1
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Spectrum of Bacterial Pathogens from Urinary Infections Associated with Struvite and Metabolic Stones. Diagnostics (Basel) 2022; 13:diagnostics13010080. [PMID: 36611372 PMCID: PMC9818859 DOI: 10.3390/diagnostics13010080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The purposes of this multi-center study were to evaluate the rate of infection stones and to evaluate the urine cultures of patients with infection stones. MATERIALS Charts of adulpatients with urinary stones were reviewed and data on stone analyses and urine cultures were collected. RESULTS In total, 1204 renal stone formers (RSFs) from 10 countries were included (776 males, 428 females). Fifty-six patients (4.6%) had struvite stones. The highest frequency of struvite stones was observed in India (23%) and Pakistan (18%). Lower rates were reported in Canada (2%), China (3%), Argentina (3%), Iraq (3%), Italy (3.5%) and Poland (3%), and intermediate rates in Egypt (5.5%) and Bulgaria (5.4%). Urine cultures were retrieved from 508 patients. Patients with struvite stones had a positive culture in 64.3% of the samples and patients with other stones, in 26.7%. In struvite stones, the most common isolates were Escherichia coli (27.7%) and Proteus spp. (27.7%), followed by Klebsiella spp. (16.7%); in other types of stone, it was Escherichia coli (47.6%), followed by Gram-positive bacteria (14.0%) Conclusions: The struvite stone composition was associated with a urinary infection, although an infection was not demonstrable with a conventional midstream urine culture in about 30%.
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2
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Arora B, Chung E. A 15-year longitudinal analysis of the trends in the surgical management of renal and ureteric stones in Australia. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158221135683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective: This study evaluates the evolving surgical management of renal stones in Australia over the past 15 years. Methods: The National Australian Medicare and Australian Institute of Health and Welfare (AIWH) data were used to obtain the annual number of hospital presentations for urolithiasis and surgical procedures for upper urinary tract stones from 2005 to 2020. The four treatment modalities observed included nephrolithotomy, shockwave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL) and endoscopic lithotripsy. Results: The total number of renal colic presentations in Australian hospitals and urology procedures claimed by Medicare has increased during the past 15 years. A total of 218,999 urological procedures were claimed by Medicare for renal stones over 15 years. There has been a dramatic rise in endoscopic lithotripsy surgery for stones. In 2005–2006, endoscopic lithotripsy comprised 56.6% of total stonework claimed by Medicare, and this proportion jumped to 88.9% in 2019–2020. All other modalities saw a decline in absolute and relative numbers. Conclusion: Endoscopic management of upper renal tract stones predominates in the current management of renal stone disease in Australia. Epidemiology audits such as this study can provide insight into national disease trends and guide future healthcare policies and resource planning. Level of evidence: 2b
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Affiliation(s)
- Bharti Arora
- Urology Department, Greenslopes Private Hospital, Australia
| | - Eric Chung
- Urology Department, Greenslopes Private Hospital, Australia
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3
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McGeorge S, Loh B, Shibu R, Dobeli K, Brown NJ, Esler R, Hacking C, Purvey M, Roberts MJ. Plain x-ray misses many ureteric calculi: Time to challenge the old dogma? BJUI COMPASS 2022; 4:59-61. [PMID: 36569499 PMCID: PMC9766866 DOI: 10.1002/bco2.192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 08/09/2022] [Accepted: 08/21/2022] [Indexed: 12/27/2022] Open
Affiliation(s)
- Stephen McGeorge
- Department of UrologyRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia,Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Brendon Loh
- Emergency and Trauma CentreRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Ryan Shibu
- Emergency and Trauma CentreRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Karen Dobeli
- Department of Medical ImagingRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Nathan J. Brown
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia,Emergency and Trauma CentreRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Rachel Esler
- Department of UrologyRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia,Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Craig Hacking
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia,Department of Medical ImagingRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Megan Purvey
- Emergency and Trauma CentreRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Matthew J. Roberts
- Department of UrologyRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia,Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia,Faculty of MedicineUniversity of Queensland Centre for Clinical ResearchBrisbaneQueenslandAustralia
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4
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Zhu C, Wang DQ, Zi H, Huang Q, Gu JM, Li LY, Guo XP, Li F, Fang C, Li XD, Zeng XT. Epidemiological trends of urinary tract infections, urolithiasis and benign prostatic hyperplasia in 203 countries and territories from 1990 to 2019. Mil Med Res 2021; 8:64. [PMID: 34879880 PMCID: PMC8656041 DOI: 10.1186/s40779-021-00359-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/15/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Urinary tract infections (UTI), urolithiasis, and benign prostatic hyperplasia (BPH) are three of the most common nonmalignant conditions in urology. However, there is still a lack of comprehensive and updated epidemiological data. This study aimed to investigate the disease burden of UTI, urolithiasis, and BPH in 203 countries and territories from 1990 to 2019. METHODS Data were extracted from the Global Burden of Disease 2019, including incident cases, deaths, disability-adjusted life-years (DALYs) and corresponding age-standardized rate (ASR) from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to evaluate the trends of ASR. The associations between disease burden and social development degrees were analyzed using a sociodemographic index (SDI). RESULTS Compared with 1990, the incident cases of UTI, urolithiasis, and BPH increased by 60.40%, 48.57%, and 105.70% in 2019, respectively. The age-standardized incidence rate (ASIR) of UTI increased (EAPC = 0.08), while urolithiasis (EAPC = - 0.83) and BPH (EAPC = - 0.03) decreased from 1990 to 2019. In 2019, the age-standardized mortality rate (ASMR) of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000, respectively. BPH had the largest increase (110.56%) in DALYs in the past three decades, followed by UTI (68.89%) and urolithiasis (16.95%). The burden of UTI was mainly concentrated in South Asia and Tropical Latin America, while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe. Moreover, the ASIR and SDI of urolithiasis in high-SDI regions from 1990 to 2019 were negatively correlated, while the opposite trend was seen in low-SDI regions. In 2019, the ASIR of UTI in females was 3.59 times that of males, while the ASIR of urolithiasis in males was 1.96 times higher than that in females. The incidence was highest in the 30-34, 55-59, and 65-69 age groups among the UTI, urolithiasis, and BPH groups, respectively. CONCLUSION Over the past three decades, the disease burden has increased for UTI but decreased for urolithiasis and BPH. The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.
