Use of non-contrast computed tomography determined urinary stone fragility in predicting the outcome of extracorporeal shockwave lithotripsy treatment: a single-center study

2020 ◽  
Vol 14 (2) ◽  
pp. 59-63
Author(s):  
Athar Hameed ◽  
Khazir Hayyat Gondal
Keyword(s):  
Shock Waves ◽  
Renal Stone ◽  
Plain Film ◽  
Renal Stones ◽  
Renal Calculus ◽  
Urinary Stone ◽  
Stone Disease ◽  
Urinary Stones ◽  
Fisher Exact Test

Background: Renal stones represent a common urological pathology where standard treatment advised is ESWL in current practice. However, NCCT based determination of stone fragility may help to predict the outcome of ESWL treatment, hence optimizing its clinical use. Therefore, this study evaluated the role of NCCT determined urinary stone fragility in predicting the outcome of ESWL treatment in local clinical settings. Patients and methods: One hundred patients with single renal calculus of 0.6-2 cm in size were included. NCCT based determination of stone fragility in HU units was done for all patients. Patients were then subjected to ESWL, with a maximum of 3000 shock waves given per ESWL session. Plain film and/or ultrasonography was used to monitor ESWL treatment progress with a final NCCT evaluation at 12 weeks to determine the clearance of the calculi for each patient. Association of NCCT based stone fragility and outcome of ESWL was statistically analyzed using Fisher exact test. Results: The mean age of the patients was 37.7 ± 10.9 years with 54% being male. Decreasing stone fragility on NCCT (high = <500HU, moderate = 500-1000HU, and high = 1000HU) required more number and intensity of ESWL sessions (1-2 visits and 3000-6000 shock waves for high stone fragility group, 3-5 visits and 7000-18000 shock waves for the moderate group, and 6 visits and >18000 shock waves for low fragility group, respectively) necessary for clearance of urinary stones (p<0.001). In 98% of patients, the clearance of urinary stones was excellent. Conclusion: Renal stone patients with NCCT determined high and moderate stone fragility show an optimal response after ESWL treatment, whereas, for low fragility renal stones attenuative treatment like percutaneous nephrolithotomy and/or ureteroscopy should be considered instead of ESWL. This approach can enable patient stratification before ESWL therapy ensuring better clinical management of the renal stone disease.

scholarly journals Chemical Analysis of Urinary Stones

2016 ◽  
Vol 19 (2) ◽  
pp. 10-12
Author(s):  
Ghanshyam Sigdel ◽  
Nirmal Lamichhane ◽  
Sudeep Raj K.C. ◽  
W.K. Belokar
Keyword(s):  
Chemical Analysis ◽  
Large Scale ◽  
Renal Stones ◽  
Urinary Stone ◽  
Stone Disease ◽  
Urinary Stones ◽  
Chemical Compositions ◽  
Metabolic Evaluation ◽  
Female Ratio ◽  
Stone Formers

Introduction: Urinary stone disease is a common urological problem. Chemical analysis of the urinary stones is a part of metabolic evaluation of first time or recurrent stone formers. The report of chemical analysis of stones may obviate the need for complete metabolic evaluation or can direct metabolic evaluation. In this study we aim to find out the chemical compositions of urinary stones in our population, so that the result might serve as a baseline for the related research in future. Methods: A prospective study was carried out in our institute with the qualitative chemical analysis of urinary stones. All patients operated for different urinary stones by various methods were included in the study. Statistical analysis was done by using Statistical Package for the Social Sciences Software (SPSS) Program for windows ® version 18. Results: A total of 55 patients were included in the study. Male to female ratio was 1.75. Mean age was 41.45 years. Ureteric and renal stones were most common accounting to 49 and 31 percentage respectively. All stones contained calcium. Calcium, phosphate, oxalate and uric acid were the major constituents of the stones representing 100, 94.5, 85.5 and 80 percentage of the stone specimen. Other constituents were amino acids, carbonate, magnesium and cystine. Conclusions: Urinary stones are of mixed chemical compositions. Further large scale prospective studies along with other parameters of metabolic work up are recommended to know more about the chemical compositions of urinary stones and its utility in clinical practice.

scholarly journals Composition of Renal Stone– An experience at Armed Forces Institute of Pathology

