scholarly journals An empirical study on hospital-based prevention of recurrent urinary stone disease in Germany

Author(s):  
Alina Reicherz ◽  
Patricia Rausch ◽  
Roman Herout ◽  
Joachim Noldus ◽  
Peter Bach

Abstract Purpose Urinary stone disease is a common disease with a prevalence of 4.7% in Germany. The incidence increased over the last decades, and recurrence rates are up to 50% in the first 5 years after diagnosis. Adequate preventive measures can avoid up to 46% of stone recurrences. These numbers outline the importance of prevention. Especially among high-risk stone formers, specific diagnostics and measures are required. Published data indicate the divergence between the importance of prevention and its implementation in everyday clinical practice. This is the first survey among German urological departments highlighting medical care concerning the prevention of recurrent urinary stone disease, identifying challenges and providing recommendations for improvements. Methods Two hundred and seventy urological hospital departments in Germany were anonymously surveyed about measurements to prevent recurrent stone disease. The questionnaire comprised 23 items dealing with diagnostics, counselling, knowledge among doctors concerning preventive measures and difficulties in preventing recurrent urinary stone disease. Results Sixty-three urological departments (23.8%) answered the survey. The majority perform stone analysis at first and repeat events. Most patients with urinary stone disease receive general advice on preventive measures during their hospitalization. General recommendations focus on fluid intake and lifestyle changes. However, specific diets are infrequently recommended by inpatient urologists. Diagnostics to identify high-risk stone formers are mostly insufficient, and guideline-compliant urine tests are uncommon. Conclusion The quality of secondary prevention needs to improve considerably. The focus should be put on identifying high-risk stone formers and offering those patients specific counselling. Furthermore, general advice on dietary recommendations should be extended.

2020 ◽  
Vol 6 (21) ◽  
pp. eaba8535
Author(s):  
Hui Li ◽  
Eugene Shkolyar ◽  
Jing Wang ◽  
Simon Conti ◽  
Alan C. Pao ◽  
...  

Urinary stone disease is among the most common medical conditions. Standard evaluation of urinary stone disease involves a metabolic workup of stone formers based on measurement of minerals and solutes excreted in 24-hour urine samples. Nevertheless, 24-hour urine testing is slow, expensive, and inconvenient for patients, which has hindered widespread adoption in clinical practice. Here, we demonstrate SLIPS-LAB (Slippery Liquid-Infused Porous Surface Laboratory), a droplet-based bioanalysis system, for rapid measurement of urinary stone–associated analytes. The ultra-repellent and antifouling properties of SLIPS, which is a biologically inspired surface technology, allow autonomous liquid handling and manipulation of physiological samples without complicated sample preparation procedures and supporting equipment. We pilot a study that examines key urinary analytes in clinical samples from patients with urinary stone. The simplicity and speed of SLIPS-LAB hold the potential to provide actionable diagnostic information for patients with urinary stone disease and rapid feedback for responses to dietary and pharmacologic treatments.


2020 ◽  
Vol 3 (3) ◽  
pp. 179-189
Author(s):  
Saurabh Nimesh ◽  
Vrish Dhwaj Ashwlayan ◽  
Rubi Rani ◽  
Om Prakash

Kidney and urinary stone disease (Nephrolithiasis and urolithiasis) are the condition where urinary stones or calculi are formed in the urinary tract. The problem of urinary stones is very ancient; these stones are found in all parts of the urinary tract, kidney, ureters, and the urinary bladder and may vary considerably in size. It is a common disease estimated to occur in approximately 12% of the population, with a recurrence rate of 70-81% in males and 47-60% in females. The treatment of kidney and urinary stone diseases such as a western (allopathy) medicine and surgery is now in trends. However, most people preferred plant-based (herbal) therapy because of the overuse of allopathic drugs, which results in a higher incidence rate of adverse or severe side effects. Therefore, people every year turn to herbal therapy because they believe plant-based medicine is free from undesirable side effects, although herbal medicines are generally considered to be safe and effective. In the present article, an attempt has been made to emphasize an herbal therapy is better than allopathic therapy for the management of the kidney and urinary stone disease.


2007 ◽  
Vol 35 (03) ◽  
pp. 533-541 ◽  
Author(s):  
Yu-Cheng Chen ◽  
Chien-Yi Ho ◽  
Lieh-Der Chen ◽  
Sheng-Feng Hsu ◽  
Wen-Chi Chen

Urinary stone disease is a common disease and has a high rate of recurrence. There is no ideal long-term medical treatment to prevent the recurrence of urinary stones. Wu-Ling-San (WLS) formula has been used for centuries in China for long-term treatment of urological diseases. However, no pharmacological studies have been conducted to evaluate its effect on urinary stone disease. Therefore, using a photospectrometer, we studied the effects of WLS on nucleation, growth and aggregation of calcium oxalate in vitro. The results showed that WLS extract significantly slowed the speed of calcium oxalate ( CaOx ) crystal nucleation. WLS extracts at concentrations of 6.25, 12.5, 25, and 50 mg/ml inhibited nucleation of calcium oxalate crystallization by 344, 387, 543, and 943%, respectively. WLS extracts did not inhibit the growth of CaOx crystallization; however, WLS extracts at concentrations of 12.5 and 25 mg/ml significantly inhibited the aggregation of CaOx crystallization by 74.24% and 75.05%, respectively. WLS extract at a concentration of 50 mg/ml inhibited CaOx aggregation by 92.49%. In conclusion, our results indicate that WLS extract inhibited calcium oxalate nucleation and aggregation, and may have the potential to prevent stone recurrence.


