Metabolic Syndrome and Kidney Stone Disease: A Systematic Review of Literature

Wong, Yee V.; Cook, Paul; Roderick, Paul; Somani, Bhaskar K.

doi:10.1089/end.2015.0567

Cited by 115 publications

(105 citation statements)

References 40 publications

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“…Our study also confirms the correlation between raised body mass index and a lower urinary pH that has previously been demonstrated in other stone types [13]. Our data demonstrate evidence of reduced renal function associated with increased surgical intervention in this cohort of patients.…”

Section: Meaning Of the Studysupporting

confidence: 91%

“…A female:male ratio of 1:1 highlights the equal spread amongst genders, and the pattern of age at diagnosis is comparable to the literature. The recurrence rate of 62.5% is on par with previously reported values and supports the assertion that cystine stone formers have higher recurrence rates than is average for all stone formers in the same time period [13][14][15].…”

Section: Meaning Of the Studysupporting

confidence: 88%

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Journey of a cystinuric patient with a long-term follow-up from a medical stone clinic: necessity to be SaFER (stone and fragments entirely removed)

2018

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There is a lack of studies looking at the longitudinal follow-up of patients with cystine stones. We wanted to assess the journey of cystinuric patients through our specialist metabolic stone clinic to improve the understanding of episodes, interventions and current outcomes in this patient cohort. After ethical approval, all patients who attended our metabolic stone clinic from 1994 to 2014 with at least one cystine stone episode were included in our study. Data were retrospectively analysed for patient demographics, stone episodes or intervention, clinical parameters and patient compliance. Over a period of 21 years, 16 patients with a median age of 15.5 years underwent a mean follow-up of 8.6 years (1-21 years). The mean number of surgical interventions was 3.1 (1-8/patient), but patients who were stone free after their first treatment had lower recurrences (p = 0.91) and lower number of interventions during their follow-up (2.7/patient, compared to those who were not stone free at 4/patient). During their follow-up period, patients with < 3 interventions had a significantly better renal function than those with ≥ 3 surgical interventions (p = 0.04). Additionally, linear regression analysis showed that eGFR was demonstrated to decline with increasing numbers of stone episodes (r 2 = 0.169). It was also noted that patients who began early medical management remained stone free during follow-up compared to those who had medical management after ≥ 2 stone episodes, of whom all had a recurrent episode. Our long-term longitudinal study of cystine stone formers highlights that patients who are stone free and receive early metabolic stone screening and medical management after their initial presentation have the lowest recurrence rates and tend to preserve their renal function. Hence, prompt referral for metabolic assessment, and the stone and fragments entirely removed (SaFER) principles are key to preventing stone episodes and improving long-term function.

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Section: Meaning Of the Studysupporting

confidence: 91%

Section: Meaning Of the Studysupporting

confidence: 88%

Journey of a cystinuric patient with a long-term follow-up from a medical stone clinic: necessity to be SaFER (stone and fragments entirely removed)

2018

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“…In this cohort of patients, there was a 51% rise in the incidence of urolithiasis from 2006/07 to 2013/14 [1]. There is also a strong association of metabolic syndrome with kidney stone disease [2, 4]. Treatments of urolithiasis have risen over the same time with 47% more procedures performed over the last decade; mainly URS, but shock wave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL) have also shown an overall increase [1].…”

Section: Introductionmentioning

confidence: 99%

“…With an epidemic of obesity worldwide and the associated difficulties in managing stone disease in these patients, there is a growing uptake and use of URS for obese stone patients [4, 13]. In this population PCNL has higher complication rates and SWL lower SFRs, resulting in more URS being performed.…”

Section: Introductionmentioning

confidence: 99%

Ureteroscopy for stone disease: expanding roles in the modern era

Sarmah

Bres-Niewada

et al. 2017

CEJU

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IntroductionThe prevalence of urolithiasis is increasing worldwide and is causing significant morbidity and cost to the healthcare systems. While ureteroscopy (URS) has been established as a treatment option, our review highlights the expanding role of URS for the management of more complex stones and patients in the modern era.Material and methodsUreteroscopy has shown to have good outcomes with stone free rates (SFR) comparable to other treatment modalities. Relevant publications have been identified. Their findings were critically appraised and used to formulate clinically oriented conclusions.ResultsThe use of URS has increased and now includes URS management for large stones, bilateral stone disease, obesity, pregnancy, pediatrics, solitary kidney, horseshoe kidney and patients with a bleeding diathesis.ConclusionsWith advances in URS technique and technology, its role has expanded to offer treatment in difficult clinical scenarios with good outcomes.

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“…2 Furthermore, patients with metabolic syndrome have been shown to have significantly higher stone recurrence post-percutaneous nephrolithotomy when compared with controls (41.9% vs. 18.9%; p=0.003). 3 In addition to the explanations provided by the authors for the lack of correlation of elevated %VAT with stone recurrence in recurrent stone formers, I would like to propose these two hypotheses.…”

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confidence: 97%