2016 ◽  
Vol 12 (2) ◽  
pp. 21-25
Author(s):  
Lubna Naznin ◽  
Debashish Saha ◽  
Md Jahangir Chowdhury ◽  
Yasmin Akter ◽  
Most Sarmin Sultana ◽  
...  
Keyword(s):  
Calcium Oxalate ◽  
Renal Stone ◽  
Colorimetric Method ◽  
Ammonium Phosphate ◽  
Armed Forces ◽  
Renal Stones ◽  
Stone Disease ◽  
Urinary Stones ◽  
Female Ratio ◽  
Renal Stone Disease

Introduction: In Asia the stone belt has been reported to stretch across our neighbouring countries Pakistan, India, Myanmar etc signifies a higher incidence of renal stone disease in Bangladesh. Objective: To determine the pattern of chemical composition of renal stones by semi-quantitative technique in patients presented to Armed Forces Institute of Pathology (AFIP) and to evaluate the predominant constituent present in them. Materials and Methods: This descriptive study was conducted at Armed Forces Institute of Pathology (AFIP), Chemical pathology department from October 2013 to October 2014. Renal stones of 37 Urolithiasis patients were analyzed chemically, using DiaSys analysis kit, employing titrimetric method for estimation of calcium and colorimetric method for Oxalate, Ammonium, Phosphate, Magnesium, Uric Acid and Cystine. Concentration of each individual component then was expressed in percentage and used to interpret renal stone composition using the calculation scale. Results: Males were more prone to renal stone disease, having male to female ratio 5.2:1. Urinary stones occur in all age groups, in this study age ranged from 4 to 72 years with mean age 38.8±16.0 years and mostly affected was the working age group 21 to 50 years (70.2%). Mixed components (i.e. mixed stone) rather than a single component was the commonest type constituting 83.8% of all renal stones. The commonest mixed stone found was Calcium Oxalate with Apatite (41.9 %). Pure Calcium Oxalate was the 2nd most common (10.8%) variant followed by Struvite stones (5.4%). Cystine and Brushite were the least common renal stones in this study. Conclusion: Calcium Oxalate was the most predominant chemical component in renal stones (94.6%). More research is needed to assess the frequency, types, and correlation of renal stones with environmental, dietary and genetic factors in Bangladesh. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 21-25

scholarly journals A 13 year hospital based study on the Trend of Urinary Stone Disease in Uttarakhand, India

2021 ◽  
Vol 11 (1) ◽  
pp. 949-958
Author(s):  
Monica Kakkar ◽  
Rakesh Kakkar
Keyword(s):  
Retrospective Study ◽  
Renal Stones ◽  
Urinary Stone ◽  
Stone Disease ◽  
Urinary Stones ◽  
Religious Groups ◽  
Medical Sciences ◽  
Urinary Stone Disease ◽  
Disease Site ◽  
Keywords Urolithiasis

Background: The present retrospective study on urinary stone disease in the Uttarakhand state was necessitated as no study has been done yet. Methods: A retrospective study covering a period of about 13 years (2005-18) was conducted on the urinary stones removed from the patients, admitted at Himalayan Institute of Medical Sciences, Dehradun. The incidence of the disease, site of stones in urinary tract upon diagnosis, composition of removed stones and occurrence of a possible co-relationship between the incidence of the urinary stone disease at different times, age, sex, religion of the patients was investigated. Results: The frequency of occurrence of urinary stones in males was found to be almost three times more as compared to their female counterparts. The above trend was consistent over the entire period of the study. Interestingly, in the Muslim and Sikh population of the area, females were found to be less prone to the problem as compared to their Hindu counterparts.  However, in all religious groups, 21-40 years old subjects were found to be most susceptible to the problem and approximately 90% of the urinary stones were recovered from the kidneys and primarily composed of calcium oxalate. Conclusion: The co-relationship between the occurrence of urinary stones with age, sex of the patients, their religion & site of stones on diagnosis was found to be statistically significant.  Keywords: Urolithiasis, Urinary Stone disease, Urinary calculus, Renal stones.

scholarly journals Improvement of Urinary Stones Analysis Combining Morphological Analysis and Infrared Spectroscopy

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jacopo Gervasoni ◽  
Aniello Primiano ◽  
Pietro Manuel Ferraro ◽  
Andrea Urbani ◽  
Giovanni Gambaro ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Morphological Analysis ◽  
Biochemical Analysis ◽  
Renal Stone ◽  
Analytical Techniques ◽  
Renal Stones ◽  
Urinary Stone ◽  
Urinary Stones ◽  
Ft Ir

