Kidney stones are common in patients with short bowel syndrome receiving long-term parenteral nutrition. A predictive model for urolithiasis.

Background In short bowel syndrome (SBS) treated with parenteral nutrition (PN), multiple complications can occur. The etiology of kidney stones may be linked to the underlying disease (mesenteric thrombosis, surgical complications and injury, complications of therapy for cancer, Crohn's disease), metabolic abnormalities resulting from morphological and functional changes in the gastrointestinal tract, and to treatment used. We analyzed all these parameters in a large cohort of patients receiving home parenteral nutrition (HPN), to define the incidence of kidney stones and groups of patients particularly at risk of stone formation. One of the objectives of the study was to develop a predictive model of urolithiasis. Materials and methods This observational retrospective study included 459 SBS patients maintained on home PN in a single center. Patient records were evaluated for demographics, SBS etiology and underlying disease, anatomy of the gastrointestinal tract, intestinal failure classification, nutrition regimen and presence of urolithiasis. Results Kidney stones were diagnosed in 24% of patients. No statistically significant differences in incidence were noted between the various etiologic groups. The incidence in patients with a colon in continuity and those with an end stoma was similar. The length of residual small bowel did not play a role in stone formation. There were no statistically significant differences between patients according to the severity of intestinal failure. In patients treated with PN and limited oral feeding, the risk of urolithiasis was twice as high as in patients receiving PN only. Conclusions Patients developed urolithiasis with no relation to the SBS etiology. The risk of kidney stone formation was higher in patients on PN with oral feeding. This article is protected by copyright. All rights reserved.