Changing Trends in the American Diet and the Rising Prevalence of Kidney Stones

De, Shubha; Liu, Xiaobo; Monga, Manoj

doi:10.1016/j.urology.2014.06.037

Cited by 38 publications

(25 citation statements)

References 15 publications

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“…The prevalence of urolithiasis has been increasing globally for reasons including diet and obesity [6]. At the same time, urologists show a dramatic adoption of endo-DOI: 10.1159/000486345 scopic techniques for management of upper tract calculi over shockwave lithotripsy [7].…”

Section: Discussionmentioning

confidence: 99%

Radiation Exposure during Ureterorenoscopy and Laser Lithotripsy: An Analysis of Stone Characteristics

et al. 2018

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Introduction and Objectives: Stone formers often have a chronic exposure to significant quantities of ionising radiation from radiological investigations and interventions. Predicting radiation exposure would allow the clinician to quantify expected cumulative radiation and find strategies to minimise exposure. We evaluated radiation exposure during ureteroscopy and laser lithotripsy (URS + LL) for a single stone episode and correlated the results to stone characteristics. Method: Data was collected retrospectively for all patients undergoing URS + LL in our institution over a 1 year period. Patients with multiple stones, staghorn stones or incomplete stone clearance were excluded to simplify the analysis. Patient characteristics, fluoroscopy data and stone characteristics were recorded. Results: We included 302 consecutive patients in the study. The majority of stones were located in the renal calyces/pelvis (54%) with the rest located in the upper (18%), middle (13%) and lower ureter (15%). Mean stone diameter was 9.9 mm (range 4–30 mm). Mean radiation exposure time during URS + LL was 44 s (range 12–119 s) with a mean total radiation exposure of 7.5 milligray (mGy; range 1.2–29.7 mGy). Renal stones were associated with 27% higher radiation exposure compared to ureteral stones (8.3 vs. 6.7 mGy; p = 0.02). There was a positive correlation between stone diameter and radiation exposure (Spearman’s correlation coefficient ρ = 0.28; p < 0.001). Stones with diameter greater than 10 mm were associated with 37% higher radiation exposure compared to smaller stones (9.1 vs. 6.6 mGy; p < 0.001). Conclusion: There is a direct correlation between stone burden, as well as location, and radiation exposure during URS + LL. Clinicians should consider strategies to reduce total radiation exposure in recurrent stone formers at risk of high radiation exposure by limiting screening time, using pulsed rather than continuous fluoroscopy, management with primary URS + LL, or using ultrasound guidance.

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Section: Discussionmentioning

confidence: 99%

Radiation Exposure during Ureterorenoscopy and Laser Lithotripsy: An Analysis of Stone Characteristics

et al. 2018

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“…In the USA, there is growth especially amongst women, elderly patients and the Black and Hispanic communities, whereas the incidence rate for the male Caucasian cohort is fairly stable . A clear correlation of stone incidence with a lithogenic diet has been demonstrated . It has been postulated that stone incidence reflects economic prosperity and growth .…”

Section: Discussionmentioning

confidence: 99%

Trends in urological stone disease: a 5‐year update of hospital episode statistics

2016

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This study provides an update on the changing landscape of the management of UUT stones in England. It shows a sustained high prevalence of stone disease commensurate with levels in other developed countries. This study reveals a trend in the last 5 years to surgically intervene on a higher proportion of patients with stones. As in other countries, there is a significant increase in the use of ureteroscopy (particularly intrarenal flexible ureteroscopy) in England. These data have important implications for work-force planning, training, service delivery, and research in the field of urolithiasis.

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“…There is an increasing prevalence of urinary stone disease, but in parallel, the widespread use of non-contrast CT has facilitated the diagnosis of stone diseases [13]. Due to the high resolution and high sensitivity of non-contrast CT in current use, this has replaced 'excretory urography' in the diagnosis of stone disease.…”

Section: Discussionmentioning

confidence: 99%

Medical dissolution therapy for kidney stone with low density on non-contrast computed tomography

Hasırcı¹,

Tekin²,

Dirim³

et al. 2018

biomedicalresearch

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Objective: To review the outcome of dissolution therapy in low-density urinary stones defined by nonenhanced computed tomography. Materials and methods: The outcome of dissolution therapy in patients treated between May 2011 and July 2016 was retrospectively reviewed. Potassium sodium hydrogen citrate was used in cases with syone of <800 Hounsfield units determined by non-enhanced computed tomography. A decrease of 50% in the long axis of the stone was defined as partial dissolution. Cases with complete and partial stone dissolution were taken as the treatment success group whereas those who could not tolerate the treatment and who has less than 50% decrease in stone size were noted as treatment failure. The patients were compared with respect to age, body mass index, stone size, stone density, duration of treatment and follow-up, urine pH and serum uric acid levels. Results: Of 46 patients 31 completed the treatment course. A full response was obtained in 22 (71%) and a partial response in 4 (12.9%) cases. The basic factors found to affect the success of treatment were stone surface area, pre-treatment urine pH and serum uric acid levels. Conclusion: Low-density urinary stones can be successfully treated with dissolution therapy. In patients with radiolucent stones, the stone density should be measured by using non-enhanced computed tomograms. In cases examined with suitable stone density, dissolution treatment can be started without determining the exact type of the stone.

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Changing Trends in the American Diet and the Rising Prevalence of Kidney Stones

Cited by 38 publications

References 15 publications

Radiation Exposure during Ureterorenoscopy and Laser Lithotripsy: An Analysis of Stone Characteristics

Radiation Exposure during Ureterorenoscopy and Laser Lithotripsy: An Analysis of Stone Characteristics

Trends in urological stone disease: a 5‐year update of hospital episode statistics

Medical dissolution therapy for kidney stone with low density on non-contrast computed tomography

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