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Affiliation(s)
- Cong Zhu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Dan-Qi Wang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Hao Zi
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Qiao Huang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.,Department of Evidence-Based Medicine and Clinical Epidemiology, Second School of Clinical Medicine, Wuhan University, Wuhan, 430071, Hubei, China
| | - Jia-Min Gu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Lu-Yao Li
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Xing-Pei Guo
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.,Institutes of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, 475000, Henan, China
| | - Fei Li
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Cheng Fang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
| | - Xiao-Dong Li
- Institutes of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, 475000, Henan, China. .,Department of Urology, Huaihe Hospital of Henan University, Kaifeng, 475000, Henan, China.
| | - Xian-Tao Zeng
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China. .,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China. .,Department of Evidence-Based Medicine and Clinical Epidemiology, Second School of Clinical Medicine, Wuhan University, Wuhan, 430071, Hubei, China.
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5
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Association between aortic calcification and the presence of kidney stones: calcium oxalate calculi in focus. Int Urol Nephrol 2021; 54:1915-1923. [PMID: 34846621 PMCID: PMC9262773 DOI: 10.1007/s11255-021-03058-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 11/11/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE The current research is aimed at analyzing the relationship between kidney stone (KS) and abdominal aortic calcification (AAC) and the relationship between KS components and AAC. METHODS This is a retrospective, case-control study. Kidney stone formers (KSFs) were treated at the Department of Urology, West China Hospital, Sichuan University for urological calculus disease from January 2014 to January 2020. Matched non-stone formers (non-SFs) were drawn from the same hospital for routine health examination from January 2018 to February 2019. Research-related information was collected and reviewed retrospectively from the hospital's computerized records. AAC were evaluated using available results of computed tomography imaging and abdominal vascular ultrasound. The relationships of AAC between KSFs and non-SFs were compared. The composition of renal calculi was analyzed by Fourier-transform infrared spectrophotometer. KSFs were divided into AAC groups and non-AAC based on AAC. The relationship of the composition of renal calculi between AAC and non-AAC were compared. The independent-sample t test, the chi-squared test and binary logistics regression were performed. RESULTS Altogether, 4516 people were included, with 1027 KSFs and 3489 non-SFs. There were no significant differences in the laboratory parameters between KSFs and non-SFs. The association between the presence of AAC and KS was significant in multivariable model 2 [adjusting hypertension, diabetes mellitus, fasting blood glucose, uric acid, serum triglyceride (TG), serum calcium, and urine pH] (OR 5.756, 95% CI 4.616-7.177, p < 0.001). The result of KSFs showed that calcium oxalate calculi (CaOx) was significantly associated with AAC in multivariable model 3 (adjusting age, hypertension, diabetes mellitus, drinking history, smoking history, and TG) (OR 1.351, 95% CI 1.002-1.822, p = 0.048). CONCLUSIONS The current study pioneered the revelation of the relationship between CaOx and AAC. Through an elimination of the confounding factors, the study demonstrated that KS and AAC were connected.
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Trends in urinary stone composition in 23,182 stone analyses from 2011 to 2019: a high-volume center study in China. World J Urol 2021; 39:3599-3605. [PMID: 33779819 DOI: 10.1007/s00345-021-03680-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/20/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To evaluate the distribution and dynamic trends in constituents of urinary stones in China. MATERIALS AND METHODS The composition of 23,182 stones were analyzed and then recorded between January 2011 and December 2019. The characteristics in terms of stone patient's gender, age and calendar year were analyzed. RESULTS Most stones (22,172, 95.64%) had several crystal components, among which 40.25% (8925/22,172) were mixtures with infection components. Calcium oxalate (CaOx) and uric acid (UA) stones were more commonly encountered in men, but calcium phosphate (CaP), magnesium ammonium phosphate (MAP) and carbonate apatite (CA) stones were more prevalent in women (p < 0.05). In males, the proportion of CaOx stones increased up to the age of 40, but subsequently decreased (p < 0.001). Interestingly, females showed an inverse trend regarding CaOx stones (p < 0.001). The proportion of UA stones increased with age (p < 0.001), and CA stones most frequently were recorded at age 20-49. Over the past 9 years, UA, CA, and MAP stones increased over time, whereas there was a tendency for CaOx stones to decrease (p < 0.05). CONCLUSIONS The scarcity of pure stones and a certain proportion of mixtures with infection stone components (e.g., mixtures of CaOx and CA) suggest that treatment directed against a single stone component is insufficient for effective recurrence prevention. Age and gender were significant determinants of stone composition, and according to the observed chronological trends, it seems that in the future, more UA, CA and MAP stones and fewer CaOx stones may be encountered in the studied population.
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7
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Trinchieri A, Maletta A, Simonelli G, Boeri L, De Lorenzis E, Montanari E. Time changes in the spectrum of urinary stone composition: a role for climate variations? BMC Nephrol 2020; 21:535. [PMID: 33297997 PMCID: PMC7726867 DOI: 10.1186/s12882-020-02193-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/29/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND An increase of the frequency of uric acid urinary stones compared to calcium-containing ones has been recently described. This study was aimed at assessing the frequency of different types of urinary stones in the population of northern Italy in the period 2016-18 compared to 2001-2003. METHODS Analyses by infrared spectroscopy of 1007 stones endoscopically removed at two institutions in the area of Milan (Northern Italy) were retrospectively considered. Stones were classified as calcium oxalate monohydrate (COM) and dihydrate (COD), mixed uric acid/calcium oxalate (UC); uric acid (UA), struvite (ST); apatite (CAP); mixed calcium oxalate / apatite (CAPOX); others. The patients were divided into two groups: 2001-2003 and 2016-2018. The average temperature values of the region over the two time periods were obtained by the national statistical institute. RESULTS The average age of the 2001-2003 group (45.8+/- 15.4 years) was significantly lower than the average age of the 2016-18 group (57.9+/- 14.8) (0.000). M / F ratio was similar in the two groups: 119 / 69 (1,0.58) in 2001-2003 and 527 / 292 (1,0.55) in 2016-18 (p = 0.862). COM stones tended to more frequent in 2016-18 group than in 2001-03. COD stones were significantly more frequent in 2001-03 than in 2016-18. ST stone frequency was increased from 2001 to 03 to 2016-18. No increase of uric acid containing stones was observed in 2016-18. Results were confirmed after adjustment by age. Averages annual regional temperatures increased from 14 °C to 15.4 °C during the two observation periods. CONCLUSIONS No increase of UA stones was observed, probably due to the limited impact of the global warming in our temperate climate.
