UC San Diego Health System, San Diego CA, USA.
authors.forename: Kerrin L
authors.initials: KL
authors.lastname: Palazzi
authors.affiliation: UC San Diego School of Medicine, La Jolla, CA, USA.
authors.forename: Ramzi
authors.initials: R
authors.lastname: Jabaji
authors.affiliation: Department of Medicine, Division of Hematology/Oncology, UC San Diego Health System, San Diego, CA, USA.
authors.forename: Erin G
authors.initials: EG
authors.lastname: Reid
authors.affiliation: Department of Medicine, Division of Hematology/Oncology, UC San Diego Health System, San Diego, CA, USA.
authors.forename: Frederick E
authors.initials: FE
authors.lastname: Millard
authors.affiliation: Department of Urology, UC San Diego Health System, San Diego CA, USA; UC San Diego School of Medicine, La Jolla, CA, USA and VA San Diego Healthcare System, San Diego, CA, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Kane
authors.affiliation: Department of Urology, UC San Diego Health System, San Diego CA, USA; UC San Diego School of Medicine, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA and Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Roger L
authors.initials: RL
authors.lastname: Sur
mesh_terms: D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use; D002118:Calcium / Q000032:analysis; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000150:complications; D033461:Hyperuricemia / Q000150:complications; D007669:Kidney Calculi / Q000209:etiology*; D008232:Lymphoproliferative Disorders / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009196:Myeloproliferative Disorders / Q000188:drug therapy*; D011188:Potassium / Q000032:analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015275:Tumor Lysis Syndrome / Q000150:complications / Q000188:drug therapy
chemical_list: D000493:Allopurinol; D011188:Potassium; D002118:Calcium