Stone composition independently predicts stone size in 18,029 spontaneously passed stones

Abstract

PURPOSE To evaluate whether the size of spontaneously passed stones (SPS) may be associated with clinical parameters. METHODS A search for SPS was conducted in our electronic stone database, comprising data on stones analyzed over the last 33 years at our institution. Adults with upper urinary tract stones were included. Cases with stenotic urinary tract disease or past history of anastomotic urinary tract surgery were excluded. Stone size expressed as maximal stone diameter (MSD) and stone volume (SV) was compared between groups by one-way ANOVA. Logistic regression analyses were performed to identify predictors of MSD 6 mm. RESULTS Overall mean MSD and SV for 18,029 SPS was 4.1 mm and 11.5 mm 3 , respectively, and significantly differed between stone composition groups (p < 0.001). The lowest mean MSD and SV were found for calcium oxalate monohydrate (3.6 mm and 9.0 mm 3 , respectively) and the highest mean MSD and SV were found for struvite (7.9 mm and 61.0 mm 3 , respectively). Stone composition and increasing age were found to be independent predictors of MSD 6 mm (both p < 0.001). Sex differentiation did not contribute as a predictor of MSD 6 mm. CONCLUSIONS Stone composition and-to a lesser extent-age serve as independent predictors of size of spontaneously passed stones. Of particular importance, large spontaneously passed stones of 6 mm may be frequently found in cystine, brushite or struvite stone formers, whereas a minority of all calcium oxalate stones exceed that cutoff. Future studies shall evaluate these parameters as possible predictors of spontaneous stone passage. AbstractPurpose: To evaluate whether size of spontaneously passed stones (SPS) may be associated with clinical parameters. Methods:A search for SPS was conducted in our electronical stone database, comprising data on stones analyzed over the last 33 years at our institution. Adults with upper urinary tract stones were included. Cases with stenotic urinary tract disease or past history of anastomotic urinary tract surgery were excluded. Stone size expressed as maximal stone diameter (MSD) and stone volume (SV) was compared between groups by one-way ANOVA. Logistic regression analyses were performed to identify predictors of MSD ≥6 mm. Results:Overall mean MSD and SV for 18'029 SPS was 4.1 mm and 11.5 mm 3 , respectively, and significantly differed between stone composition groups (p<0.001).Lowest mean MSD and SV was found for calcium oxalate monohydrate (3.6 mm and 9.0 mm 3 , respectively) and highest mean MSD and SV was found for struvite (7.9 mm and 61.0 mm 3 , respectively). Stone composition and increasing age were found as independent predictors of MSD ≥6 mm (both p<0.001). Sex differentiation did not contribute as a predictor of MSD ≥6 mm. Conclusions:Stone composition and -to a lesser extent -age serve as independent predictors of size of spontaneously passed stones. Of particular importance, large spontaneously passed stones of ≥6 mm may be frequently found in Cystine, Brushite or Struvite stone formers, whereas a minority of al...

Analysis of Factors Associated with Large Kidney Stones: Stone Composition, Comorbid Conditions, and 24-H Urine Parameters—a Machine Learning-Aided Approach

“…It has been demonstrated that in more advanced kidney disease, there is less filtrate of solutes in the glomerulus, thus less supersaturation of elements. A recent study in patients with spontaneously passed stones showed the presence of calcium oxalate stone was associated with smaller maximal stone diameter (MSD) and stone volume (SV) compared with other stone types; this evidence combined with our findings suggested that calcium oxalate is potentially associated with slower stone growth [22]. There are limitations in the present study.…”

Study on Renal stones: A review

“…The prevalence rate of the calcium oxalate type is high compared to the calcium phosphate type, sometimes both types were also detected with the same sample. The estimated size of calcium oxalate monohydrate has the lowest diameter of stone and its volume (3.6mm and 9.0mm 3 ) compared to other types 13 . These calcium stones have the highest recurrence rate compared to all other types 14 .…”

What is the role of inflammatory markers in predicting spontaneous ureteral stone passage?

“…The advantages and disadvantages of conservative management and early intervention make it difficult to decide whether to choose conservative management or active stone removal. In addition to the size and location of the stone, previous papers have assessed several other parameters [7][8][9][10][11] to predict SSP; however, it remains unclear which patients are appropriate for conservative management. In recent years, inflammatory parameters, including white blood cell (WBC) and neutrophil counts [1], neutrophil-to-lymphocyte ratio (NLR) [12,13], and platelet-to-lymphocyte ratio (PLR) [13] have been assessed to predict SSP.…”