The ROKS Nomogram for Predicting a Second Symptomatic Stone Episode

Rule, Andrew D.; Lieske, John C.; Li, Xujian; Melton, L. Joseph; Krambeck, Amy E.; Bergstralh, Eric J.

doi:10.1681/asn.2013091011

Cited by 225 publications

(195 citation statements)

References 22 publications

Supporting

Mentioning

176

Contrasting

Unclassified

Order By: Relevance

“…Perhaps first degree relatives of stone formers merit intervention as a higher-risk group. A first iteration of a recurrence risk prediction nomogram (Recurrence of Kidney Stone) is available (98). It could be useful to identify patients most worthy of prevention strategies.…”

Section: Population Health Management-primary and Secondary Preventionmentioning

confidence: 99%

Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health

Scales

Tasian

Schwaderer

et al. 2016

CJASN

139

View full text Add to dashboard Cite

Expanding epidemiologic and physiologic data suggest that urinary stone disease is best conceptualized as a chronic metabolic condition punctuated by symptomatic, preventable stone events. These acute events herald substantial future chronic morbidity, including decreased bone mineral density, cardiovascular disease, and CKD. Urinary stone disease imposes a large and growing public health burden. In the United States, 1 in 11 individuals will experience a urinary stone in their lifetime. Given this high incidence and prevalence, urinary stone disease is one of the most expensive urologic conditions, with health care charges exceeding $10 billion annually. Patient care focuses on management of symptomatic stones rather than prevention; after three decades of innovation, procedural interventions are almost exclusively minimally invasive or noninvasive, and mortality is rare. Despite these advances, the prevalence of stone disease has nearly doubled over the past 15 years, likely secondary to dietary and health trends. The NIDDK recently convened a symposium to assess knowledge and treatment gaps to inform future urinary stone disease research. Reducing the public health burden of urinary stone disease will require key advances in understanding environmental, genetic, and other individual disease determinants; improving secondary prevention; and optimal population health strategies in an increasingly cost-conscious care environment.

show abstract

Section: Population Health Management-primary and Secondary Preventionmentioning

confidence: 99%

Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health

Scales

Tasian

Schwaderer

et al. 2016

CJASN

139

View full text Add to dashboard Cite

show abstract

“…The incidence of kidney stones is increasing with an estimated prevalence of 10% to 15% worldwide. [1][2][3][4] In the United States, approximately 13% of men and 7% of women will develop a kidney stone during their life time 1,5 and more than $2 billion are spent annually on treatment. 6 Obesity has increasingly become a major public health problem worldwide.…”

Section: Introductionmentioning

confidence: 99%

The risk of kidney stones following bariatric surgery: a systematic review and meta-analysis

et al. 2016

View full text Add to dashboard Cite

Background With rising prevalence of morbid obesity, the number of bariatric surgeries performed each year has been increasing worldwide. The objective of this meta-analysis was to assess the risk of kidney stones following bariatric surgery. Methods A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through July 2015. Only studies reporting relative risks, odd ratios or hazard ratios (HRs) to compare risk of kidney stones in patients who underwent bariatric surgery versus no surgery were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Results Four studies (One randomized controlled trial and three cohort studies) with 11,348 patients were included in analysis to assess the risk of kidney stones following bariatric surgery. The pooled RR of kidney stones in patients undergoing bariatric surgery was 1.22 (95% CI, 0.63-2.35). The type of bariatric surgery subgroup analysis demonstrated an increased risk of kidney stones in patients following Roux-en-Y gastric bypass (RYGB) with the pooled RR of 1.73 (95% CI, 1.30-2.30) and a decreased risk of kidney stones in patients following restrictive procedures including laparoscopic banding or sleeve gastrectomy with the pooled RR of 0.37 (95% CI, 0.16-0.85). Conclusions Our meta-analysis demonstrates an association between RYGB and increased risk of kidney stones. Restrictive bariatric surgery, on the other hand, may decrease kidney stone risk. Future study with long-term follow-up data is needed to confirm this potential benefit of restrictive bariatric surgery.

show abstract

“…The ROKS nomogram has shown promise, but is based mainly on data related to an acute stone episode that essentially provide a snapshot in time. 12 Papillary appearance presumably provides details related to the duration and severity of disease, as indicated by the degree of visible pathology. Other methods of classifying stone formers such as 24-hour urine collections, the mainstay of metabolic evaluation, are variable based on patient compliance and diet.…”

Section: Figmentioning

confidence: 99%

Endoscopic Evidence That Randall's Plaque is Associated with Surface Erosion of the Renal Papilla

Cohen

Borofsky

Anderson

et al. 2017

Journal of Endourology

View full text Add to dashboard Cite

Objective: This study was conducted to assess the reliability and precision of an endoscopic grading scale to identify renal papillary abnormalities across a spectrum of equipment, locations, graders, and patients. Materials and Methods: Intra-and interobserver reliability of the papillary grading system was assessed using weighted kappa scoring among 4 graders reviewing a single renal papilla from 50 separate patients on 2 occasions. Grading was then applied to a cohort of patients undergoing endoscopic stone removal procedures at two centers. Patient factors were compared with papillary scores on the level of the papilla, kidney, and patient. Results: Graders achieved substantial (kappa >0.6) intra-and inter-rater reliability in scored domains of ductal plugging, surface pitting, and loss of contour. Agreement for Randall's Plaque (RP) was moderate. Papillary scoring was then performed for 76 patients (89 kidneys, 533 papillae). A significant association was discovered between pitting and RP that held both within and across institutions. A general linear model was then created to further assess this association and it was found that RP score was a highly significant independent correlate of pitting score (F = 7.1; p < 0.001). Mean pitting scores increased smoothly and progressively with increasing RP scores. Sums of the scored domains were then calculated as a reflection of gross papillary abnormality. When analyzed in this way, a history of stone recurrence and shockwave lithotripsy were strongly predictive of higher sums. Conclusions: Renal papillary pathology can be reliably assessed between different providers using a newly described endoscopic grading scale. Application of this scale to stone-forming patients suggests that the degree of RP appreciated in the papilla is strongly associated with the presence of pitting. It also suggests that patients with a history of recurrent stones and lithotripsy have greater burdens of gross papillary disease.

show abstract

The ROKS Nomogram for Predicting a Second Symptomatic Stone Episode

Cited by 225 publications

References 22 publications

Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health

Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health

The risk of kidney stones following bariatric surgery: a systematic review and meta-analysis

Endoscopic Evidence That Randall's Plaque is Associated with Surface Erosion of the Renal Papilla

Contact Info

Product

Resources

About