Pietro Manuel Ferraro1, Andrea Ticinesi2, Tiziana Meschi2, Allen Rodgers3, Federica Di Maio4, Pierluigi Fulignati4, Loris Borghi2, Giovanni Gambaro4. 1. 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. 2. Department of Medicine and Surgery, University of Parma and Medical-Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. 3. Department of Chemistry, University of Cape Town, Cape Town, South Africa. 4. U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
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.
RCT Entities:
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: Matteo Bargagli; Nasser A Dhayat; Manuel Anderegg; Mariam Semmo; Uyen Huynh-Do; Bruno Vogt; Pietro Manuel Ferraro; Daniel G Fuster Journal: Clin J Am Soc Nephrol Date: 2020-06-11 Impact factor: 8.237
Authors: Pietro Manuel Ferraro; Miguel Ángel Arrabal-Polo; Giovambattista Capasso; Emanuele Croppi; Adamasco Cupisti; Thomas Ernandez; Daniel G Fuster; Juan Antonio Galan; Felix Grases; Ewout J Hoorn; Felix Knauf; Emmanuel Letavernier; Nilufar Mohebbi; Shabbir Moochhala; Kremena Petkova; Agnieszka Pozdzik; John Sayer; Christian Seitz; Pasquale Strazzullo; Alberto Trinchieri; Giuseppe Vezzoli; Corrado Vitale; Liffert Vogt; Robert J Unwin; Olivier Bonny; Giovanni Gambaro Journal: Urolithiasis Date: 2019-03-08 Impact factor: 3.436
Authors: Nancy S Krieger; Marc Grynpas; Amy VandenEynde; John R Asplin; Kevin K Frick; Min Ho Kim; Felix M Ramos; Ignacio Granja; David A Bushinsky Journal: Nephron Date: 2019-02-06 Impact factor: 2.847
Authors: Nancy S Krieger; John Asplin; Ignacio Granja; Luojing Chen; Daiana Spataru; Tong Tong Wu; Marc Grynpas; David A Bushinsky Journal: Kidney Int Date: 2021-01-05 Impact factor: 10.612
Authors: Anna L Zisman; Fredric L Coe; Andrew J Cohen; Christopher B Riedinger; Elaine M Worcester Journal: Clin J Am Soc Nephrol Date: 2020-06-19 Impact factor: 8.237
Authors: Simone J M Stoots; Guido M Kamphuis; Rob Geraghty; Liffert Vogt; Michaël M E L Henderickx; B M Zeeshan Hameed; Sufyan Ibrahim; Amelia Pietropaolo; Enakshee Jamnadass; Sahar M Aljumaiah; Saeed B Hamri; Eugenio Ventimiglia; Olivier Traxer; Vineet Gauhar; Etienne X Keller; Vincent De Coninck; Otas Durutovic; Nariman K Gadzhiev; Laurian B Dragos; Tarik Emre Sener; Nick Rukin; Michele Talso; Panagiotis Kallidonis; Esteban Emiliani; Ewa Bres-Niewada; Kymora B Scotland; Naeem Bhojani; Athanasios Vagionis; Angela Piccirilli; Bhaskar K Somani Journal: J Clin Med Date: 2021-06-27 Impact factor: 4.241