Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Urol J. 2021 May 8;18(3):252-258. doi: 10.22037/uj.v18i02.6531.
Nephrolithiasis is a rare complication in transplanted kidneys and limited information is available about its therapeutic options. This study aimed to review the conservative management of urinary lithiasis and its outcomes in renal transplanted patients.
A systematic review and meta-analysis of the scientific literature were performed in the Medline, Scopus, and Embase databases. Inclusion criteria were studies which include patients with kidney stones in transplanted kidney no matter de-novo or donated stones and use conservative treatment for all or part of their patients. Exclusion criteria were bladder and ureteral stones, full text unavailable, conference paper. (from January 1st, 1980, to the 19th May 2020). The results of included studies, in the final analysis, were combined using a random-effect model and using metaprop method prevalence and 95% CI of renal stone were reported.
A total of 8 studies (14988 transplant patients) met the inclusion criteria for the final analysis. A total of 195 patients suffered from renal stone and the prevalence of renal stone was 1.3% (95% CI: 0.89% - 1.7%). The mean age of these patients was 43 years. analysis, the prevalence of conservative treatment in 195 patients was 35% (95% CI: 19%-51%). The mean stone size ranged from 0.29 cm to 1 cm. Three studies reported a stone-free rate of %100. Except for two studies that did not report complications, other studies reported zero percent.
More than one-third of nephrolithiasis were conservatively managed in transplanted patients. Despite limited data, conservative treatment could be done in less than 4 mm stones with high Stone Free Rate (SFR) and very low complications.
肾结石是移植肾脏的罕见并发症，关于其治疗选择的信息有限。本研究旨在回顾肾移植患者尿结石的保守治疗及其结果。
在 Medline、Scopus 和 Embase 数据库中进行了系统的文献综述和荟萃分析。纳入标准为包括移植肾肾结石患者（无论为新发性结石还是捐赠性结石）且对所有或部分患者采用保守治疗的研究。排除标准为膀胱和输尿管结石、全文不可用、会议论文。（从 1980 年 1 月 1 日至 2020 年 5 月 19 日）。最终分析中，使用随机效应模型和 metaprop 方法合并纳入研究的结果，报告肾结石的患病率和 95%CI。
共有 8 项研究（14988 例移植患者）符合最终分析的纳入标准。共有 195 例患者患有肾结石，肾结石的患病率为 1.3%（95%CI：0.89%-1.7%）。这些患者的平均年龄为 43 岁。分析中，195 例患者保守治疗的患病率为 35%（95%CI：19%-51%）。结石平均大小为 0.29 厘米至 1 厘米。有 3 项研究报告结石清除率为 100%。除了 2 项未报告并发症的研究外，其他研究均报告为零。
超过三分之一的肾结石在移植患者中采用保守治疗。尽管数据有限，但对于小于 4 毫米的结石，可以采用保守治疗，结石清除率高（SFR），并发症极低。
