Recurrence Rates and Severity of Urinary Calculi

Leusmann, D. B.; Niggemann, Hiltrud; Roth, Stephan; Ahlen, H von

doi:10.3109/00365599509180576

Cited by 42 publications

(13 citation statements)

References 7 publications

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“…Moreover, this is also a reasonable step for patients with brushite stones because of the very high recurrence rate with this CaP crystal phase [31]. Uric acid stones or fragments can be successfully dissolved with oral pharmacological treatment [32,33] (Table 1).…”

Section: © 2 0 0 3 B J U I N T E R N a T I O N A Lmentioning

confidence: 99%

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Epidemiology and medical management of stone disease

2003

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SUMMARYRecurrent stone formation in the urinary tract is a common and important problem that must be considered in daily urological practice. With a prevalence of> 10% and an expected recurrence rate of ≈ 50%, stone disease has an important effect on the healthcare system. It is generally agreed that patients with uric acid/urate, cystine or infection stones always should be treated pharmacologically. For calcium stone formers the treatment should be chosen according to the severity of the disease. Recurrence in patients with calcium‐stone disease can be prevented with general or specific dietary and drinking advice, and with pharmacological therapy. For idiopathic calcium stone formers the most convincing therapeutic effects have been reported with thiazide and alkaline citrate.

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Section: © 2 0 0 3 B J U I N T E R N a T I O N A Lmentioning

confidence: 99%

“…Extensive stone formation in category R s also favours a pharmacological approach. The risk of recurrence is higher in patients with a large proportion of CaP in the stones [15] and a higher risk has been recorded for stones containing CaOx dihydrate than for those containing CaOx monohydrate [31].…”

Section: © 2 0 0 3 B J U I N T E R N a T I O N A Lmentioning

confidence: 99%

Epidemiology and medical management of stone disease

2003

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“…CT may be preferred in follow-up for patients with infection stones or aggressive stone formers because of the clinical relevance of smaller fragments. In general, however, it is important that providers increasingly consider alternatives to conventional CT; recurrence and repeated acute presentations are standard for these patients, and radiation exposure can rapidly accrue [48]. Combination KUB/US should be more routinely considered, and low-dose CT should be broadly applied as its technique is refined.…”

Section: Discussionmentioning

confidence: 98%

Evaluation and Follow-Up of Patients with Urinary Lithiasis: Minimizing Radiation Exposure

Hyams

Shah

2010

Curr Urol Rep

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As unenhanced computed tomography (CT) has supplanted other modalities (eg, intravenous urography, ultrasonography) as the "test of choice" for evaluation of stone disease, patients have been exposed to higher doses of ionizing radiation in both primary evaluation and follow-up. There has been progressive recognition that low doses of radiation in the range of conventional CT may increase the long-term risk of cancer in exposed patients; these data have been extrapolated from longitudinal and ongoing study of atomic bomb survivors. There have been mounting efforts to develop alternative approaches to conventional CT (eg, low-dose protocols, substitution of ultrasound/plain X-ray) to provide comparable data while reducing total radiation exposure. It is essential that urologists collaborate with radiologists, emergency room physicians, and other providers to appropriately balance the theoretical risks and practical benefits of ionizing radiation in the diagnosis of stone disease.

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“…A German study reported an overall 35% 10-yr recurrence rate, which varied considerably according to the chemical composition of the calculi. Of struvite stones, 75% recurred compared with 66.7% and 50% recurrence rates for calcium brushite and weddellite, respectively ( 27 ). Sutherland reported a mean interval to fi rst recurrence of 8.8 yr ( 50 ).…”

Section: Surveillance Considerationsmentioning

confidence: 98%

Aeromedical Certification of Aircrew and Controllers with Renal Calculi

Drane¹,

Navathe²,

Clem³

2013

Aviation, Space, and Environmental Medicine

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Acute renal colic is an incapacitating condition. Advances in understanding the pathogenesis of calculi and their detection and treatment require a new approach to aeromedical risk assessment. Can this new information support the stratification of aeromedical risk into "High" and "Low" categories, and fulfill the paramount responsibility of the Civil Aviation Safety Authority, Australia's aviation regulator, which isthe maintenance of aviation safety? This article reviews the epidemiology of calculi and finds 2-10% annual risk of a symptomatic event following incidental detection of a calculus. While calculi 4 mm or less in size may not require surgical intervention, this does not equate to a pain-free passage. Similarly, calculus recurrence rates may vary in different anatomical locations, but no location can be considered "safe." The recognition of parenchymal calcification and Randall's plaques as precursors to the development of calculi places such individuals at elevated risk of developing calculi. More recently evidence has supported a link between metabolic syndrome and calculus formation. In an occupational group where there is potential for elevated radiation exposure, appropriate imaging is of particular importance. CT, X-ray, and ultrasound modalities are reviewed with recommendations presented for aeromedical assessment and surveillance based on identification of those at high risk of colic and minimization of investigational radiation exposure.

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Recurrence Rates and Severity of Urinary Calculi

Cited by 42 publications

References 7 publications

Epidemiology and medical management of stone disease

Epidemiology and medical management of stone disease

Evaluation and Follow-Up of Patients with Urinary Lithiasis: Minimizing Radiation Exposure

Aeromedical Certification of Aircrew and Controllers with Renal Calculi

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