Optimal Delivery of Follow-Up Care for the Prevention of Stone Recurrence in Urolithiasis Patients: Improving Outcomes

Tzelves, Lazaros; Berdempes, Marinos; Mourmouris, Panagiotis; Mitsogiannis, Iraklis; Skolarikos, Andreas

doi:10.2147/rru.s277498

Cited by 7 publications

(5 citation statements)

References 64 publications

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“…After 90 days of treatment, a check-up was made by a radiologist (who did not have access to the study data). In all cases, ultrasound was performed as suggested in the lectures [32]. When stones were identified during this examination, a low dose computed tomography (CT scan) was used to determine the exact number, stone size and localization.…”

Section: Methodsmentioning

confidence: 99%

Stone Free-Rate Experience in Post-Interventional Patients Undergoing Citrates and Pyridoxine Administration

ENE¹

2023

FARMACIA

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In order to achieve stone-free status following flexible ureteroscopy and Holmium laser lithotripsy of kidney stones, multiple remaining fragments require adjuvant treatment. This study aimed to evaluate the effectiveness of citrate and pyridoxine therapy in preventing lithiasis recurrence. Patients with kidney stones who have undergone endourological treatment were examined. We conducted a prospective, randomized trial study on 182 patients who had kidney stones up to 2 cm in diameter and received digital flexible ureteroscopy with Holmium laser lithotripsy. Afterwards, the general treatment consisted of 2 -3 L of water per day -approximately 400 mL every four hours -and a predominantly low-protein diet. We divided them into 2 groups. Group B received only general treatment, while in Group A (92 patients), a combination of 2703 mg potassium citrate, 376 mg magnesium citrate, and 25 mg pyridoxine per sachet was added. At 90 days, the stone-free rate was higher (84.78%) in Group A compared to Group B (70.2%) (p < 0.05). It was also found that Group A had a higher expulsion rate than Group B (34.78% versus 20%, p < 0.05) and a better reduction in mean residual stone size (2.36 mm versus 1.66 mm, p < 0.05). Administration of potassium citrate, magnesium citrate, and pyridoxine provided favourable results for obtaining stone-free status after digital flexible ureteroscopy with Holmium laser lithotripsy. RezumatPentru a obține statusul stone-free secundar ureteroscopiei flexibile cu litotriție laser Holmium pentru litiaza renală, fragmentele restante necesită tratament adjuvant. Acest studiu are ca scop evaluarea eficacității tratamentului cu citrați și piridoxină în prevenția recurențelor litiazice. Au fost studiați pacienți care au beneficiat de tratament endourologic pentru litiaza renală. Am efectuat un studiu prospectiv, randomizat pe 182 de pacienți cu litiază renală până în 2 cm diametru, care au beneficiat de ureteroscopie flexibilă digitală cu litotriție laser Holmium. Apoi un tratament general care constând în doi-trei litri de apă pe zi -aproximativ 400 mL la fiecare 4 ore -și o dietă săracă în proteine a fost instituit. Am împărțit pacienții în 2 grupuri. Grupul B a primit doar tratament general în timp ce Grupul A a beneficiat de o adăugare a unei combinații de 2703 mg citrat de potasiu, 376 mg citrat de magneziu și 25 de mg piridoxină la acesta. La 90 de zile rata stone-free a fost mai mare în Grupul A (84,78%) comparativ cu Grupul B (70%) (p < 0,05). De asemenea Grupul A a avut o rată de expulzie mai mare comparativ cu Grupul B (34,78% versus 20%, p < 0,05) și rezultate mai bune în reducerea dimensiunii medii a litiazei reziduale (2,36 mm versus 1,66 mm, p < 0,05). Administrarea citratului de potasiu, citratului de magneziu și piridoxinei a oferit rezultate favorabile în obținerea statusului stone-free secundar ureteroscopie flexibile digitale cu litotriție laser Holmium.

