Presented by: Jonathan Katz
UCSD/Department of Urology

Introduction

Metabolic evaluation and treatment for the prevention of nephrolithiasis in individuals with increased risk of kidney stones due to a family history of a first-degree relative with nephrolithiasis has not been explored. To better characterize this clinical scenario and potential patient interest, we surveyed patients with nephrolithiasis.

Materials

With IRB approval, we conducted telephone surveys of 50 patients being treated for nephrolithiasis at the UCSD Comprehensive Kidney Stone Center regarding demographics, number of first-degree relatives whose medical histories they were familiar with, and the number and age of onset of kidney stones within these family members. We compared the age of onset of nephrolithiasis in first-degree family members to determine if there was a trend towards earlier stone-disease in progeny. Finally, we asked patients if they would have been interested in metabolic testing and treatment prior to their initial stone event.

Results

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The median age of our patient’s first kidney stone was 43 (25.5, 58) years. 60% of patients were female. 40% had a first-degree relative with a kidney stone and within these families 83% had stones occurring earlier in successive generations (Figure 1). 10% of patients had children already affected by nephrolithiasis. Overall 66% of patients would have been interested in the option for metabolic testing prior to their first kidney stone had this been offered and of patients with a first-degree family member with kidney stones this number increased to 89%.  

Conclusion

Our data suggests that not only are progeny at increased risk for nephrolithiasis, but that they are also at risk at an earlier age. These individuals may be interested in metabolic evaluation and treatment prior to having their first stone, which offers a novel opportunity for intervention to stop nephrolithiasis before it starts. 

Funding

None

Lead Authors

Roger Sur,
UCSD/Department of Urology

Co-Authors

Henry Horita,
UCSD/Department of Urology

Cesar Delgado,
UCSD/Department of Urology

Seth Bechis,
UCSD/Department of Urology