Kidney stones and autosomal dominant polycystic kidney disease: a state-of-the-art review

Abstract Kidney stones (nephrolithiasis/urolithiasis) are a clinically significant yet underrecognized complication of autosomal dominant polycystic kidney disease (ADPKD), with reported prevalence ranging from 3% to 59% due to differences in diagnostic criteria and study design. Patients with ADPKD are predisposed to uric acid and calcium oxalate stones, driven by metabolic abnormalities, such as low urine pH, hypocitraturia, hyperuricosuria, as well as structural factors including cyst-induced distortion of the collecting system and impaired urinary drainage. These anatomical changes complicate both diagnosis and intervention, posing challenges, such as reduced stone-free rates, longer operative times, increased need for repeat procedures, and higher complication risk. While non-contrast computed tomography (CT) remains the diagnostic gold standard, low-dose CT is preferred to minimize cumulative radiation exposure. Management generally aligns with that of the broader population and includes aggressive hydration, correction of metabolic derangements, dietary modification, and individualized urologic intervention. Tolvaptan, a vasopressin V2 receptor antagonist, may have additional benefit by increasing urine volume, reducing supersaturation, and potentially mitigating stone risk. This review integrates nephrology, urology, and imaging perspectives to summarize the current understanding of nephrolithiasis in ADPKD, including its pathophysiology, clinical manifestations, diagnostic challenges, and management. We propose an ADPKD-specific diagnostic and management algorithm to optimize prevention, evaluation, and treatment of stone disease in this complex population.

• Publication year

  2025

• Venue

  Renal Failure

• Publication date

  2025-11-09

• Fields of study

  Medicine

• Identifiers
  DOI 10.1080/0886022X.2025.2570071PMID 41208250PMCID 12604128
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• KDIGO 2025 Clinical Practice Guideline for the Evaluation, Management, and Treatment of Autosomal Dominant Polycystic Kidney Disease (ADPKD).

  2025cited by this paper
• Associations between clinical, biochemical, and nutritional factors in kidney stone formation and recurrence

  2025cited by this paper
• Metabolic Differences in 24-Hour Urine Parameters Between Calcium Oxalate Monohydrate and Dihydrate Kidney Stones: A Clinical Study

  2025cited by this paper
• The impact of asymptomatic kidney stones on disease progression in autosomal dominant polycystic kidney disease

  2025cited by this paper
• Empyema Resulting From a Nephro-Pleural Fistula in an Adult With Polycystic Kidney Disease With Obstructive Uropathy

  2024cited by this paper
• Prevalence and characteristics of genetic disease in adult kidney stone formers

  2024cited by this paper
• Kidney Stones Account for Increased Imaging Studies in Autosomal Dominant Polycystic Kidney Disease

  2024cited by this paper
• Urological Guidelines for Kidney Stones: Overview and Comprehensive Update

  2024cited by this paper
• Quantitative susceptibility mapping for detection of kidney stones, hemorrhage differentiation, and cyst classification in ADPKD

  2024cited by this paper
• Therapeutic Potential of Ketogenic Interventions for Autosomal-Dominant Polycystic Kidney Disease: A Systematic Review

  2024cited by this paper
• Biomarkers of Kidney Disease Progression in ADPKD

  2024cited by this paper
• Acute Kidney Injury Due to Nephrolithiasis in Autosomal Dominant Polycystic Kidney Disease Treated With Tolvaptan: A Case Report

  2024cited by this paper
• Tolvaptan and Kidney Function Decline in Older Individuals With Autosomal Dominant Polycystic Kidney Disease: A Pooled Analysis of Randomized Clinical Trials and Observational Studies

  2023cited by this paper
• Beyond Loss of Kidney Function: Patient Care in Autosomal Dominant Polycystic Kidney Disease

  2023cited by this paper
• Cystic Kidney Diseases in Children and Adults: Differences and Gaps in Clinical Management.

  2023cited by this paper
• Drivers of calcium oxalate stone formation in the octogenarian population

  2023cited by this paper
• The value of dual-energy computed tomography (DECT) in the diagnosis of urinary calculi: a systematic review and meta-analysis of retrospective studies

  2023cited by this paper
• Kidney Stone Pathophysiology, Evaluation and Management: Core Curriculum 2023.

  2023cited by this paper
• Assessment of metabolic risk factors for nephrolithiasis in patients with autosomal dominant polycystic kidney disease: a cross-sectional study

  2023cited by this paper
• Drug Development in Autosomal Dominant Polycystic Kidney Disease: Opportunities and Challenges.

  2023cited by this paper
• Utility of new image-derived biomarkers for autosomal dominant polycystic kidney disease prognosis using automated instance cyst segmentation.

