Medical Reduction of Stone Risk in a Network of Treatment Centers Compared to a Research Clinic

Lingeman, James E.; Mardis, Hal K.; Kahnoski, Richard J.; Goldfarb, David S.; Lacy, Sushil S.; Grasso, Michael; Scheinman, Steven J.; Parks, Joan H.; Asplin, John R.; Coe, Fredric L.

doi:10.1097/00005392-199811000-00005

Cited by 8 publications

(10 citation statements)

References 28 publications

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“…The distinction is important because supersaturation is accepted as "the most direct available expression of crystallization potential that one can obtain in clinical practice." 8 The sensitivity and specificity of 24-hour calcium for detecting elevated CaOxSS and CaPhosSS were similar for men and for women. This held true for calcium alone or in combination with oxalate or phosphate.…”

Section: Discussionmentioning

confidence: 85%

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Sensitivity and specificity of 24-hour urine chemistry levels for detecting elevated calcium oxalate and calcium phosphate supersaturation

Rossi

Singer

Golijanin

et al. 2013

CUAJ

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Section: Discussionmentioning

confidence: 85%

“…1 This calculation represents the supersaturation ratio, which is the activity product (of calcium and oxalate ions, for instance) divided by the solubility product. 8 …”

Section: Patientsmentioning

confidence: 99%

Sensitivity and specificity of 24-hour urine chemistry levels for detecting elevated calcium oxalate and calcium phosphate supersaturation

Rossi

Singer

Golijanin

et al. 2013

CUAJ

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“…Moreover, stone prevention programs have been proven capable and efficient in several studies with the enrollment of stone formers, which has the potential to lead to the reduction of medical expenditures related to kidney stones disease. [19][20][21][22][23] Finally, the 2016 updated CUA guidelines still categorize metabolic evaluation as grade C Oxford levels of evidence while the 2014 EAU guidelines upgraded the level of evidence regarding metabolic evaluations in highrisk stone formers to a grade A recommendation. [12,14,24] Therefore, quantitative research, randomized clinical trials and cost-effectiveness studies of metabolic evaluations in high-risk and interested first-time stone formers may be warranted to reassess the level of evidence of metabolic evaluations.…”

Section: Harmouch Et Al Adherence To Kidney Stone Evaluation Guidelinesmentioning

confidence: 99%

Metabolic evaluation guidelines in patients with nephrolithiasis: Are they being followed? Results of a national, multi-institutional, quality-assessment study

Harmouch

Abou-Haidar

ElHawary

et al. 2018

CUAJ

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Introduction: The significant cost burden of kidney stones underscores the importance of best clinical practice in kidney stone management. We evaluated adherence to kidney stone metabolic evaluation guidelines in a Canadian population and the interest of patients with regard to prevention. Methods: A questionnaire based on Canadian Urological Association (CUA) best practice guidelines was designed. Patients presenting for extracorporeal shockwave lithotripsy treatment (ESWL) were administered this questionnaire to evaluate risk factors of stone disease and assess the use of metabolic evaluations. Patients were asked if they received explanations about their results and if they were interested in kidney stone prevention. Results: We identified 530 patients at five academic institutions; 79.4% had at least one indication to receive a metabolic evaluation (high-risk stone formers), which increased to 96.6% if first-time stone formers that reported an interest in metabolic evaluation were included. However, only 41.1 % of these patients had a metabolic evaluation. Endourologists ordered metabolic evaluation more often than other referring urologists (63.6% vs. 36.5%; p<0.001). Furthermore, urologists ordered metabolic evaluations more often than other prescribing physicians (68.9% vs. 31.1%; p<0.001). Sixty-two percent of patients received explanations about their metabolic evaluation results and 77.5%

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“…An antimicrobial and a urine volume marker were added to each urine container and then a 50-ml aliquot of urine was obtained. The participants performed the urine collections at home, and then mailed their urine collections to Litholink Corp (Chicago, IL), a commercial laboratory for analysis [12]. Results of individuals in whom 24-h excretion of creatinine varied between collections by 30% or more were judged to have been inaccurately collected and were excluded.…”

Section: Urine Chemistry Analysismentioning

confidence: 99%

Effect of diet orange soda on urinary lithogenicity

et al. 2011

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Studies have shown that certain beverages decrease urinary lithogenicity by increasing urine citrate excretion. Diet Sunkist Orange soda had the highest concentration of citrate and total alkali content among 12 diet sodas previously assayed. We studied the effect of Diet Sunkist Orange soda consumption on urinary chemistry. Nine healthy men and women ages 26-54 years completed the study. During the control period, subjects drank 36 oz of water for 3 days in addition to their own, self-selected diet and recorded a food diary. During the study period, the subjects drank three 12-oz cans of Diet Sunkist Orange soda a day instead of water, and replicated their diets from the control period. In each period, the subjects performed 24-h urine collections on days 2 and 3. Urine chemical analysis was performed, including urinary citrate levels and pH. Diet Sunkist Orange soda increased urinary citrate excretion by 60 mg/day, which was not statistically significant (95% CI -75 to 195, P value 0.34). There was no significant change in pH from the control period to the study period (pH: 6.29-6.21; 95% CI: -0.09 to 0.25, P = 0.30). Urine volumes and creatinine excretions were not significantly different between the control and study periods. Despite the relatively high citrate and total alkali content of Diet Sunkist Orange soda, the volume consumed in this study (36 oz per day) did not provide sufficient potential base to significantly alter urine composition in healthy subjects with normocitraturia. The effect of Diet Sunkist Orange soda on urinary chemistry in patients with hypocitraturia and nephrolithiasis is not likely to have a clinically significant effect to prevent calcium or uric acid stones.

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Medical Reduction of Stone Risk in a Network of Treatment Centers Compared to a Research Clinic

Abstract: Given proper software and laboratory support, a network of treatment centers can rival but not quite match results in a dedicated metabolic stone research and prevention clinic. Therefore, large scale stone prevention in a network system appears feasible and effective.

Cited by 8 publications

References 28 publications

Sensitivity and specificity of 24-hour urine chemistry levels for detecting elevated calcium oxalate and calcium phosphate supersaturation

Sensitivity and specificity of 24-hour urine chemistry levels for detecting elevated calcium oxalate and calcium phosphate supersaturation

Metabolic evaluation guidelines in patients with nephrolithiasis: Are they being followed? Results of a national, multi-institutional, quality-assessment study

Effect of diet orange soda on urinary lithogenicity

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