The Changing Incidence and Presentation of Urinary Stones Over 3 Decades

Kittanamongkolchai, Wonngarm; Vaughan, Lisa E.; Enders, Felicity; Dhondup, Tsering; Mehta, Ramila A.; Krambeck, Amy E.; McCollough, Cynthia H.; Vrtiska, Terri J.; Lieske, John C.; Rule, Andrew D.

doi:10.1016/j.mayocp.2017.11.018

Cited by 136 publications

(112 citation statements)

References 33 publications

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“…Although various techniques for treatment of renal stones are available, expectant management with AS is a very commonly adopted option for asymptomatic renal calculi. However, it remains unknown as to the optimal follow‐up period required for these patients, and when active treatment should be offered to prevent stone‐related events for this cohort of patients . Koh et al retrospectively reviewed 50 patients undergoing observation of asymptomatic renal calculi with a mean follow‐up of 46 months.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of long‐term follow‐up of asymptomatic renal stones and prediction of stone‐related events

Zhu

Lam

et al. 2018

BJU International

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Objectives To evaluate the long‐term outcomes of patients undergoing observation of asymptomatic renal calculi and identify factors associated with stone‐related events. Patients and Methods Patients with asymptomatic renal calculi electing active surveillance of their stones were retrospectively reviewed. Patients underwent annual ultrasonography and clinical visits with standardised questions regarding the development of symptoms or complications from calculi. Spontaneous stone passage, stone growth, development of stone‐related symptoms, and requirement for intervention during follow‐up were deemed as stone‐related events. Results Between 2007 and 2017, 293 patients were reviewed to evaluate the natural history of asymptomatic renal calculi. The mean follow‐up was 4.2 years. Overall incidences of spontaneous passage, stone growth, development of stone‐related symptoms, and requirement of intervention were 32.1%, 16.7%, 28.3% and 12.3%, respectively. Stones >5 mm and lower pole stones were significantly less likely to pass spontaneously. Patients with diabetes mellitus (DM), hyperuricaemia or non‐lower calyceal stone were more likely to experience stone growth. Stones >5 mm or non‐lower pole stones were more likely to become symptomatic. Significant predictors of surgical intervention were stone size (>5 mm) and patients' age (>60 years). Primary therapy was extracorporeal shockwave lithotripsy in 33 patients and flexible ureteroscopy in three. Conclusion The natural history of asymptomatic renal stones rarely requires intervention, although they do have a slightly higher rate of symptomatic events and growth over the intermediate term. In particular, patients with stones >5 mm, DM, hyperuricaemia, or non‐lower calyceal stones are at higher risk of developing stone‐related events, and should therefore be recommended for regular follow‐up.

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Section: Discussionmentioning

confidence: 99%

Outcomes of long‐term follow‐up of asymptomatic renal stones and prediction of stone‐related events

Zhu

Lam

et al. 2018

BJU International

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“…The peak age of incidence is between 35 and 55 years. The recent evidence suggests that in western nations the incidence of renal stones has increased and women might be nearly as affected as men [3][4][5]. Risk of recurrence is estimated to be 50% within 5 years of the first stone episode.…”

Section: Introductionmentioning

confidence: 99%

The impact of urinary stone disease and their treatment on patients’ quality of life: a qualitative study