  2023cited by this paper
• More dissimilarities than affinities between DNAJB11-PKD and ADPKD

  2022cited by this paper
• Urinary Citrate Is Associated with Kidney Outcomes in Early Polycystic Kidney Disease

  2022cited by this paper
• Laparoscopic ureterolithotomy versus percutaneous nephrolithotomy for large proximal ureteral stones: a systematic review and meta-analysis

  2022cited by this paper
• Genetic Polymorphisms and Kidney Stones Around the Globe: A Systematic Review and Meta-Analysis

  2022cited by this paper
• Management of autosomal dominant polycystic kidney disease in the era of disease-modifying treatment options

  2022cited by this paper
• Update - 2022 Canadian Urological Association guideline: Evaluation and medical management of the kidney stone patient.

  2022cited by this paper
• OUP accepted manuscript

  2022cited by this paper
• Using retroperitoneal laparoscopic ureterolithotomy in the treatment of impacted upper ureteric calculi

  2022cited by this paper
• Urinary citrate as a marker of renal function in patients with autosomal dominant polycystic kidney disease

  2021cited by this paper
• Recent advances on the mechanisms of kidney stone formation (Review)

  2021cited by this paper
• The CT scout view: complementary value added to abdominal CT interpretation

  2021cited by this paper
• Opioids and Kidney Stones.

  2021cited by this paper
• Shockwave Lithotripsy Versus Ureteroscopic Treatment as Therapeutic Interventions for Stones of the Ureter (TISU): A Multicentre Randomised Controlled Non-inferiority Trial☆

  2021cited by this paper
• Risk of Hospital Encounters With Kidney Stones in Autosomal Dominant Polycystic Kidney Disease: A Cohort Study

  2021cited by this paper
• Acid-Base Homeostasis During Vasopressin V2 Receptor Antagonist Treatment in Autosomal Dominant Polycystic Kidney Disease Patients

  2021cited by this paper
• Assessing Risk of Rapid Progression in Autosomal Dominant Polycystic Kidney Disease and Special Considerations for Disease-Modifying Therapy.

  2021cited by this paper
• Efficacy and Safety of Surgical Kidney Stone Interventions in Autosomal Dominant Polycystic Kidney Disease: A Systematic Review

  2020cited by this paper
• Urinary Lithogenic Risk Profile in ADPKD Patients Treated with Tolvaptan.

  2020cited by this paper
• Complications in Patients With Autosomal Dominant Polycystic Kidney Disease Undergoing Ureteroscopy: A Cohort Study

  2020cited by this paper
• ADPKD, Tolvaptan, and Nephrolithiasis Risk.

  2020cited by this paper
• Percutaneous Nephrolithotomy Under X-Ray–Free Technique in Upper Urinary Stone Patients with Autosomal Dominant Polycystic Kidney Disease: Experience from a Large-Volume Stone Management Center

  2020cited by this paper
• Laparoscopic ureterolithotomy, flexible ureteroscopic lithotripsy and percutaneous nephrolithotomy for treatment of upper urinary calculi in patients with autosomal dominant polycystic kidney disease

  2020cited by this paper
• Thiazide diuretics and the rate of disease progression in autosomal dominant polycystic kidney disease: an observational study

  2020cited by this paper
• Stone Prevalence in Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis

  2020cited by this paper
• Laparoscopic ureterolithotomy for large proximal ureteric stones: Surgical technique, outcomes and literature review

  2020cited by this paper
• Oral chemolysis is an effective, non-invasive therapy for urinary stones suspected of uric acid content

  2020cited by this paper
• Autosomal dominant polycystic kidney disease: updated perspectives

  2019cited by this paper
• Genetic variants of calcium and vitamin D metabolism in kidney stone disease

  2019cited by this paper
• Laparoscopic ureterolithotomy: Experience of 60 cases from a developing world hospital

  2019cited by this paper
• Autosomal dominant polycystic kidney disease

  2019cited by this paper
• Crystal deposition triggers tubule dilation that accelerates cystogenesis in polycystic kidney disease.

  2019cited by this paper
• Long-Term Administration of Tolvaptan in Autosomal Dominant Polycystic Kidney Disease.

  2018cited by this paper
• Tolvaptan in the treatment of autosomal dominant polycystic kidney disease: patient selection and special considerations

  2018cited by this paper
• Recent Advances in the Management of Autosomal Dominant Polycystic Kidney Disease.

  2018cited by this paper
• A Practical Guide for Treatment of Rapidly Progressive ADPKD with Tolvaptan.

  2018cited by this paper
• Ultrasound‐guided percutaneous nephrolithotomy for upper urinary tract calculi in patients with spinal deformity: a decade's experience

  2018cited by this paper
• Genetics of common complex kidney stone disease: insights from genome-wide association studies

  2018cited by this paper
• Noncontrast Computed Tomography Parameters for Predicting Shock Wave Lithotripsy Outcome in Upper Urinary Tract Stone Cases

  2018cited by this paper
• A Systematic Review and Meta-analysis Comparing the Efficacy of Nonsteroidal Anti-inflammatory Drugs, Opioids, and Paracetamol in the Treatment of Acute Renal Colic.

