Clinical Outcomes of hemodialysis optimization in Patients with nephrolithiasis
DOI:
https://doi.org/10.5281/zenodo.22812972Keywords:
hemodialysis, nephrolithiasis, dialysis adequacy, mineral metabolism, residual renal functionAbstract
Background: Patients with a history of nephrolithiasis who progress to maintenance hemodialysis represent a distinct clinical group in whom stone-related mineral derangements overlap with the dialysis adequacy and mineral-bone disturbances already common in end-stage renal disease.
Objective: This study evaluated clinical outcomes, symptomatic stone events, biochemical stone-risk markers, residual renal function, and hospitalization, in a hemodialysis cohort with documented nephrolithiasis before and after a structured dialysis-optimization protocol.
Methods: A single-center, retrospective, pre-post cohort analysis compared a 12-month baseline period of conventional thrice-weekly hemodialysis with a 12-month period following optimization of dialysis dose, ultrafiltration rate, and dialysate calcium composition, in patients with imaging-confirmed nephrolithiasis.
Results: Delivered single-pool Kt/V rose toward guideline targets, predialysis calcium, phosphate, and uric acid shifted favorably, all-cause hospitalization declined, and symptomatic stone events remained infrequent and stable across both periods, with no increase in vascular access complications.
Conclusions: Structured hemodialysis optimization was associated with favorable biochemical and hospitalization outcomes and preserved residual renal function in stone-forming dialysis patients, without a stone-specific benefit or safety signal, supporting individualized prescribing pending larger prospective study.
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