Chronic Kidney Disease Secondary to Urolithiasis in Sudan: Clinical Presentation, Risk Factors and Renal Outcome

Abstract

Background: Chronic kidney disease (CKD) is a major global health burden. Although urolithiasis contributes to a small proportion of end-stage renal disease (ESRD) worldwide, delayed diagnosis and limited access to urological care may increase its impact in low-resource settings. Objective: To assess the clinical presentation, management, and outcomes of patients with CKD secondary to renal stone disease in Khartoum State, Sudan. Methods: A prospective, multicentre, hospital-based cohort study was conducted between April 2016 and April 2018. Adult patients with symptomatic urolithiasis for more than three months and evidence of renal impairment were enrolled. Estimated glomerular filtration rate (eGFR) was assessed at baseline and six weeks after intervention. Data were analyzed using SPSS. Results: A total of 215 patients were included; 64.7% were male, with the majority aged 40–59 years. Most patients originated from regions lacking specialized urological services. Delayed treatment (>3 months after diagnosis) was observed in 79.5%. Emergency intervention was required in 42.3% of cases. Complete stone clearance was achieved in 80%. At six-week follow-up, 51.6% had normal eGFR, while 8.5% progressed to ESRD. Nephrectomy was performed in 10.7%, and mortality was 1.9%. Emergency intervention and incomplete stone clearance were significantly associated with poor renal outcomes. Conclusion: Renal stone disease is an important and potentially preventable cause of CKD in Sudan. Delayed presentation and emergency intervention are associated with worse outcomes, while complete stone clearance significantly improves renal recovery. Strengthening early referral and urological services may reduce progression to ESRD. Keywords: Chronic Kidney Disease, Renal Stone, estimated GFR, Sudan.