  2017cited by this paper
• Kidney stones

  2016cited by this paper
• Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II.

  2016cited by this paper
• The genetic framework for development of nephrolithiasis

  2016cited by this paper
• The Capabilities and Limitations of Clinical Magnetic Resonance Imaging for Detecting Kidney Stones: A Retrospective Study

  2016cited by this paper
• Tolvaptan and Kidney Pain in Patients With Autosomal Dominant Polycystic Kidney Disease: Secondary Analysis From a Randomized Controlled Trial

  2016cited by this paper
• An overview of kidney stone imaging techniques

  2016cited by this paper
• Autosomal Dominant Polycystic Kidney Disease: Core Curriculum 2016.

  2016cited by this paper
• Association between Nephrolithiasis, Hypertension and Obesity in Polycystic Kidney Disease

  2015cited by this paper
• Common and rare variants associated with kidney stones and biochemical traits

  2015cited by this paper
• Autosomal-dominant polycystic kidney disease (ADPKD): executive summary from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.

  2015cited by this paper
• KHA-CARI Autosomal Dominant Polycystic Kidney Disease Guideline: Management of Renal Stone Disease.

  2015cited by this paper
• Comparison between extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy for treating large proximal ureteral stones: a meta-analysis.

  2015cited by this paper
• Appropriate kidney stone size for ureteroscopic lithotripsy: When to switch to a percutaneous approach.

  2015cited by this paper
• Quantitative susceptibility mapping (QSM): Decoding MRI data for a tissue magnetic biomarker

  2014cited by this paper
• Systematic Review and Meta-Analysis of the Effect of Alcohol Intake on the Risk of Urolithiasis Including Dose-Response Relationship

  2014cited by this paper
• Renal relevant radiology: radiologic imaging in autosomal dominant polycystic kidney disease.

  2014cited by this paper
• Medical management of kidney stones: AUA guideline.

  2014cited by this paper
• Using Hounsfield unit measurement and urine parameters to predict uric acid stones.

  2013cited by this paper
• Clinical effectiveness protocols for imaging in the management of ureteral calculous disease: AUA technology assessment.

  2013cited by this paper
• Clinical characteristics and predictors of progression of chronic kidney disease in autosomal dominant polycystic kidney disease: a single center experience

  2013cited by this paper
• Complete staghorn calculus in polycystic kidney disease: infection is still the cause

  2013cited by this paper
• Percutaneous Nephrolithotomy in Autosomal Dominant Polycystic Kidney Disease: Is it Different from Percutaneous Nephrolithotomy in Normal Kidney?

  2013cited by this paper
• Pain determinants of pain in autosomal dominant polycystic kidney disease.

  2013cited by this paper
• Acute cyst rupture, hemorrhage and septic shock after a shockwave lithotripsy in a patient with autosomal dominant polycystic kidney disease

  2013cited by this paper
• Flexible ureteroscopy and holmium laser lithotripsy for treatment of upper urinary tract calculi in patients with autosomal dominant polycystic kidney disease

  2012cited by this paper
• Percutaneous nephrolithotomy in polycystic kidney disease: is it safe and effective?

  2012cited by this paper
• Management of nephrolithiasis in autosomal dominant polycystic kidney disease — A single center experience

  2012cited by this paper
• Clinical review. Kidney stones 2012: pathogenesis, diagnosis, and management.

  2012cited by this paper
• The role of laparoscopic surgery for renal calculi management

  2011cited by this paper
• Nephrolithiasis in Autosomal Dominant Polycystic Kidney Disease

  2010cited by this paper
• Limitations to ultrasound in the detection and measurement of urinary tract calculi.

  2010cited by this paper
• Evaluation of nephrolithiasis in autosomal dominant polycystic kidney disease patients.

  2009cited by this paper
• Physiopathology and etiology of stone formation in the kidney and the urinary tract

  2009cited by this paper
• Diet, fluid, or supplements for secondary prevention of nephrolithiasis: a systematic review and meta-analysis of randomized trials.

  2009cited by this paper
• The influence of renal manifestations to the progression of autosomal dominant polycystic kidney disease.

  2009cited by this paper
• Alfuzosin stone expulsion therapy for distal ureteral calculi: a double-blind, placebo controlled study.

  2008cited by this paper
• Diagnostic performance of low-dose CT for the detection of urolithiasis: a meta-analysis.

  2008cited by this paper
• Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less.

  2008cited by this paper
• Noninvasive differentiation of uric acid versus non-uric acid kidney stones using dual-energy CT.

  2007cited by this paper
• Prospective, randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less.

  2005cited by this paper

• No citing papers are available for this paper.