Daudon et al. have developed a complex morphoconstitutional classification of renal stone in six different morphological types and several subtypes. According to this classification, a precise correspondence exists between causes of renal stones and subtypes with a great clinical relevance and can be considering a sort of shortcut for the metabolic diagnosis in renal stone patients. Now the diagnosis of causes of renal stones generally requires repeated biochemical investigations on urine and blood samples and usually remains presumptive. We analyzed 150 urinary stones both by stereoscopic microscopy and Fourier transform infrared spectroscopy. The comparison of 150 stones did not reveal any disagreement. We have only 20 partial agreement, and clinicians agreed that the imprecise information obtained with morphological analysis alone would have missed an important clinical finding only in 3 cases. In conclusion, in our opinion, the analysis of urinary stone must combine two different analytical techniques: morphological analysis by stereomicroscope and biochemical analysis with the FT-IR.

scholarly journals Nutrition and Kidney Stone Disease

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1917
Author(s):  
Roswitha Siener
Keyword(s):  
Kidney Stone ◽  
Fluid Intake ◽  
Stone Formation ◽  
Urinary Stone ◽  
Stone Disease ◽  
Urinary Stones ◽  
Dietary Therapy ◽  
Effective Prevention ◽  
Kidney Stone Disease ◽  
Nutrition And Diet

The prevalence of kidney stone disease is increasing worldwide. The recurrence rate of urinary stones is estimated to be up to 50%. Nephrolithiasis is associated with increased risk of chronic and end stage kidney disease. Diet composition is considered to play a crucial role in urinary stone formation. There is strong evidence that an inadequate fluid intake is the major dietary risk factor for urolithiasis. While the benefit of high fluid intake has been confirmed, the effect of different beverages, such as tap water, mineral water, fruit juices, soft drinks, tea and coffee, are debated. Other nutritional factors, including dietary protein, carbohydrates, oxalate, calcium and sodium chloride can also modulate the urinary risk profile and contribute to the risk of kidney stone formation. The assessment of nutritional risk factors is an essential component in the specific dietary therapy of kidney stone patients. An appropriate dietary intervention can contribute to the effective prevention of recurrent stones and reduce the burden of invasive surgical procedures for the treatment of urinary stone disease. This narrative review has intended to provide a comprehensive and updated overview on the role of nutrition and diet in kidney stone disease.

scholarly journals Renal stones

2018 ◽  
Vol 56 (1) ◽  
pp. 15-27 ◽  
Author(s):  
Adie Viljoen ◽  
Rabia Chaudhry ◽  
John Bycroft
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Renal Stone ◽  
Surgical Intervention ◽  
Recurrent Disease ◽  
Renal Stones ◽  
Evidence Base ◽  
Stone Disease ◽  
Significant Morbidity ◽  
Renal Stone Disease

Renal stone disease is a worldwide problem which carries significant morbidity. It frequently requires specialist urology intervention. Patients with recurrent disease and those at high risk require specialist investigations and review. Certain cases benefit from medical and surgical intervention. In this review, we discuss the pathophysiology, risk assessment, specialist investigations and various interventions, their rationale and evidence base. This review aims to provide an update of the previous publication in 2001 in this journal on this topic.

High Incidence of Renal Stones in Severely Disabled Children with Epilepsy Treated with Topiramate

2019 ◽  
Vol 50 (03) ◽  
pp. 160-163 ◽  
Author(s):  
Nobutsune Ishikawa ◽  
Hiroo Tani ◽  
Yoshiyuki Kobayashi ◽  
Akira Kato ◽  
Masao Kobayashi
Keyword(s):  
Medical Records ◽  
Renal Stone ◽  
Stone Formation ◽  
Renal Stones ◽  
Treated Group ◽  
Urinary Stones ◽  
Disabled Children ◽  
High Incidence ◽  
Diuretic Drugs ◽  
History Of

Purpose This study was aimed to assess the accurate incidence of renal stones in severely disabled children treated with topiramate (TPM). Method We reviewed the medical records of severely disabled children with epilepsy under 15 years old who underwent radiological examinations to investigate urinary stones. The study enrolled 26 patients who were divided into two groups. One group had been treated with TPM for at least 1 year and the other had not been treated with TPM, zonisamide, acetazolamide, or other diuretic drugs. We collected parameters from the medical records and compared the groups. Results All participants were evaluated radiologically, with computed tomography (CT) in two patients, ultrasonography in 22 patients, and both in two. No patient had any morphological abnormality of the kidneys and history of urinary tract infection. There were no significant differences in sex, age, body weight, or feeding manner between the groups, while the incidence of renal stones or calcifications was significantly higher in the TPM-treated group (60 vs. 0%; p = 0.00241). Conclusion There is a high incidence of renal stone formation in severely disabled children treated with TPM.

