Tags

Type your tag names separated by a space and hit enter

Short-Term Changes in Urinary Relative Supersaturation Predict Recurrence of Kidney Stones: A Tool to Guide Preventive Measures in Urolithiasis.
J Urol 2018; 200(5):1082-1087JU

Abstract

PURPOSE

Kidney stone disease is characterized by a relatively high rate of recurrence. In our study we analyzed the association between relative supersaturation and the risk of stone recurrence. Additionally, we examined the association between the risk of recurrence and changes in relative supersaturation and urinary composition after 1 week of medical treatment.

MATERIALS AND METHODS

We performed a post hoc analysis of data from a previously published randomized controlled trial comparing the effect of 2 diets in 120 men with recurrent calcium oxalate stones and hypercalciuria. Baseline and followup 24-hour urine parameters were used to calculate the relative supersaturation of calcium oxalate, calcium phosphate and uric acid using the EQUIL2, JESS and LithoRisk computer programs. Cox models were used to calculate the estimated association between each baseline relative supersaturation, and 1-week changes and the risk of recurrence during followup.

RESULTS

During a 5-year followup 35 patients (34%) experienced recurrence. A reduction in calcium oxalate relative supersaturation at 1 week was significantly associated with a lower risk of recurrence using the EQUIL2 calculation (for every 10% reduction from baseline HR 0.92, 95% CI 0.86-1.00, p = 0.044). However, there was no association for relative supersaturation calculated by other methods or for the relative supersaturation of other salts. Changes in the 24-hour urine excretion of citrate, potassium and magnesium were significantly associated with a risk of recurrence.

CONCLUSIONS

In recurrent stone formers with hypercalciuria baseline values and changes in the relative supersaturation of calcium oxalate may be associated with the risk of recurrence. Changes in urinary citrate, potassium and magnesium following dietary intervention may also be predictive.

Authors+Show Affiliations

U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: pietromanuel.ferraro@unicatt.it.Department of Medicine and Surgery, University of Parma and Medical-Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.Department of Medicine and Surgery, University of Parma and Medical-Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.Department of Chemistry, University of Cape Town, Cape Town, South Africa.U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.Department of Medicine and Surgery, University of Parma and Medical-Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

29940247

Citation

Ferraro, Pietro Manuel, et al. "Short-Term Changes in Urinary Relative Supersaturation Predict Recurrence of Kidney Stones: a Tool to Guide Preventive Measures in Urolithiasis." The Journal of Urology, vol. 200, no. 5, 2018, pp. 1082-1087.
Ferraro PM, Ticinesi A, Meschi T, et al. Short-Term Changes in Urinary Relative Supersaturation Predict Recurrence of Kidney Stones: A Tool to Guide Preventive Measures in Urolithiasis. J Urol. 2018;200(5):1082-1087.
Ferraro, P. M., Ticinesi, A., Meschi, T., Rodgers, A., Di Maio, F., Fulignati, P., ... Gambaro, G. (2018). Short-Term Changes in Urinary Relative Supersaturation Predict Recurrence of Kidney Stones: A Tool to Guide Preventive Measures in Urolithiasis. The Journal of Urology, 200(5), pp. 1082-1087. doi:10.1016/j.juro.2018.06.029.
Ferraro PM, et al. Short-Term Changes in Urinary Relative Supersaturation Predict Recurrence of Kidney Stones: a Tool to Guide Preventive Measures in Urolithiasis. J Urol. 2018;200(5):1082-1087. PubMed PMID: 29940247.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short-Term Changes in Urinary Relative Supersaturation Predict Recurrence of Kidney Stones: A Tool to Guide Preventive Measures in Urolithiasis. AU - Ferraro,Pietro Manuel, AU - Ticinesi,Andrea, AU - Meschi,Tiziana, AU - Rodgers,Allen, AU - Di Maio,Federica, AU - Fulignati,Pierluigi, AU - Borghi,Loris, AU - Gambaro,Giovanni, Y1 - 2018/06/22/ PY - 2018/06/12/accepted PY - 2018/6/26/pubmed PY - 2019/6/7/medline PY - 2018/6/26/entrez KW - calcium oxalate KW - diet KW - kidney calculi KW - recurrence KW - urine SP - 1082 EP - 1087 JF - The Journal of urology JO - J. Urol. VL - 200 IS - 5 N2 - PURPOSE: Kidney stone disease is characterized by a relatively high rate of recurrence. In our study we analyzed the association between relative supersaturation and the risk of stone recurrence. Additionally, we examined the association between the risk of recurrence and changes in relative supersaturation and urinary composition after 1 week of medical treatment. MATERIALS AND METHODS: We performed a post hoc analysis of data from a previously published randomized controlled trial comparing the effect of 2 diets in 120 men with recurrent calcium oxalate stones and hypercalciuria. Baseline and followup 24-hour urine parameters were used to calculate the relative supersaturation of calcium oxalate, calcium phosphate and uric acid using the EQUIL2, JESS and LithoRisk computer programs. Cox models were used to calculate the estimated association between each baseline relative supersaturation, and 1-week changes and the risk of recurrence during followup. RESULTS: During a 5-year followup 35 patients (34%) experienced recurrence. A reduction in calcium oxalate relative supersaturation at 1 week was significantly associated with a lower risk of recurrence using the EQUIL2 calculation (for every 10% reduction from baseline HR 0.92, 95% CI 0.86-1.00, p = 0.044). However, there was no association for relative supersaturation calculated by other methods or for the relative supersaturation of other salts. Changes in the 24-hour urine excretion of citrate, potassium and magnesium were significantly associated with a risk of recurrence. CONCLUSIONS: In recurrent stone formers with hypercalciuria baseline values and changes in the relative supersaturation of calcium oxalate may be associated with the risk of recurrence. Changes in urinary citrate, potassium and magnesium following dietary intervention may also be predictive. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/29940247/Short_Term_Changes_in_Urinary_Relative_Supersaturation_Predict_Recurrence_of_Kidney_Stones:_A_Tool_to_Guide_Preventive_Measures_in_Urolithiasis_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2018.06.029?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -