Metabolic and Radiological Characteristics of Nephrolithiasis in Liver Transplant Candidates and Donors: A Retrospective Comparative Cohort Study

Nephrolithiasis is a globally prevalent condition with increasing incidence; however, its occurrence in patients with end-stage liver disease awaiting liver transplantation is less well known. The aim of this study is to evaluate and compare the prevalence and characteristics of kidney stones, the occurrence of stone-related surgery, the findings of urinalysis, and certain serum biomarkers in liver transplant candidates and liver donors. A total of 4970 individuals, 2485 liver transplant candidates and 2485 liver transplant donors, were scanned for nephrolithiasis. Kidney stones were detected in 85 (3.42%) liver transplant candidates and 71 (2.86%) liver transplant donors, and the male-to-female ratio was 3.72:1 among the transplant candidatesand 2.23:1 among the transplant donors. The median stone size and density were significantly higher in the transplant candidate group than in the donor group. Although urine pH and serum uric acid levels were significantly higher in the transplant candidates, no significant differences were detected in urine specific gravity, serum creatinine levels, or the percentage with a history of stone-related surgery. These findings suggest that hepatic dysfunction may be associated with larger and denser stones and altered biochemical parameters, although its role in increasing stone prevalence should be interpreted with caution.