Contemporary Management of Struvite Stones Using Combined Endourologic and Medical Treatment: Predictors of Unfavorable Clinical Outcome

Iqbal, Muhammad Waqas; Youssef, Ramy; Neisius, Andreas; Kuntz, Nicholas; Hanna, Jonathan; Ferrandino, Michael N.; Preminger, Glenn M.; Lipkin, Michael

doi:10.1089/end.2013.0257

Cited by 25 publications

(17 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The ARI found in patients upon initial laboratory testing may have been associated with complete ureteral obstruction or delayed urinary stone treatment. In another study, the rate of post-operative UTI was lower in stone-free patients than in patients with remnant stone (38% vs. 64%) [11]. However in our study, the stone-free rate was not different between the two groups.…”

Section: Discussioncontrasting

confidence: 85%

“…Kofteridis et al [10] reported that an elderly APN patient with DM showed an increased risk of bacteremia, long hospitalization, and mortality. In another study, it was found that comorbidity factors, such as DM, could influence urinary stone activity and the recurrence of UTI after the treatment of infection and stone [11]. DM, as a comorbidity factor, may be associated with stone activity and UTI recurrence; however, multivariate analysis did not find DM to be an independent risk factor (p=0.150).…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

The Risk Factors of Recurrent Febrile Urinary Tract Infection within 1 Year in Urinary Stone Patients with Acute Obstructive Pyelonephritis

Lee

Yoon

et al. 2017

Urogenit Tract Infect

View full text Add to dashboard Cite

Purpose: To identify and evaluate the risk factors for the development of recurrent febrile urinary tract infection (fUTI) among patients with previous urinary stone and acute obstructive pyelonephritis (OPN). Materials and Methods:We retrospectively reviewed the medical records of 52 patients, who had urinary tract stones presented with OPN, between 2010 and 2015. Following their initial treatment, patients who were subsequently admitted with fUTI were included. Results: The mean age of patients was 62.2±14.6 years, and the mean follow-up duration was 26.0±20.39 months. Escherichia coli was found to be the dominating organism (68.2%, 15/22) in the initial urine culture. Patients were divided into two groups: The recurrent fUTI group (n=23) and the non-recurrent fUTI group (n=29). Between these two groups, significant differences were found with respect to diabetes history (recurrent group: 47.8% vs. non-recurrent group; 17.2%, p=0.018), stone location (kidney, 60.9% vs. ureter, 31.0%, p=0.031), and initially positive urine culture (60.9% vs. 27.6%, p=0.016). In a multivariate analysis, having an initially positive urine culture (95% confidence interval, 1.130-224.117; p=0.040) was identified as being an independent risk factor for developing recurrent fUTI. In a multivariate analysis, the initial laboratory test finding of acute renal insufficiency (ARI, p=0.019) and presence of a kidney stone (p=0.022) were significant factors associated with a newly-diagnosed-positive urine culture diagnosis. Conclusions: Having an initially positive urine culture was a significant risk factor for the development of recurrent fUTI in urinary stone patients with acute OPN. In addition, repeated urine tests were also needed in patients with ARI or renal stones during the follow-up period.

show abstract

Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 97%

The Risk Factors of Recurrent Febrile Urinary Tract Infection within 1 Year in Urinary Stone Patients with Acute Obstructive Pyelonephritis

Lee

Yoon

et al. 2017

Urogenit Tract Infect

View full text Add to dashboard Cite

show abstract

“…Owing to the low incidence of metabolic abnormalities in struvite stone formers and the apparent strong association between struvite stone formation and UTIs, the 2005 American Urological Association (AUA) guidelines on management of staghorn calculi recommended against the metabolic evaluation of pure struvite stone formers 44 . However, studies published after 2005 suggest that metabolic abnormalities occur more frequently in struvite stone formers, including patients with pure struvite stones, than previously reported 45,46 . For instance, a 2017 study by Iqbal et al 45 found metabolic abnormalities in 57% of pure struvite stone formers (from a total of 75 patients), the most common of which were hypercalciuria, hyperoxaluria, hyperuricosuria, and hypocitraturia.…”

Section: Key Pointsmentioning

confidence: 87%

Current insights into the mechanisms and management of infection stones

et al. 2018

View full text Add to dashboard Cite

Infection stones are complex aggregates of crystals amalgamated in an organic matrix that are strictly associated with urinary tract infections. The management of patients who form infection stones is challenging owing to the complexity of the calculi and high recurrence rates. The formation of infection stones is a multifactorial process that can be driven by urine chemistry , the urine microenvironment, the presence of modulator substances in urine, associations with bacteria, and the development of biofilms. Despite decades of investigation, the mechanisms of infection stone formation are still poorly understood. A mechanistic understanding of the formation and growth of infection stones-including the role of organics in the stone matrix, microorganisms, and biofilms in stone formation and their effect on stone characteristics-and the medical implications of these insights might be crucial for the development of improved treatments. Tools and approaches used in various disciplines (for example, engineering, chemistry , mineralogy , and microbiology) can be applied to further understand the microorganism-mineral interactions that lead to infection stone formation. Thus, the use of integrated multidisciplinary approaches is imperative to improve the diagnosis, prevention, and treatment of infection stones.

show abstract

“…Obstructive pyelonephritis, or a kidney stone that has blocked the kidney ducts, is one of the more severe complications of urinary stones, requiring immediate treatment to avoid serious complications such as urosepsis and death [4,7]. Even with stone removal, residual stone fragments may remain in the urinary system, putting these patients at a 40–85% risk for recurrent stones, versus a 0–10% risk for patients who had complete stone removal [8]. …”

Section: Cautis and Urinary Stonesmentioning

confidence: 99%

From Catheter to Kidney Stone: The Uropathogenic Lifestyle of Proteus mirabilis

Norsworthy

Pearson

2017

Trends in Microbiology

View full text Add to dashboard Cite

Proteus mirabilis is a model organism for urease-producing uropathogens. These diverse bacteria cause infection stones in the urinary tract and form crystalline biofilms on indwelling urinary catheters, frequently leading to poly-microbial infection. Recent work has elucidated how P. mirabilis causes all of these disease states. Particularly exciting is the discovery that this bacterium forms large clusters in the bladder lumen that are sites for stone formation. These clusters, and other steps of infection, require two virulence factors in particular: urease and MR/P fimbriae. Highlighting the importance of MR/P fimbriae is the cotranscribed regulator, MrpJ, which globally controls virulence. Overall, P. mirabilis exhibits an extraordinary lifestyle, and further probing will answer exciting basic microbiological and clinically relevant questions.

show abstract

Contemporary Management of Struvite Stones Using Combined Endourologic and Medical Treatment: Predictors of Unfavorable Clinical Outcome

Cited by 25 publications

References 27 publications

The Risk Factors of Recurrent Febrile Urinary Tract Infection within 1 Year in Urinary Stone Patients with Acute Obstructive Pyelonephritis

The Risk Factors of Recurrent Febrile Urinary Tract Infection within 1 Year in Urinary Stone Patients with Acute Obstructive Pyelonephritis

Current insights into the mechanisms and management of infection stones

From Catheter to Kidney Stone: The Uropathogenic Lifestyle of Proteus mirabilis

Contact Info

Product

Resources

About