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Section: Methodsmentioning

confidence: 99%

Stone Free-Rate Experience in Post-Interventional Patients Undergoing Citrates and Pyridoxine Administration

ENE¹

2023

FARMACIA

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“…75 Catastrophic events in Hiroshima and Nagasaki have made clear how harmful ionizing radiation is for human tissues; yet according to a recent survey education is lacking and protective equipment is not used ideally among endourologists. 76 Patients are exposed to radiation during diagnosis, management and follow-up of urolithiasis, [77][78][79] while surgeons are also prone to its mutagenic effects due to long-term, low-dose exposure. 80 Although not a technological innovation per se, the establishment and adoption of radiation-free protocols for URS and PCNL can drastically reduce radiation exposure and associated risks.…”

Section: Miniaturization Of Pcnl Sheaths -Innovations In Pcnl Lithotr...mentioning

confidence: 99%

Innovations in Kidney Stone Removal

Tzelves¹,

Geraghty²,

Hughes³

et al. 2023

RRU

Self Cite

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Urolithiasis is a common clinical condition, and surgical treatment is performed with different minimally invasive procedures, such as ureteroscopy, shockwave lithotripsy and percutaneous nephrolithotomy. Although the transition from open surgery to endourological procedures to treat this condition has been a paradigm shift, ongoing technological advancements have permitted further improvement of clinical outcomes with the development of modern equipment. Such innovations in kidney stone removal are new lasers, modern ureteroscopes, development of applications and training systems utilizing three-dimensional models, artificial intelligence and virtual reality, implementation of robotic systems, sheaths connected to vacuum devices and new types of lithotripters. Innovations in kidney stone removal have led to an exciting new era of endourological options for patients and clinicians alike.

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“…While there are several ways to relieve symptoms promptly, but none guarantee the prevention of a recurrence. 5 Furthermore, substantial, serious adverse events and post-treatment distress are associated with modern surgical and therapeutic interventions for kidney stones. 6 A plethora of novel therapeutic strategies, notably urolithiasis therapy, are currently being spoke of into traditional medicine.…”

Section: Introductionmentioning

confidence: 99%

Phytochemical Screening, Acute Toxicity and Evaluation of in vitro Antiurolithaitic Activity of Ethanolic and Methanolic Root and Leaf Extracts of Acalypha indica Linn.

Kumar,

Sharma

2024

J. Young Pharm.

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Background: A plethora of novel therapeutic strategies, notably urolithiasis therapy, are currently being spoke of into traditional medicine. A particularly significant herbal remedy that is employed in indigenous medicine for its antiurolithiatic property is Acalypha indica Linn. Although A. indica is widely used in traditional medicine as an antiurolithiatic, there is currently no scientific data to substantiate this claim. Moreover, deriving inferences from the suggested theories and limited in vitro investigation casts doubt on its significance. Hence, this work focuses on the preliminary evaluation, acute oral toxicity and in vitro evaluation for antiurolithiatic activity of A. indica. Materials and Methods: Phytochemical evaluation was carried out using various standardized tests. Acute toxicity studies for Methanolic and Ethanolic extract of Roots and Leaves was conducted according to OECD guideline 420 using Wistar albino rats. The inhibitory activity of the extracts with concentrations of 100, 200, 400, 600, 800 and 1000 μg/mL on the nucleation of Calcium oxalate (CaOx) crystals was determined by a spectrophotometric assay. Results: A phytochemical screening resulted in identification of secondary metabolites such as carbohydrates, alkaloids, flavonoids, saponins and terpenoids with varying amounts in each extract. There were no signs of toxicity in the initial investigation on a single rat given a dosage of 2000 mg/kg of methanolic and ethanolic root and leaf extracts. The maximum inhibition was observed in Methanolic Root Extract (71.26%) at a concentration of 1000 mg/mL, which is followed by Ethanolic Leaf Extract (60.91%) at the same concentration. Conclusion: Acalypha indica Linn. was discovered to possess therapeutic value in the management of urolithiasis.

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Optimal Delivery of Follow-Up Care for the Prevention of Stone Recurrence in Urolithiasis Patients: Improving Outcomes

Cited by 7 publications

References 64 publications

Stone Free-Rate Experience in Post-Interventional Patients Undergoing Citrates and Pyridoxine Administration

Stone Free-Rate Experience in Post-Interventional Patients Undergoing Citrates and Pyridoxine Administration

Innovations in Kidney Stone Removal

Phytochemical Screening, Acute Toxicity and Evaluation of in vitro Antiurolithaitic Activity of Ethanolic and Methanolic Root and Leaf Extracts of Acalypha indica Linn.

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