Evaluating the Natural History of Incidentally Recognized Clinically Silent Nephrolithiasis in Healthy Adults: an Updated Systematic Review with Meta-Analysis

Mohammadreza Padooiy Nooshabadi,Behnam Shakiba,Hamid Reza Baradaran,Seyyed Amir Yasin Ahmadi, Hosein Akbarnataj Bishe,Asaad Moradi

Urolithiasis（2025）

School of Medicine | Iran University of Medical Sciences | Department of Community and Family Medicine

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Abstract

The incidental detection of asymptomatic renal stones has risen with increased use of imaging and screening programs. While guidelines exist for treating kidney stones, managing asymptomatic stones remains controversial due to limited understanding of their natural history. A systematic search of the PubMed, Web of Science, Embase, and Scopus databases was conducted on 3rd June 2024 with a distinct search strategy and citation tracking to identify English language publications evaluating the natural history of asymptomatic renal stones in healthy adults. systematic report of the included studies was provided; besides, meta-analysis of proportions and meta regression was conducted to find the pooled estimation of stone-related events and to evaluate factors affecting natural history of these stones. Quality assessment of the included articled was conducted by means of the Newcastle–Ottawa Scale. This study was registered on PROSPERO (CRD42023409454). Out of 4,574 identified publications, twelve studies met inclusion criteria. Reported outcome rates ranged from 28.12

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Key words

Clinically silent nephrolithiasis,Asymptomatic nephrolithiasis,Asymptomatic renal stones,Asymptomatic renal calculi,Active surveillance,Conservative management

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【要点】：本文通过系统回顾和荟萃分析，评估了健康成人中偶然发现的临床静默肾结石的自然病史，发现其相关事件的发生率并探究影响结石自然病史的因素。

【方法】：使用PubMed、Web of Science、Embase和Scopus数据库进行系统搜索，纳入英文研究，提供系统报告，并进行比例荟萃分析和元回归分析。

【实验】：通过筛选4574篇文献，最终纳入12项研究，使用Newcastle–Ottawa Scale进行质量评估，并在PROSPERO注册（CRD42023409454）。