2019

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Urinary stone disease is a common, often recurrent disease, that can have a negative impact on patients' health-related quality of life (HRQoL), often effecting working, productive members of society. The literature lacks data from structured, qualitative research which could give unique insight into patients' HRQoL. The objective is to understand the impact of urinary stone disease and treatments on patients' HRQoL, from patients' and their relatives' perspective using qualitative and quantitative methodologies. Semi-structured interviews and a focus group were used to understand the HRQoL issues of patients with urinary stones disease, covering the American Urology Association index stone categories. Thematic analysis was performed (using qualitative data analysis software). Familial impact was assessed using the family-related outcome measure (FROM-16©). 62 patients with stone disease and interventions (mean age 51, range 19-92) participated. Data collection stopped when data saturation was achieved. Analysis revealed negative impact of stone disease and interventions on the patients' HRQoL, affecting domains of pain, physical symptoms, outlook on life, work/career, change in lifestyle/diet, social life, difficulties of daily living, travel/holiday problems, relationships and family member impact (106 themes grouped under ten broad headings). Subgroup analyses revealed similar impact in either sex, ureteric and renal stone groups. Recurrent stones were associated with work/financial concerns and treatment preferences varied accordingly. Our qualitative study presents detailed insights into the multidimensional impact of urinary calculi and their treatments on various domains of the HRQoL, confirming previous findings and adding new observations. The findings are expected to help in the development of patient-centric measures and communication tools.

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“…Nephrolithiasis is one of the most common urological diseases that affects approximately 5-15% of the global population [1][2][3]. The disease is accompanied with a life-DOI: 10.1159/000505822 long risk of recurrence of almost 50% and associated with high costs to the health care systems [4].…”

Section: Introductionmentioning

confidence: 99%

Impact of Anterior Kidney Calyx Involvement of Complex Stones on Outcomes for Patients Undergoing Percutaneous Nephrolithotomy

et al. 2020

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Introduction: A number of factors that can impact the outcomes of percutaneous nephrolithotomy (PCNL) procedures have previously been investigated. Complex stones that extend to the anterior calyx could affect the success and complication rates of PCNL. Objective: We analyzed the effect of anterior calyx involvement on the outcomes of patients with complex stones treated with PCNL. Methods: A total of 132 consecutive patients who underwent PCNL due to complex stones (multiple, partial staghorn, or staghorn stones) between 2015 and 2017 were enrolled in this study. They were stratified into two groups based on whether the stone extended to the anterior calyx (group 1, n = 45) or not (group 2, n = 87). The stratification was achieved through contrast-enhanced computerized tomography (CT). Demographics, laboratory tests, and peri-and postoperative findings (operation and fluoroscopy duration, hospital stay, utilization of flexible instruments, access numbers, total blood count change, stone-free rate [SFR], and complications) were compared between the groups. The SFR was evaluated by plain kidney-ureter-bladder radiography or CT. Results: The demographics, operation and fluoroscopy duration, access number, and hospital stay were similar between the groups (p < 0.05). A higher drop in the hemoglobin level in group 1 was identified (group 1 [2.14 ± 1.49 g/dL] vs. group 2 [1.43 ± 1.31 g/dL]) (p = 0.006). The SFR among the patients with extension to the anterior calyx was 60%, compared to 77% among the patients with no extension to the anterior calyx (p = 0.041). Flexible instruments were utilized in 60% of the patients of group 1, which was a higher rate than for group 2 (36%) (p = 0.007). Complication rates were similar in the two groups according to the Clavien-Dindo classification (p > 0.05). Conclusions: Our study demonstrated that complicated stones with extension to the anterior calyx are more challenging than cases without extension to the anterior calyx. This was noted by a lower SFR, a more prominent drop in total blood count, and more frequent utilization of flexible scopes.

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The Changing Incidence and Presentation of Urinary Stones Over 3 Decades

Abstract: The incidence of both symptomatic and asymptomatic kidney stones has increased dramatically. The increased utilization of computed tomography during this period may have improved stone detection and contributed to the increased kidney stone incidence.

Cited by 136 publications

References 33 publications

Outcomes of long‐term follow‐up of asymptomatic renal stones and prediction of stone‐related events

Outcomes of long‐term follow‐up of asymptomatic renal stones and prediction of stone‐related events

The impact of urinary stone disease and their treatment on patients’ quality of life: a qualitative study

Impact of Anterior Kidney Calyx Involvement of Complex Stones on Outcomes for Patients Undergoing Percutaneous Nephrolithotomy

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