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Affiliation(s)
- Alberto Trinchieri
- Department of Urology, IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Commenda 15, 20100, Milan, Italy.
| | | | | | - Luca Boeri
- Department of Urology, IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Commenda 15, 20100, Milan, Italy
| | - Elisa De Lorenzis
- Department of Urology, IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Commenda 15, 20100, Milan, Italy
| | - Emanuele Montanari
- Department of Urology, IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Commenda 15, 20100, Milan, Italy
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8
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Bagheri N, Pearce S, Mazumdar S, Sturgiss E, Haxhimolla H, Harley D. Identifying community chronic kidney disease risk profile utilising general practice clinical records and spatial analysis: approach to inform policy and practice. Intern Med J 2020; 51:1278-1285. [PMID: 32449982 DOI: 10.1111/imj.14924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 05/14/2020] [Accepted: 05/16/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) causes a significant health burden in Australia, and up to 50% of Australians with CKD remain undiagnosed. AIMS To estimate the 5-year risk for CKD from general practice (GP) clinical records and to investigate the spatial variation and hot spots of CKD risk in an Australian community. METHOD A cross-sectional study was designed using de-identified GP clinical data recorded from 2010 to 2015. A total of 16 GP participated in this study from West Adelaide, Australia. We used health records of 36 565 patients aged 35-74 years, with no prior history of CKD. The 5-year estimated CKD risk was calculated using the QKidney algorithm. Individuals' risk score was aggregated to Statistical Area Level 1 to predict the community CKD risk. A spatial hotspot analysis was applied to identify the communities with greater risk. RESULTS The mean estimated 5-year risk for CKD in the sample population was 0.95% (0.93-0.97). Overall, 2.4% of the study population was at high risk of CKD. Significant hot spots and cold spots of CKD risk were identified within the study region. Hot spots were associated with lower socioeconomic status. CONCLUSIONS This study demonstrated a new approach to explore the spatial variation of CKD risk at a community level, and implementation of a risk prediction model into a clinical setting may aid in early detection and increase disease awareness in regions of unmet CKD care.
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Affiliation(s)
- Nasser Bagheri
- Visual and Data Analytics Lab, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Scott Pearce
- Visual and Data Analytics Lab, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Soumya Mazumdar
- University of New South Wales, South West Sydney Local Health District, Sydney, New South Wales, Australia
| | - Elizabeth Sturgiss
- General Practice, Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Hodo Haxhimolla
- Urology, National Capital Private Hospital, Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - David Harley
- Queensland Centre for Intellectual and Developmental Disability, MRI-UQ, University of Queensland, Brisbane, Queensland, Australia
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9
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Ye Z, Zeng G, Yang H, Li J, Tang K, Wang G, Wang S, Yu Y, Wang Y, Zhang T, Long Y, Li W, Wang C, Wang W, Gao S, Shan Y, Huang X, Bai Z, Lin X, Cheng Y, Wang Q, Xu Z, Xie L, Yuan J, Ren S, Fan Y, Pan T, Wang J, Li X, Chen X, Gu X, Sun Z, Xiao K, Jia J, Zhang Q, Wang G, Sun T, Li X, Xu C, Xu C, Shi G, He J, Song L, Sun G, Wang D, Liu Y, Wang C, Han Y, Liang P, Wang Z, He W, Chen Z, Xing J, Xu H. The status and characteristics of urinary stone composition in China. BJU Int 2020; 125:801-809. [PMID: 30958622 DOI: 10.1111/bju.14765] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To explore characteristics of urinary stone composition in China, and determine the effects of gender, age, body mass index (BMI), stone location, and geographical region on stone composition. PATIENTS AND METHODS We prospectively used Fourier-transform infrared spectroscopy to analyse stones from consecutive patients presenting with new-onset urolithiasis at 46 hospitals in seven geographical areas of China, between 1 June 2010 and 31 May 2015. Chi-squared tests and logistic regression analyses were used to determine associations between stone composition and gender, age, BMI, stone location, and geographical region. RESULTS The most common stone constituents were: calcium oxalate (CaOx; 65.9%), carbapatite (15.6%), urate (12.4%), struvite (2.7%), and brushite (1.7%). CaOx and urate stones occurred more frequently in males, whereas carbapatite and struvite were more common in females (P < 0.01). CaOx and carbapatite were more common in those aged 30-50 and 20-40 years than in other groups. Brushite and struvite were most common amongst those aged <20 and >70 years. The detection rate of urate increased with age, whilst cystine decreased with age. Obese patients were more likely to have urate stones than carbapatite or brushite stones (P < 0.01). CaOx, carbapatite, brushite, and cystine stones were more frequently found in the kidney than other types, whereas urate and struvite were more frequent in the bladder (P < 0.01). Stone composition varied by geographical region. CONCLUSIONS The most common stone composition was CaOx, followed by carbapatite, urate, struvite, and brushite. Stone composition differed significantly in patients grouped by gender, age, BMI, stone location, and geographical region.
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Affiliation(s)
- Zhangqun Ye
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
| | - Guohua Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huan Yang
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
| | - Jianxin Li
- Department of Urology, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Kun Tang
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
| | - Guomin Wang
- Department of Urology, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, China
| | - Shusheng Wang
- Department of Urology, GuangDong Province Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Yonggang Yu
- Department of Urology, The No. 181 Hospital of the People's Liberation Army, Guilin, China
| | - Yujie Wang
- Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Tao Zhang
- Department of Urology, The No. 5 Hospital of the People's Liberation Army, Yinchuan, China
| | - Yongfu Long
- Department of Urology, Shaoyang Central Hospital, Shaoyang, China
| | - Weibin Li
- Department of Urology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Changmin Wang
- Department of Laboratory, The People's Hospital of Xinjiang Autonomous Region, Urumqi, China
| | - Wei Wang
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Sihe Gao
- Department of Urology, Gaomi City Hospital of Traditional Chinese Medicine, Gaomi, China
| | - Yuxi Shan
- Department of Urology, The Second Hospital of Suzhou University Medical School, Suzhou, China
| | - Xiaobo Huang
- Department of Urology, Peking University People's Hospital, Beijing, China
| | - Zhiming Bai
- Department of Urology, Haikou People's Hospital, Haikou, China
| | - Xiaohan Lin
- Department of Urology, The Second Hospital of Xiamen City, Xiamen, China
| | - Yue Cheng
- Department of Urology, The First People's Hospital of Ningbo City, Ningbo University Medical School, Ningbo, China
| | - Qinzhang Wang
- Department of Urology, The First Affiliated Hospital of Shihezi University Medical School, Shihezi, China
| | - Zhuoqun Xu
- Department of Urology, Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Liping Xie