Author(s):  
Mehmet Yiğit Yalçın ◽  
Mert Hamza Özbilen ◽  
Mehmet Zeynel Keskin ◽  
Yusuf Özlem İlbey

Urinary stone disease is a very common disease in our country. Some problems may be experienced in stone surgery of physically disabled patients. This special patient group may require both minimally invasive and open stone surgery techniques. In this study, the difficulties encountered in the surgery of two physically disabled patients who were operated for stone disease were shared.


2004 ◽  
Vol 4 ◽  
pp. 35-41 ◽  
Author(s):  
Hans-Göran Tiselius

Formation of urinary tract concrements is a common disease and steps should be taken in order to elucidate the underlying mechanisms and to give the patients appropriate advice and medical treatment. This present article summarizes the principles for recurrence preventive measures in patients with uric acid, infection, cystine and calcium stone disease. Categories of stone formers are identified with the aim of providing a basis for an individualised treatment with a reasonable patient's compliance. The recommendations are in line with those given by the EAU guideline group for urolithiasis.


2017 ◽  
Vol 4 (5) ◽  
pp. 1477
Author(s):  
Adnan Firdous Raina ◽  
Mohd Ashraf Bhat ◽  
Imtiyaz Wani ◽  
Majid Kawaja ◽  
Mosin Saleem ◽  
...  

Background: Urolithiasis is a common disorder. Studies have shown that metabolic causes of urolithiasis include hypercalciuria, hypocitraturia, high or low pH of urine, hyperuricosuria, hyperoxaluria and hypomagnesuria. We intended to conduct this study with the aim to provide historical data regarding the 24-hour urinary analysis in this part of India with a distinct and different geographical and cultural background.Methods: A total of 186 patients having urinary stone disease attending the departments of Nephrology and Urology in Sher-I- Kashmir institute of medical sciences were included. 26 healthy members of hospital staff were taken as controls. Demographic and clinico-pathological characteristics of each patient were recorded in a questionnaire. Urine was collected for 24-hours from 186 patients and 26 controls. 10ml sample of this urine collection was stored at 20c0 before processing for urinary parameters.Results: The mean concentration of calcium salts, Magnesium, Oxalate and Uric acid in the 24-hour urinary analysis of urolithiasis patients is higher than that of the normal healthy controls and the relation was statistically significant. On comparing the 24-hour urinary constituents among urolithiasis patients and health controls, the concentration of phosphate was almost equal in both cases and controls while the concentration of oxalate was much higher in cases than controls.Conclusions: In present study hypercalciuria is main cause of renal calculi along with hypocitraturia, hypomagnesuria and hyperphosphaturia in our valley. Measurement of 24-hour urine constituents is still gold standard for evaluation of stone formers.  


2019 ◽  
Vol 14 (12) ◽  
pp. 1773-1780 ◽  
Author(s):  
Shen Song ◽  
I-Chun Thomas ◽  
Calyani Ganesan ◽  
Ericka M. Sohlberg ◽  
Glenn M. Chertow ◽  
...  

Background and objectivesCurrent guidelines recommend 24-hour urine testing in the evaluation and treatment of persons with high-risk urinary stone disease. However, how much clinicians use information from 24-hour urine testing to guide secondary prevention strategies is unknown. We sought to determine the degree to which clinicians initiate or continue stone disease–related medications in response to 24-hour urine testing.Design, setting, participants, & measurementsWe examined a national cohort of 130,489 patients with incident urinary stone disease in the Veterans Health Administration between 2007 and 2013 to determine whether prescription patterns for thiazide diuretics, alkali therapy, and allopurinol changed in response to 24-hour urine testing.ResultsStone formers who completed 24-hour urine testing (n=17,303; 13%) were significantly more likely to be prescribed thiazide diuretics, alkali therapy, and allopurinol compared with those who did not complete a 24-hour urine test (n=113,186; 87%). Prescription of thiazide diuretics increased in patients with hypercalciuria (9% absolute increase if urine calcium 201–400 mg/d; 21% absolute increase if urine calcium >400 mg/d, P<0.001). Prescription of alkali therapy increased in patients with hypocitraturia (24% absolute increase if urine citrate 201–400 mg/d; 34% absolute increase if urine citrate ≤200 mg/d, P<0.001). Prescription of allopurinol increased in patients with hyperuricosuria (18% absolute increase if urine uric acid >800 mg/d, P<0.001). Patients who had visited both a urologist and a nephrologist within 6 months of 24-hour urine testing were more likely to have been prescribed stone-related medications than patients who visited one, the other, or neither.ConclusionsClinicians adjust their treatment regimens in response to 24-hour urine testing by increasing the prescription of medications thought to reduce risk for urinary stone disease. Most patients who might benefit from targeted medications remain untreated.


Urology ◽  
2020 ◽  
Vol 142 ◽  
pp. 60-64
Author(s):  
Kyle Spradling ◽  
Ericka M. Sohlberg ◽  
Shufeng Li ◽  
Chiyuan Amy Zhang ◽  
William D. Brubaker ◽  
...  

2021 ◽  
Author(s):  
Kyle Spradling ◽  
Chiyuan A Zhang ◽  
Alan C Pao ◽  
Joseph C Liao ◽  
John T Leppert ◽  
...  

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