What is the Incidence of Kidney Stones after Chemotherapy in Patients with Lymphoproliferative or Myeloproliferative Disorders?

Abstract

ARTICLE INFO ______________________________________________________________ ______________________Introduction: This study describes the incidence and risk factors of de novo nephrolithiasis among patients with lymphoproliferative or myeloproliferative diseases who have undergone chemotherapy. Materials and 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.

Neck Circumference, a Novel Indicator for Hyperuricemia

“…Epidemiology studies from mainland China spanning 2000–2014 have shown that the prevalence of hyperuricemia is 13.7% in urban Chinese and 12.3% in rural Chinese individuals (Liu et al, 2015 ). Hyperuricemia causes gouty arthritis (Zamudio-Cuevas et al, 2015 ), kidney stones (Mirheydar et al, 2014 ) and chronic renal failure (Tsai et al, 2017 ), which significantly impact quality of life (Scire et al, 2013 ). Hyperuricemia has also been considered to be a risk factor for metabolic syndrome (Cibicková et al, 2017 ; Rubio-Guerra et al, 2017 ), diabetes mellitus (Wang et al, 2013 ), hypertension (Lyngdoh et al, 2012 ), stroke (Wu et al, 2017 ), chronic kidney disease (Ceriello et al, 2017 ) and cardiovascular disease (Qin et al, 2014 ; Amin et al, 2017 ; Moulin et al, 2017 ).…”

Can conventional clinical chemistry tests help doctors in the monitoring of oncology patients?

“…Approximately 20% of patients with lympho-and myeloproliferative diseases have hyperuricemia. Excess production of uric acid is associated with extremely rapid production and destruction of blood cells and hypermetabolism syndrome [68]. Severe hyperuricemia is observed as a result of tumour lysis [69], which allows the use of the uric acid levels in the blood serum to assess the risk of tumour lysis syndrome [41,70,71], and for the monitoring of the patient's life-threatening condition [42,45].…”

Prevalence and risk factors for hyperuricemia and hyperuricosuria in patients with hematologic malignancies

“…Although the tumor lysis syndrome (TLS) is the life-threatening complication, with a prevalence ranging from 6.1% to 27.8% in patients with acute leukemia and non-Hodgkin lymphoma, that results in hyperuricemia and acute kidney injury, the study on the risk factors of hyperuricemia or hyperuricosuria remains controversial ( 1 – 4 ). A 5.5% incidence of de novo kidney stones in patients with myeloproliferative and lymphoproliferative disorders after initiation of chemotherapy had been reported ( 11 ). Uric nephrolithiasis typically develops in patients who have acidified urine, hyperuricosuria, and low urine volume.…”