scholarly journals Open Surgery for Urinary Stones in a Resource Poor Setting: A Look at Dalhatu Araf Specialist Hospital, Lafia, Nigeria

2021 ◽  
Vol 2 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Christian Agbo
Keyword(s):  
Open Surgery ◽  
Urinary Stone ◽  
Stone Disease ◽  
Urinary Stones ◽  
Endoscopic Management ◽  
Resource Poor Setting ◽  
Cost Of Treatment ◽  
Urinary Stone Disease ◽  
Resource Poor ◽  
The Cost

Urinary stone disease has afflicted humankind since antiquity[1]. It remains a common urological condition worldwide, including in our environment[2]. Although open surgery was previously the main option for stone removal, advances in technology mean that treatment is now largely through minimally invasive surgery, as recommended by a number of urological guidelines[3,4]. Unfortunately, at our centre, we still treat urinary stones solely through open surgery, mostly because we lack endoscopic equipment. In addition, most of our patients, even if referred to facilities where endoscopic management is possible, cannot afford the cost of treatment.

scholarly journals Application of uCT-scan and infrared spectroscopy for determination of urinary stone components

2021 ◽  
Vol 10 (4) ◽  
pp. 88-93
Author(s):  
Vepy Asyana ◽  
Leni Aziyus Fitri ◽  
Freddy Haryanto ◽  
Taufik Ridwan ◽  
Nanda Fitri Ayu Muningrat
Keyword(s):  
Uric Acid ◽  
Infrared Spectroscopy ◽  
Calcium Oxalate ◽  
Mineral Content ◽  
Hounsfield Unit ◽  
Urinary Stone ◽  
Urinary Stones ◽  
Ftir Characterization ◽  
High Prevalence

Abstrak. Batu kemih merupakan salah satu penyakit dengan tingkat prevalensi yang cukup tinggi di Indonesia. Pengetahuan komposisi pada kandungan batu kemih dapat membantu tenaga medis dalam melakukan justifikasi penanganan tindakan lanjut pada pasien dengan tepat.Tujuan penelitian iniadalah menentukan kandungan mineral yang terdapat pada batu kemih menggunakan metode analisa spektrum inframerah dan nilai hounsfield unit (HU) yang terdapat pada citra yang dihasilkan dari modality mCT-Scan. Hasil karakterisasi fourier transform infrared spectroscopy (FTIR) memperlihatkan kandungan mineral batu kemih terdiri dari batu kemih calcium oxlate monohydrate, uric acid, batu campuran calcium oxalate dengan phosphate dan batu campuran cystine dengan phosphate sedangkan hasil dari scanning mCT memperlihatkan adanya kandungan mineral batu kemih campuran seperti batu campuran calcium oxalate dan cystine, batu campuran calcium oxalate, struvite, dan cystine, dan batu campuran calciumoxalate dan uric acid.Dari hasil penelitian ini dapat disimpulkan bahwa kedua modaliti tersebut mampu memperlihatkan kandungan mineral batu kemih dengan baik. Hal ini terlihat adanya spektrum serapan karakteristik dari FTIR setiap sampel berbeda-beda dan dari hasil citra mCT-Scan memperlihatkan nilai HU yang bervariasi sehingga mengindikasikan kandungan mineral pada sampel batu kemih yang diamati juga memiliki jenis yang berbeda-beda. Abstract. Urinary stones are a disease with a high prevalence rate in Indonesia. Knowledge of the composition of the urinary stone is an essential part to determine suitable treatments for patients. The aim of this research is to determine the mineral contained in urinary stones using the infrared spectrum and the value of HU (hounsfield unit) from the image mCT-Scan. The results of FTIR characterization showed that the mineral content of urinary stones consisted of calcium oxlate monohydrate, uric acid, calcium oxalate and phosphate mixed stones and cystine-phosphate mixed stones. mCT-Scan results showed the mineral content of urinary stones such as calcium oxalate and cystine mixed stone, calcium oxalate, struvite, and cystine mixed stones, and calcium oxalate and uric acid mixed stones. This show that the two modalities are be able to determine the mineral content of urinary stones. It can be seen that the characteristic absorption spectrum of the FTIR for each sample is different and from the mCT-Scan image results, the HU value varies so that it indicates the mineral content of the observed urine stone sample are different.

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