- Department of Urology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital of the Fourth Military Medical University, Xi'an, China
| | - Shengqiang Ren
- Department of Urology, The No. 113 Hospital of the People's Liberation Army, Ningbo, China
| | - Yuhui Fan
- Department of Urology, Xi'an Gaoxin Hospital, Xi'an, China
| | - Tiejun Pan
- Department of Urology, Wuhan General Hospital of Guangzhou Military Region, Wuhan, China
| | - Jing Wang
- Department of Urology, The First People's Hospital of Changshu City, Changshu, China
| | - Xun Li
- Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xuehua Chen
- Department of Urology, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Xiaojian Gu
- Department of Urology, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Zhaolin Sun
- Department of Urology, The People's Hospital of Guizhou Province, Guiyang, China
| | - Kefeng Xiao
- Department of Urology, The People's Hospital of Shenzhen City, Shenzhen, China
| | - Jianye Jia
- Department of Urology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qinghua Zhang
- Department of Urology, Taizhou Municipal Hospital, Taizhou, China
| | - Gongxian Wang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ting Sun
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xuedong Li
- Department of Urology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Changbao Xu
- Department of Urology, The Second Affiliated Hospital of Zhengzhou University Medical School, Zhengzhou, China
| | - Chuangliang Xu
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Guowei Shi
- Department of Urology, The Fifth People's Hospital of Shanghai City, Shanghai, China
| | - Jiayang He
- Department of Urology, The Fifth People's Hospital of Shanghai City, Shanghai, China
| | - Leming Song
- Department of Urology, Ganzhou People's Hospital, Ganzhou, China
| | - Guang Sun
- Department of Urology, The Second Affiliated Hospital of Tianjin Medical University, Tianjin, China
| | - Dongwen Wang
- Department of Urology, The First Affiliated Hospital of Shanxi Medical University, Taiyuan, China
| | - Yili Liu
- Department of Urology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Chunxi Wang
- Department of Urology, The First Hospital of Jilin University, Changchun, China
| | - Yi Han
- Department of Urology, Shenyang Red-Cross Hospital, Shenyang, China
| | - Peiyu Liang
- Department of Urology, The Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Zhiping Wang
- Department of Urology, The Second Hospital of Lanzhou University Medical School, Lanzhou, China
| | - Wei He
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
| | - Zhiqiang Chen
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
| | - Jinchun Xing
- Department of Urology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Hua Xu
- Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.,Hubei Institute of Urology, Wuhan, China
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10
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Cherng JH, Hsu YJ, Liu CC, Tang SH, Sartika D, Chang SJ, Fan GY, Wu ST, Meng E. Activities of Ca 2+-related ion channels during the formation of kidney stones in an infection-induced urolithiasis rat model. Am J Physiol Renal Physiol 2019; 317:F1342-F1349. [PMID: 31509008 DOI: 10.1152/ajprenal.00199.2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Bacterial infection has long been recognized to contribute to struvite urinary stone deposition; however, its contribution to the development of chronic kidney stones has not been extensively investigated. In the present study, we hypothesized another possible method of bacteria contributing to the formation of calcium oxalate (CaOx) that accounts for the biggest part of the kidney stone. Bacteria may play important roles by influencing renal Ca2+-related ion channel activities, resulting in chronic inflammation of the kidney along with rapid aggregation of stones. We examined the correlation among infection-promoted CaOx kidney stones and alterations in Ca2+-related ion channels in an animal model with experimentally induced Proteus mirabilis and foreign body infection. After the bladder was infected for 7 days, the data demonstrated that stones were presented and induced severe renal tubular breakage as well as altered levels of monocyte chemoattractant protein-1, cyclooxygenase-2, osteopontin, and transient receptor potential vanilloid member 5 expression, reflecting responses of kidney ion channels. Monocyte chemoattractant protein-1, osteopontin, and transient receptor potential vanilloid member 5 expression was significantly downregulated over time, indicating the chronic inflammation phase of the kidney and accelerated aggregation of CaOx crystals, respectively, whereas cyclooxygenase-2 exhibited no differences. These results indicated that bacterial infection is considerably correlated with an alteration in renal Ca2+-related ion channels and might support specific and targeted Ca2+-related ion channel-based therapeutics for urolithiasis and related inflammatory renal damage.
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Affiliation(s)
- Juin-Hong Cherng
- Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, Republic of China
| | - Yu-Juei Hsu
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chuan-Chieh Liu
- Department of Cardiology, Cardinal Tien Hospital, Taipei, Taiwan, Republic of China
| | - Shou-Hung Tang
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Dewi Sartika
- Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Shu-Jen Chang
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Gang-Yi Fan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Sheng-Tang Wu
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - En Meng
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
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11
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Talati VM, Soares RMO, Khambati A, Nadler RB, Perry KT. Trends in urinary calculi composition from 2005 to 2015: a single tertiary center study. Urolithiasis 2019; 48:305-311. [PMID: 31372690 DOI: 10.1007/s00240-019-01151-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
Abstract
The goal of this study was to investigate recent changes in stone composition and patient demographics to identify factors influencing stone formation for the purpose of reducing the incidence of urolithiasis and preventing stone recurrence. This retrospective analysis includes patients who underwent percutaneous nephrolithotripsy or ureteroscopy at our institution from 2005 to 2015. Northwestern Medicine Enterprise Data Warehouse was used to retrieve demographic information and stone composition analyses. The composition of mixed stones containing uric acid (UA) and calcium oxalate monohydrate (COM) was analyzed further. Chi-squared tests were used for categorical variables and logistic regression was used to assess trends. From 2005 to 2015, 5268 stones were treated. COM was predominant in 42.2% and only 16.6% were pure. The male/female ratio decreased significantly from 1.8 to 1.08 and patient age increased (p < 0.001) with 45.6% of patients being 60 or older in 2015. Females formed more CO dihydrate (COD; p = 0.008) and struvite (p = 0.001) overall. The incidence of COM (p = 0.007) and UA (p < 0.001) rose significantly in men whereas both sexes saw a decrease in carbonate apatite (CA; p < 0.001). COM increased considerably from 12 to 75% amongst mixed stones with UA over the 11-year span. We concluded that stone formers have become older and more gender-equal. The increase in female patients parallels the increase in female obesity in the US. The rising predominance of COM, including when mixed with UA, and the scarcity of pure stones indicates it may be necessary to develop new approaches to managing and preventing urolithiasis.
