Published online Sep 25, 2025. doi: 10.5527/wjn.v14.i3.105288
Revised: March 26, 2025
Accepted: June 9, 2025
Published online: September 25, 2025
Processing time: 243 Days and 15.5 Hours
Urolithiasisposes challenges in patients with chronic kidney disease (CKD), nece
To assess the safety, feasibility, and efficacy of surgical interventions for uro
Systematic review adhering to PRISMA guidelines. Comprehensive searches of PubMed, Scopus, Cochrane Library, Web of Science, and Embase were conducted for studies published from January 2014 to June 2024. Studies involving adult patients (≥ 18 years) with CKD undergoing surgical interventions for urolithiasis, including randomized controlled trials, cohort studies, case-control studies, and observational studies. Studies involving pediatric patients, those not specifically addressing CKD patients, review articles, commentaries, and editorials. Despite an extensive search, only six studies met the strict inclusion criteria, reflecting the limited available data on this topic. This limitation has been acknowledged and discussed.
A total of 6 studies met the inclusion criteria, encompassing a diverse range of surgical interventions such as percutaneous nephrolithotomy (PCNL), ureteroscopy (URS), and extracorporeal shock wave lithotripsy (ESWL). Perioperative and postoperative complications varied across studies, with bleeding, infection, and acute kidney injury being the most common. The risk of complications was higher in patients with advanced CKD. Technical success rates were generally high, but feasibility was influenced by patient-specific factors such as CKD stage and comorbidities. Modifications to standard surgical techniques were often necessary. Stone-free rates and recurrence rates varied, with PCNL generally achieving higher stone-free rates compared to URS and ESWL. Long-term outcomes on renal function were inconsistent, highlighting the need for individualized treatment plans.
Surgical interventions for urolithiasis in CKD patients are associated with significant risks but can be effective in achieving stone clearance and symptom relief. The safety, feasibility, and efficacy of these interventions depend on patient-specific factors, necessitating a tailored approach. Further high-quality studies are needed to develop standardized guidelines and improve clinical outcomes in this complex patient population.
Core Tip: This systematic review evaluates the safety, feasibility, and efficacy of surgical interventions for urolithiasis in patients with chronic kidney disease (CKD). Key findings highlight that while techniques such as percutaneous nephrolithotomy, ureteroscopy, and shock wave lithotripsy achieve technical success rates, they are associated with significant risks, including bleeding, infection, and acute kidney injury, especially in advanced CKD. Modifications to standard surgical methods are often required to address patient-specific factors. Stone-free rates vary across interventions, and long-term renal outcomes remain inconsistent, emphasizing the need for individualized treatment plans and further high-quality research to guide optimal management of patients with CKD.