A Prospective Study of Recurrence Rate and Risk Factors for Recurrence After a First Renal Stone

Trinchieri, Alberto; F, Ostini; Nespoli, R.; Rovera, F.; Montanari, Emanuele; Zanetti, G.

doi:10.1097/00005392-199907000-00007

Cited by 197 publications

(122 citation statements)

References 11 publications

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“…The current study shows that success rate had ahigher range regarding upper calyceal and pelvic stones (70%-90%) compared to 50%-70% success rate for the lower calyceal stones, this finding is similar to data of some previously published studies [2,[5][6][7].…”

Section: Discussionsupporting

confidence: 92%

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Success Rate of Stone Recurrence after Extracorporeal Shockwave Lithotripsy and Factors affecting Success of Treatment among Egyptian Patients

Gadalla¹

2016

Med Surg Urol

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Objectives: To evaluate the factors that affect the success rate of ESWL for treatment of renal stones and to estimate the prevalence of stone recurrence during a 1-year period. Materials and Methods:During the period of January, 2010 and December, 2010, prospective study of 142 subjects with single or multiple renal stones (<30 mm, largest diameter) undergone ESWL monotherapyby Siemens-LITHOSKOP lithotriptor. The results of treatment were assessedafter a follow-up period of 3 months. Treatment success was a complete clearance of the stones or presence of insignificantresidual fragments<4 millimeters. Correlation of the success rate with the characteristics of the subjects, conditionsof the urinary tract and features of the stone was done.Results: During the 3-months follow-up period, the success rate was 111/142 (78%). Re-treatment was needed in 75 patients (52.8%). Post-treatment procedures were done in 12 subjects (8.4%). Post-ESWL complications were observed in 5 subjects (3.5%). Out of 10 prognosticfactors studied, 5 had a powerful influence on the success rate, which are: renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number. Other factors including age, sex, nationality, stonenature (de novo or recurrent) and ureteric stenting had no significant impact on the success rate. Conclusions:Prediction of success of treatment with ESWL and the recurrence depends and may be predicted by renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number.

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Section: Discussionsupporting

confidence: 92%

“…In addition, retained stone fragments following this therapy may reform or compose a nucleus for another stone formation, hence causes a high rate of stone growth [2][3][4][5]. The patient's chances of first episode recurrent stone formation range between 27% and 50% [6,7].…”

Section: Introductionmentioning

confidence: 99%

Success Rate of Stone Recurrence after Extracorporeal Shockwave Lithotripsy and Factors affecting Success of Treatment among Egyptian Patients

Gadalla¹

2016

Med Surg Urol

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“…High levels of supersaturation with CaOx and/or CaP in categories S res and R mres might be associated with an increased risk of new stone formation [27,34]. Extensive stone formation in category R s also favours a pharmacological approach.…”

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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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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“…14 Furthermore, the rates of metabolic abnormalities were similar among single stone formers compared to recurrent stone formers. 15,16 Therefore, additional study is needed to further refine the analysis of urinary risk factors to predict stone recurrence. Stone formers can have normal 24-hour urine collections and nonstone formers can have abnormal collections, raising the question of whether current laboratory cutoff parameters are appropriate.…”

Section: Drawbacksmentioning

confidence: 99%

The Role of the 24-Hour Urine Collection in the Prevention of Kidney Stone Recurrence

et al. 2017

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Purpose: Kidney stone prevention relies on the 24-hour urine collection to diagnose metabolic abnormalities and direct dietary and pharmacological therapy. While its use is guideline supported for high risk and interested patients, evidence that the test can accurately predict recurrence or treatment response is limited. We sought to critically reassess the role of the 24-hour urine collection in stone prevention. Materials and Methods: In addition to a MEDLINEÒ search to identify controlled studies of dietary and pharmacological interventions, evidence supporting the AUA (American Urological Association) and EAU (European Association of Urology) guidelines for metabolic stone prevention were evaluated. Additionally, the placebo arms of these studies were examined to assess the stone clinic effect, that is the impact of regular office visits without specific treatment on stone recurrence. Results: The 24-hour urine test has several limitations, including the complexity of interpretation, the need for repeat collections, the inability to predict stone recurrence with individual parameters and supersaturation values, the unclear rationale of laboratory cutoff values and the difficulty of determining collection adequacy. Only 1 prospective trial has compared selective dietary recommendations based on 24-hour urine collection results vs general dietary instructions. While the trial supported the intervention arm, significant limitations to the study were found. Placebo arms of intervention trials have noted a 0% to 61% decrease in stone recurrence rate and a remission rate during the study of 20% to 86%. Conclusions: Whether all recurrent stone formers benefit from 24-hour urine collection has not been established. Additional comparative effectiveness trials are needed to determine which stone former benefits from selective therapy, as guided by the 24-hour urine collection.

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A Prospective Study of Recurrence Rate and Risk Factors for Recurrence After a First Renal Stone

Cited by 197 publications

References 11 publications

Success Rate of Stone Recurrence after Extracorporeal Shockwave Lithotripsy and Factors affecting Success of Treatment among Egyptian Patients

Success Rate of Stone Recurrence after Extracorporeal Shockwave Lithotripsy and Factors affecting Success of Treatment among Egyptian Patients

Epidemiology and medical management of stone disease

The Role of the 24-Hour Urine Collection in the Prevention of Kidney Stone Recurrence

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