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Affiliation(s)
- Vidit M Talati
- Feinberg School of Medicine, Department of Urology, Northwestern University, 675 N St Clair St, Galter Pavilion, 20th Floor, Chicago, IL, 60611, USA
| | - Ricardo M O Soares
- Feinberg School of Medicine, Department of Urology, Northwestern University, 675 N St Clair St, Galter Pavilion, 20th Floor, Chicago, IL, 60611, USA.
| | - Aziz Khambati
- Feinberg School of Medicine, Department of Urology, Northwestern University, 675 N St Clair St, Galter Pavilion, 20th Floor, Chicago, IL, 60611, USA
| | - Robert B Nadler
- Feinberg School of Medicine, Department of Urology, Northwestern University, 675 N St Clair St, Galter Pavilion, 20th Floor, Chicago, IL, 60611, USA
| | - Kent T Perry
- Feinberg School of Medicine, Department of Urology, Northwestern University, 675 N St Clair St, Galter Pavilion, 20th Floor, Chicago, IL, 60611, USA
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12
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Taguchi K, Cho SY, Ng AC, Usawachintachit M, Tan YK, Deng YL, Shen CH, Gyawali P, Alenezi H, Basiri A, Bou S, Djojodemedjo T, Sarica K, Shi L, Singam P, Singh SK, Yasui T. The Urological Association of Asia clinical guideline for urinary stone disease. Int J Urol 2019; 26:688-709. [PMID: 31016804 DOI: 10.1111/iju.13957] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 03/04/2019] [Indexed: 12/12/2022]
Abstract
The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries. The committee members of the Urological Association of Asia on the clinical guidelines for urinary stone disease carried out a surveillance study to better understand the diversity of the treatment strategy among different regions and subsequent systematic literature review through PubMed and MEDLINE database between 1966 and 2017. Levels of evidence and grades of recommendation for each management were decided according to the relevant strategy. Each clinical question and answer were thoroughly reviewed and discussed by all committee members and their colleagues, with suggestions from expert representatives of the American Urological Association and European Association of Urology. However, we focused on the pragmatic care of patients and our own evidence throughout Asia, which included recent surgical trends, such as miniaturized percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. This guideline covers all fields of stone diseases, from etiology to recurrence prevention. Here, we present a short summary of the first version of the guideline - consisting 43 clinical questions - and overview its key practical issues.
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Affiliation(s)
- Kazumi Taguchi
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Sung Yong Cho
- Department of Urology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea.,Seoul National University Hospital, Seoul, Korea
| | - Anthony Cf Ng
- SH Ho Urology Center, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Manint Usawachintachit
- Division of Urology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Yung-Khan Tan
- Urohealth Medical Clinic, Mt Elizabeth Hospital, Singapore
| | - Yao Liang Deng
- Department of Urology, Langdong Hospital and The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Cheng-Huang Shen
- Department of Urology, Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Prem Gyawali
- Department of Urology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | | | - Abbas Basiri
- Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sopheap Bou
- Department of Urology, Royal Phnom Penh Hospital, Phnom Penh, Cambodia
| | - Tarmono Djojodemedjo
- Department of Urology, Soetomo General Academia Hospital/Faculty of Medicine, Airlangga University, Surabaya, Indonesia
| | - Kemal Sarica
- Department of Urology, Kafkas University Medical School, Kars, Turkey
| | - Lei Shi
- Department of Urology, Yantai Yuhuangding Hospital and Medical School, Qingdao University, Yantai, China
| | | | - Shrawan Kumar Singh
- Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Takahiro Yasui
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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13
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Mediators of the Effects of Gender on Uric Acid Nephrolithiasis: A Novel Application of Structural Equation Modeling. Sci Rep 2018; 8:6077. [PMID: 29666405 PMCID: PMC5904184 DOI: 10.1038/s41598-018-24485-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/04/2018] [Indexed: 11/08/2022] Open
Abstract
Numerous epidemiological studies have shown that male patients with uric acid nephrolithiasis outnumber female patients. To our knowledge, no research exists evaluating the reasons gender affects the development of uric acid nephrolithiasis. We hereby used a novel application of structural equation modeling to analyze the mediators of the effects of gender on uric acid nephrolithiasis. In 1,098 patients with nephrolithiasis between 2012 and 2016, male gender was found to have a statistically significant positive indirect effect on the development of uric acid nephrolithiasis, which was mediated by lower urine pH (estimate: 0.010, standard error: 0.005, critical ratio: 2.135, 95% confidence interval: 0.002–0.023, P = 0.017), lower estimated glomerular filtration rate (estimate: 0.014, standard error: 0.005, critical ratio: 2.993, 95% confidence interval: 0.006–0.025, P < 0.001), and higher incidence rate of gout (estimate: 0.009, standard error: 0.005, critical ratio: 2.028, 95% confidence interval: 0.002–0.021, P = 0.009). We conclude that low urine pH, impaired renal function, and gout are the mediators of the effect of male gender on the development of uric acid nephrolithiasis. The survey, treatment, and follow-up of kidney diseases, acidic urine, and uric acid metabolism disorders should be considered in men with uric acid nephrolithiasis.
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14
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Flannigan RK, Battison A, De S, Humphreys MR, Bader M, Lellig E, Monga M, Chew BH, Lange D. Evaluating factors that dictate struvite stone composition: A multi-institutional clinical experience from the EDGE Research Consortium. Can Urol Assoc J 2017; 12:131-136. [PMID: 29319486 DOI: 10.5489/cuaj.4804] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Struvite stones account for 15% of urinary calculi and are typically associated with urease-producing urinary tract infections and carry significant morbidity. This study aims to characterize struvite stones based on purity of stone composition, bacterial speciation, risk factors, and clinical features. METHODS Retrospective data was collected from patients diagnosed with infection stones between 2008 and 2012. Stone analysis, perioperative urine cultures, bacterial speciation, and clinical data were collected and analyzed. The purity of struvite stones was determined. Statistical comparisons were made among homogeneous and heterogeneous struvite stones. RESULTS From the four participating centres, 121 struvite stones were identified. Only 13.2% (16/121) were homogenous struvite. Other components included calcium phosphate (42.1%), calcium oxalate (33.9%), calcium carbonate (27.3%), and uric acid (5.8%). Partial or full staghorn calculi occurred in 23.7% of cases. Urease-producing bacteria were only present in 30% of cases. Proteus, E. coli, and Enterococcus were the most common bacterial isolates from perioperative urine, and percutaneous nephrolithotomy was the most common modality of treatment. Only 40% of patients had a urinalysis that was nitrite-positive, indicating that urinalysis alone is not reliable for diagnosing infection stones. The study's limitation is its retrospective nature; as such, the optimal timing of cultures with respect to stone analysis or treatment was not always possible, urine cultures were often not congruent with stone cultures in the same patient, and our findings of E. coli commonly cultured does not suggest causation. CONCLUSIONS Struvite stones are most often heterogeneous in composition. Proteus remains a common bacterial isolate; however, E. coli and Enterococcus were also frequently identified. This new data provides evidence that patients with struvite stones can have urinary tract pathogens other than urease-producing bacteria, thus challenging previous conventional dogma.
