Risk stratification for repeat stone surgery: the role of stone composition.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Sagi A Shpitzer, Igal Shpunt, Nadav Loebl, Leor Perl, Dmitry Enikeev, Abd E Darawsha, Yaron Ehrlich, David Lifshitz
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引用次数: 0

Abstract

Purpose: Kidney stones have a recurrence risk of 30-50% within five years, with surgical recurrence often being the most clinically significant and burdensome. Stone composition results obtained after surgery are readily available and typically precede metabolic evaluation. However, only few, relatively small studies, correlated stone composition with surgical reccurence. This study aims to determine whether stone composition alone can reliably predict recurrent stone surgery, offering insights into personalized management strategies.

Methods: A retrospective analysis of surgically treated patients with an available stone composition analysis performed between 2013 and 2020 in a large healthcare provider database. Data were analyzed for up to 5 years from the initial surgery.

Results: 8,561 patients underwent surgical procedures for stones and 2,097 (24.5%) had repeat surgery within 5 years. Compared to calcium oxalate stone formers, individuals forming uric acid, calcium phosphate, infection, brushite, and cystine stones were 1.5, 1.5, 1.87, 2.64, and 2.71 times more likely, respectively, to undergo a second stone surgery (p < 0.001). The median time for repeat stone surgery in cystine and infection stone formers was significantly shorter compared to calcium oxalate (p < 0.01).

Conclusions: Stone composition significantly affects the 5-year surgical recurrence rates and the median time to recurrence, with non-calcium oxalate stone formers at a higher risk for recurrence. Sharing this information with patients may improve compliance with preventive strategies, including comprehensive metabolic evaluation and adherence to preventive therapy. Emphasizing this risk may help prioritize proactive management in high-risk patients.

重复结石手术的风险分层:结石成分的作用。
目的:肾结石在5年内的复发风险为30-50%,手术复发往往是临床上最显著和最繁重的。手术后获得的结石成分结果很容易获得,通常先于代谢评估。然而,只有少数相对较小的研究将结石成分与手术复发联系起来。本研究旨在确定单独的结石成分是否可以可靠地预测复发性结石手术,为个性化治疗策略提供见解。方法:回顾性分析2013年至2020年期间在大型医疗保健提供者数据库中进行手术治疗的可用结石成分分析的患者。数据分析从初次手术开始长达5年。结果:8561例患者接受了结石手术治疗,其中2097例(24.5%)在5年内重复手术。与草酸钙结石形成者相比,尿酸结石、磷酸钙结石、感染结石、毛刷石结石和胱氨酸结石形成者接受第二次结石手术的可能性分别是1.5倍、1.5倍、1.87倍、2.64倍和2.71倍(p)结论:结石组成显著影响5年手术复发率和中位复发时间,非草酸钙结石形成者复发风险更高。与患者共享这些信息可以提高对预防策略的依从性,包括综合代谢评估和对预防治疗的依从性。强调这种风险可能有助于优先考虑高危患者的主动管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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