Assessment of Metabolic, Clinical and Radiological Risk Factors for Nephrolithiasis in Autosomal Dominant Polycystic Kidney Disease: A Single-Center Retrospective Study

Autosomal dominant polycystic kidney disease (ADPKD) is a common monogenic disorder associated with an increased risk of nephrolithiasis. This study aimed to evaluate the clinical, metabolic, and radiological risk factors contributing to kidney stone formation in patients with ADPKD. A total of 55 patients followed in the nephrology outpatient setting at Bursa City Hospital between January 2022 and January 2025, with available non-contrast abdominopelvic CT scans, were retrospectively analyzed. Demographic data, laboratory values, radiological characteristics, and 24-hour urine analyses were recorded. Kidney stones were detected in 58.2% of patients based on CT reports. Macroscopic hematuria was observed exclusively in the stone-positive group. In multivariate logistic regression analysis, the presence of hepatic cysts (OR: 4.34) and increased 24-hour urinary calcium excretion (OR: 1.01) were identified as independent risk factors for nephrolithiasis. No significant association was found between stone formation and urinary citrate or oxalate levels. The number of patients receiving Tolvaptan therapy was equal between the two groups, limiting the assessment of its potential effect on stone formation. Although the prevalence of hypertension was higher in the stone-positive group, the difference was not statistically significant. The higher prevalence of nephrolithiasis observed in our cohort compared to the literature suggests that even asymptomatic ADPKD patients may benefit from non-contrast CT screening. Evaluating parameters such as hypercalciuria and hepatic cysts may aid in the development of individualized monitoring and management strategies.