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Affiliation(s)
- Ryan K Flannigan
- The Stone Centre at Vancouver General Hospital, Department of Urologic Sciences, University of British Columbia, Vancouver BC, Canada
| | - Andrew Battison
- The Stone Centre at Vancouver General Hospital, Department of Urologic Sciences, University of British Columbia, Vancouver BC, Canada
| | - Shubha De
- Stevan Streem Centre of Endourology & Stone Disease, The Cleveland Clinic, Cleveland, OH, United States
| | - Mitchell R Humphreys
- Department of Urology, Mayo Clinic, Phoenix, Arizona, Mayo Clinic, Phoenix, AZ, United States
| | | | | | - Manoj Monga
- Stevan Streem Centre of Endourology & Stone Disease, The Cleveland Clinic, Cleveland, OH, United States
| | - Ben H Chew
- The Stone Centre at Vancouver General Hospital, Department of Urologic Sciences, University of British Columbia, Vancouver BC, Canada
| | - Dirk Lange
- The Stone Centre at Vancouver General Hospital, Department of Urologic Sciences, University of British Columbia, Vancouver BC, Canada
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15
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He Z, Jing Z, Jing-Cun Z, Chuan-Yi H, Fei G. Compositional analysis of various layers of upper urinary tract stones by infrared spectroscopy. Exp Ther Med 2017; 14:3165-3169. [PMID: 28912866 DOI: 10.3892/etm.2017.4864] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 02/03/2017] [Indexed: 11/06/2022] Open
Abstract
The objective of the present study was to determine the composition of various layers of upper urinary stones and assess the mechanisms of stone nucleation and aggregation. A total of 40 integrated urinary tract stones with a diameter of >0.8 cm were removed from the patients. All of the stones were cut in half perpendicularly to the longitudinal axis. Samples were selected from nuclear, internal and external layers of each stone. Fourier transform infrared spectroscopy (FT-IR) was adopted for qualitative and quantitative analysis of all of the fragments and compositional differences among nuclear, internal and external layers of various types of stone were subsequently investigated. A total of 25 cases of calcium oxalate (CaOx) stones and 10 cases of calcium phosphate (CaP) stones were identified to be mixed stones, while 5 uric acid (UA) calculi were pure stones (purity, >95%). In addition, the contents of CaOx and carbapatite (CA.AP) crystals in various layers of the mixed stones were found to be variable. In CaOx stones, the content of CA.AP in nuclear layers was significantly higher than that of the outer layers (32.0 vs. 6.8%; P<0.05), while the content of CaOx was lower in the inner than in the outer layers (57.6 vs. 86.6%; P<0.05). In CaP stones, the content of CA.AP in the nuclear layers was higher than that in the outer layers (74.0 vs. 47.3%; P<0.05), while the content of CaOx was lower in the inner than in the outer layers (7.0 vs. 40.0%; P<0.05). The UA stones showed no significant differences in their composition among different layers. In conclusion, FT-IR analysis of various layers of human upper urinary tract stones revealed that CaOx and CaP stones showed differences in composition between their core and surface, while all of the UA calculi were pure stones. The composition showed a marked variation among different layers of the stones, indicating that metabolism has an important role in different phases of the evolution of stones. The present study provided novel insight into the pathogenesis of urinary tract stones and may contribute to their prevention and treatment.
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Affiliation(s)
- Zhang He
- Department of Urology, Shanghai Pudong New Area Gongli Hospital, Shanghai 200135, P.R. China
| | - Zhang Jing
- Department of Urology, Shanghai Pudong New Area Gongli Hospital, Shanghai 200135, P.R. China
| | - Zheng Jing-Cun
- Department of Urology, Shanghai Pudong New Area Gongli Hospital, Shanghai 200135, P.R. China
| | - Hu Chuan-Yi
- Department of Urology, Shanghai Pudong New Area Gongli Hospital, Shanghai 200135, P.R. China
| | - Gao Fei
- Department of Urology, The Second People's Hospital of Yulin, Yulin, Shaanxi 719000, P.R. China
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16
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Raheem OA, Khandwala YS, Sur RL, Ghani KR, Denstedt JD. Burden of Urolithiasis: Trends in Prevalence, Treatments, and Costs. Eur Urol Focus 2017; 3:18-26. [PMID: 28720363 DOI: 10.1016/j.euf.2017.04.001] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 03/17/2017] [Accepted: 02/21/2017] [Indexed: 12/19/2022]
Abstract
CONTEXT The recent evolution of management options for urolithiasis has presented a unique dilemma for the modern urologist. A comprehensive understanding of epidemiological trends along with current provider preferences in treating urinary stones would be beneficial. OBJECTIVE To review trends in the prevalence, treatments, and costs of urolithiasis worldwide. EVIDENCE ACQUISITION A literature review was performed using the MEDLINE database, the Cochrane Library Central search facility, Web of Science, and Google Scholar between 1986 and 2016. Keywords used for the search were "urolithiasis" and "prevalence; treatment; and cost". EVIDENCE SYNTHESIS The incidence and prevalence of urinary stones are rising around the world, including regions that have historically had low rates of urolithiasis. Common theories explaining this trend involve climate warming, dietary changes, and obesity. Shockwave lithotripsy (SWL) has been the preferred mode of treatment since its introduction in the 1980s. However, ureteroscopy (URS) has become increasingly popular for small stones regardless of location because of lower recurrence rates and costs. Developing countries have been slower to adopt URS technology and continue to use percutaneous nephrolithotomy at a steady rate. CONCLUSIONS URS has recently challenged SWL as the treatment modality preferred for small upper urinary tract stones. In some cases it is less expensive but still highly effective. As the burden of stone disease increases worldwide, appropriate selection of stone removal therapies will continue to play an important role and will thus require further investigation. PATIENT SUMMARY Urinary stones are becoming more prevalent. Recent advances in technology have improved the management of this disease and have decreased costs.
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Affiliation(s)
- Omer A Raheem
- Department of Urology, University of California San Diego Health, San Diego, CA, USA
| | - Yash S Khandwala
- University of California San Diego School of Medicine, San Diego, CA, USA
| | - Roger L Sur
- Department of Urology, University of California San Diego Health, San Diego, CA, USA.
| | - Khurshid R Ghani
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - John D Denstedt
- Department of Surgery, Western University, London, ON, Canada
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17
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Trinchieri A, Montanari E. Prevalence of renal uric acid stones in the adult. Urolithiasis 2017; 45:553-562. [PMID: 28258472 DOI: 10.1007/s00240-017-0962-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/28/2017] [Indexed: 01/25/2023]
Abstract
The aim of this study was to estimate uric acid renal stone prevalence rates of adults in different countries of the world. PubMed was searched for papers dealing with "urinary calculi and prevalence or composition" for the period from January 1996 to June 2016. Alternative searches were made to collect further information on specific topics. The prevalence rate of uric acid stones was computed by the general renal stone prevalence rate and the frequency of uric acid stones in each country. After the initial search, 2180 papers were extracted. Out of them, 79 papers were selected after the reading of the titles and of the abstracts. For ten countries, papers relating to both the renal stone prevalence in the general population and the frequency of uric stones were available. Additional search produced 13 papers that completed information on 11 more countries in 5 continents. Estimated prevalence rate of uric acid stones was >0.75% in Thailand, Pakistan, Saudi Arabia, Iran, South Africa (white population), United States and Australia; ranged 0.50-0.75% in Turkey, Israel, Italy, India (Southern), Spain, Taiwan, Germany, Brazil; and <0.50% in Tunisia, China, Korea, Japan, Caribe, South Africa (blacks), India (Northern). Climate and diet are major determinants of uric acid stone formation. A hot and dry climate increases fluid losses reducing urinary volume and urinary pH. A diet rich in meat protein causes low urinary pH and increased uric acid excretion. On the other hand, uric acid stone formation is frequently associated with obesity, metabolic syndrome and diabetes type 2 that are linked to dietary energy excess mainly from carbohydrate and saturated fat and also present with low urine pH values. An epidemic of uric acid stone formation could be if current nutritional trends will be maintained both in developed countries and in developing countries and the areas of greater climatic risk for the formation of uric acid stones will enlarge as result of the "global warming".
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Affiliation(s)
- Alberto Trinchieri
- Urology Unit, Manzoni Hospital, Via dell'Eremo 9/11, 23900, Lecco, Italy.
| | - Emanuele Montanari
- IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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18
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Wang W, Fan J, Huang G, Li J, Zhu X, Tian Y, Su L. Prevalence of kidney stones in mainland China: A systematic review. Sci Rep 2017; 7:41630. [PMID: 28139722 PMCID: PMC5282506 DOI: 10.1038/srep41630] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 12/20/2016] [Indexed: 12/21/2022] Open
Abstract
The data on the prevalence of kidney stones in mainland China are still lacking. We performed the present meta-analysis to assess the stone prevalence in mainland China from 1990 through 2016. A total of 18 articles were included. The pooled overall prevalence was 7.54% (95% CI, 5.94-9.15). The prevalence in age groups of <20 years, 20-29 years, 30-39 years, 40-49 years, 50-59 years, and 60 years and older was 0.27%, 3.15%, 5.96%, 8.18%, 9.14%, and 9.68%, respectively, showing that it increased with age. Moreover, the prevalence was 10.34% in males and 6.62% in females, with an odds ratio (OR) of 1.63 [95% CI: 1.51-1.76], indicating that males are more likely to suffer from this disease than females. However, urban areas (6.03%, 95% CI: 3.39-8.68) and rural areas (7.48%, 95% CI: 3.39-11.57) did not differ in the stone prevalence rate (OR = 0.84, 95% CI: 0.42-1.68). The prevalence in the year groups of 1991-2000, 2001-2010, and 2011 to date was 5.95%, 8.86%, and 10.63%, respectively, which indicated an increasing trend. Further high-quality surveys throughout mainland China are needed to confirm these findings.
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Affiliation(s)
- Wenying Wang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Jingyuan Fan
- School of Public Health of Guangxi Medical University, Guangxi Colleges and Universities Key Laboratory of the Prevention and Control of High Prevalence Diseases, Nanning, Guangxi, 530021, China
| | - Guifeng Huang
- School of Public Health of Guangxi Medical University, Guangxi Colleges and Universities Key Laboratory of the Prevention and Control of High Prevalence Diseases, Nanning, Guangxi, 530021, China
| | - Jun Li
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Xi Zhu
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Ye Tian
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Li Su
- School of Public Health of Guangxi Medical University, Guangxi Colleges and Universities Key Laboratory of the Prevention and Control of High Prevalence Diseases, Nanning, Guangxi, 530021, China
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19
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Habashy D, Xia R, Ridley W, Chan L, Ridley L. Impact of dual energy characterization of urinary calculus on management. J Med Imaging Radiat Oncol 2016; 60:624-631. [PMID: 27469443 DOI: 10.1111/1754-9485.12497] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/28/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Dual energy CT (DECT) is a recent technique that is increasingly being used to differentiate between calcium and uric acid urinary tract calculi. The aim of this study is to determine if urinary calculi composition analysis determined by DECT scanning results in a change of patient management. METHOD All patients presenting with symptoms of renal colic, who had not previously undergone DECT scanning underwent DECT KUB. DECT data of all patients between September 2013 and July 2015 were reviewed. Urinary calculi composition based on dual energy characterization was cross-matched with patient management and outcome. RESULTS A total of 585 DECT KUB were performed. 393/585 (67%) DECT scans revealed urinary tract calculi. After excluding those with isolated bladder or small asymptomatic renal stones, 303 patients were found to have symptomatic stone(s) as an explanation for their presentation. Of these 303 patients, there were 273 (90.1%) calcium calculi, 19 (6.3%) uric acid calculi and 11 (3.4%) mixed calculi. Of those with uric acid calculi, 15 were commenced on dissolution therapy. Twelve of those commenced on dissolution therapy had a successful outcome, avoiding need for surgical intervention (lithotripsy or stone retrieval). Three patients failed dissolution therapy and required operative intervention for definitive management of the stone. CONCLUSION Predicting urinary tract calculi composition by DECT plays an important role in identifying patients who may be managed with dissolution therapy. Identification of uric acid stone composition altered management in 15 of 303 (5.0%) patients, and was successful in 12, thereby avoiding surgery and its attendant risks.
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Affiliation(s)
- David Habashy
- Department of Urology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Ryan Xia
- Department of Radiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - William Ridley
- University of Sydney, Sydney, New South Wales, Australia.,University of New England, Armidale, New South Wales, Australia
| | - Lewis Chan
- Department of Urology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia
| | - Lloyd Ridley
- Department of Radiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
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20
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Yang X, Zhang C, Qi S, Zhang Z, Shi Q, Liu C, Yang K, Du E, Li N, Shi J, Xu Y. Multivariate Analyses of Urinary Calculi Composition: A 13-Year Single-Center Study. J Clin Lab Anal 2016; 30:873-879. [PMID: 27075109 DOI: 10.1002/jcla.21950] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 12/29/2015] [Accepted: 01/13/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The incidence and prevalence of urinary stone are increasing throughout the world. Compared to the past, recent demographics of patient with urolithiasis compositions are strikingly different. Furthermore, recent clinical studies implied that seasonal cyclicity might influence the distribution of stone composition. METHODS We sought to determine the trends in pathogenesis of urolithiasis based on urinary stone analyses. Between 2002 and 2014, a total of 2,383 eligible urinary stone samples from different patients were collected in our center. Infrared spectroscopy was used for urinary calculi analysis. A logistic regression analysis was used to investigate the relationship between urinary calculi composition and calendar month (season), gender, and age in north China during the past 13 years. RESULTS Calcium-containing calculi were the most frequent with an overall incidence of 84.1%. Calcium phosphate (CaP) or magnesium ammonium phosphate (MAP) stones were more frequent in females, while monohydrate calcium oxalate (COM), dihydrate calcium oxalate (COD), or uric acid (UA) stones were more common in males. Older individuals were associated with an increased risk of UA stones and a decreased risk of COD, CaP, or cystine stones. Additionally, from 2002 to 2014, the frequency of COD and MAP stone increased, whereas the trend of CaP, UA and cystine stones decreased. However, calendar month (season) was not significantly associated with differences in composition. CONCLUSION This study provides the present distribution of urolithiasis compositions in China. From 2002 to 2014, age and gender were significantly associated with stone composition, whereas calendar month was not.
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Affiliation(s)
- Xiong Yang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Changwen Zhang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Shiyong Qi
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Zhihong Zhang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Qiduo Shi
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Chunyu Liu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Kuo Yang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - E Du
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Na Li
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Jian Shi
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Yong Xu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China.
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Kum F, Mahmalji W, Hale J, Thomas K, Bultitude M, Glass J. Do stones still kill? An analysis of death from stone disease 1999-2013 in England and Wales. BJU Int 2016; 118:140-4. [DOI: 10.1111/bju.13409] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Francesca Kum
- Department of Urology; Guy's and St. Thomas' Hospital; London UK
| | - Wasim Mahmalji
- Department of Urology; Guy's and St. Thomas' Hospital; London UK
| | - Jemma Hale
- Department of Urology; Guy's and St. Thomas' Hospital; London UK
| | - Kay Thomas
- Department of Urology; Guy's and St. Thomas' Hospital; London UK
| | | | - Jonathan Glass
- Department of Urology; Guy's and St. Thomas' Hospital; London UK
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22
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Parr JM, Desai D, Winkle D. Natural history and quality of life in patients with cystine urolithiasis: a single centre study. BJU Int 2015. [DOI: 10.1111/bju.13169] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Justin M. Parr
- School of Medicine; The University of Queensland; Brisbane Queensland Australia
| | - Devang Desai
- School of Medicine; The University of Queensland; Brisbane Queensland Australia
- Department of Urology; Mater Hospital Brisbane; Brisbane Queensland Australia
| | - David Winkle
- School of Medicine; The University of Queensland; Brisbane Queensland Australia
- Department of Urology; Mater Hospital Brisbane; Brisbane Queensland Australia
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23
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Flukes S, Hayne D, Kuan M, Wallace M, McMillan K, Rukin NJ. Retrograde ureteric stent insertion in the management of infected obstructed kidneys. BJU Int 2015; 115 Suppl 5:31-4. [PMID: 25174441 DOI: 10.1111/bju.12918] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To quantify the outcomes of retrograde ureteric stenting in the setting of infected hydronephrosis secondary to ureteric calculi. PATIENTS AND METHODS Prospective analysis of all patients over a 15-month period admitted with infected obstructed kidneys secondary to ureteric calculi. Inclusion criteria were based on clinical evidence of systemic inflammatory response syndrome (SIRS) and radiological evidence of obstructing ureteric calculi. Outcome measures included success of procedure, admission to intensive care unit (ICU), length of hospital stay, morbidity, and all-cause mortality during hospital admission. RESULTS In all, 52 patients were included. Success of retrograde ureteric stenting was 98%. In all, 17% of patients required an ICU admission, with a post ureteric instrumentation ICU admissions rate of 6%. The mean white cell count and serum creatinine improved significantly after the procedure. Major complication rate included septic shock 6%, but there were no episodes of major haemorrhage and no deaths. CONCLUSION Retrograde ureteric stenting is safe and effective in infected obstructed kidneys with results comparable to percutaneous nephrostomy tube insertion. Post instrumentation ICU admissions occur in 6% of retrograde stentings.
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Affiliation(s)
- Stephanie Flukes
- Department of Urological Surgery, Fremantle Hospital, Perth, Australia
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Flannigan R, Choy WH, Chew B, Lange D. Renal struvite stones--pathogenesis, microbiology, and management strategies. Nat Rev Urol 2014; 11:333-41. [PMID: 24818849 DOI: 10.1038/nrurol.2014.99] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Infection stones-which account for 10-15% of all urinary calculi-are thought to form in the presence of urease-producing bacteria. These calculi can cause significant morbidity and mortality if left untreated or treated inadequately; optimal treatment involves complete stone eradication in conjunction with antibiotic therapy. The three key principles of treating struvite stones are: removal of all stone fragments, the use of antibiotics to treat the infection, and prevention of recurrence. Several methods to remove stone fragments have been described in the literature, including the use of urease inhibitors, acidification therapy, dissolution therapy, extracorporeal shockwave lithotripsy, ureteroscopy, percutaneous nephrolithotomy (PCNL), and anatrophic nephrolithotomy. PCNL is considered to be the gold-standard approach to treating struvite calculi, but adjuncts might be used when deemed necessary. When selecting antibiotics to treat infection, it is necessary to acquire a stone culture or, at the very least, urine culture from the renal pelvis at time of surgery, as midstream urine cultures do not always reflect the causative organism.
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Affiliation(s)
- Ryan Flannigan
- The Stone Centre at Vancouver General Hospital, Jack Bell Research Centre, 2660 Oak Street, Vancouver, BC V6H 3Z6, Canada
| | - Wai Ho Choy
- The Stone Centre at Vancouver General Hospital, Jack Bell Research Centre, 2660 Oak Street, Vancouver, BC V6H 3Z6, Canada
| | - Ben Chew
- The Stone Centre at Vancouver General Hospital, Jack Bell Research Centre, 2660 Oak Street, Vancouver, BC V6H 3Z6, Canada
| | - Dirk Lange
- The Stone Centre at Vancouver General Hospital, Jack Bell Research Centre, 2660 Oak Street, Vancouver, BC V6H 3Z6, Canada
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