Evaluation of the recurrent stone former.

For frequent stone formers, and even for some first-time stone formers interested in preventing future episodes of renal colic, a metabolic evaluation is necessary. The urologist, rather than members of other medical specialties, seems to have the primary responsibility of the medical management of stone disease. Thus, it is essential for the urologist to have a good working knowledge of the principles of metabolic evaluation and kidney stone prevention.

Does a slower treatment rate impact the efficacy of extracorporeal shock wave lithotripsy for solitary kidney or ureteral stones?

Purpose: We compared the efficacy of an SR (70 to 80 shocks per minute) and an FR (120 shocks per minute) for ESWL for solitary stones less than 2 cm located in the kidney or proximal ureter.

Materials And Methods: A total of 349 patients with a solitary, radiopaque kidney or ureteral stone underwent ESWL on a DoLi(R) 50 lithotriptor. Patients were grouped based on stone size, stone location and whether SR or FR treatment was performed.

Oxalate toxicity in cultured mouse inner medullary collecting duct cells.

Purpose: Oxalate, a metabolic end product and a major constituent of the majority of renal stones, has been shown to be toxic to renal epithelial cells of cortical origin. However, to our knowledge it is unknown whether inner medullary collecting duct (IMCD) cells, which are physiologically exposed to higher concentrations of oxalate, also behave in a similar manner.

Materials And Methods: A line of IMCD cells was exposed to oxalate (0.

Gender Differences among Hispanics and Caucasians in symptomatic presentation of kidney and ureteral stones.

Purpose: We determined gender differences in the symptomatic presentation of kidney and ureteral stones among the Hispanic population and compared it with presentation in the Caucasian population.

Patients And Methods: A retrospective chart review was performed on 443 patients seen in our Emergency Department or Urgent Care Center for symptomatic kidney or ureteral stones over a 5-year period. Demographic information was obtained, including sex, race, age, location of stone, stone size, and type of urologic intervention.

Is stone radiodensity a useful parameter for predicting outcome of extracorporeal shockwave lithotripsy for stones < or = 2 cm?

Purpose: Several factors determine the success of extracorporeal shockwave lithotripsy (SWL) for kidney stones: stone size, stone location within the collecting system, stone type, and the SWL machine used. It has been suggested that stone radiodensity, as determined either by plain radiography or computed tomography attenuation values, may be an independent predictor of SWL success. We examined the outcome of SWL for solitary stones less than or equal to 2 cm located within the renal pelvis, based on their radiodensity.

Effects of oxalate on IMCD cells: a line of mouse inner medullary collecting duct cells.

Oxalate, a metabolic end product and a major constituent of the majority of renal stones, has been shown to be toxic to renal epithelial cells of cortical origin. However, it is unknown whether inner medullary collecting duct (IMCD) cells that are physiologically exposed to higher concentrations of oxalate also behave in a similar manner. In the present study, we examined the effects of oxalate on IMCD cells.

The urinary response to an oral oxalate load in recurrent calcium stone formers.

Purpose: Dietary oxalate may contribute up to 50% to 80% of the oxalate excreted in urine. We studied the urinary response to an oral oxalate load in male and female idiopathic recurrent calcium oxalate stone formers with and without mild hyperoxaluria to evaluate the potential pathophysiological significance of dietary oxalate.

Materials And Methods: A total of 60 recurrent calcium stone formers underwent an oral oxalate load test.

Hyperuricosuric calcium nephrolithiasis.

Since the findings of Yü and Gutman [1], the hyperuricosuric calcium stone former is a unique clinical entity. While an impressive number of clinical and epidemiologic studies implicate hyperuricosuria in calcium stone formation, the exact physicochemical mechanism by which uric acid affects calcium oxalate crystallization has not been proven. Allopurinol decreases stone recurrences and is the drug of choice for patients with isolated HCN.

Is lower pole caliceal anatomy predictive of extracorporeal shock wave lithotripsy success for primary lower pole kidney stones?

Purpose: The management of lower pole kidney stones is controversial. We examined whether lower pole caliceal anatomy could predict the success of extracorporeal shock wave lithotripsy of primary lower pole kidney stones 20 mm. or less.

When is medical prophylaxis cost-effective for recurrent calcium stones?

Purpose: Medical management is generally recommended for recurrent calcium stones to prevent future episodes. However, in this era of extracorporeal shock wave lithotripsy and outpatient ureteroscopy it is not known whether medical prophylaxis is more cost-effective than treatment of recurrent stone episodes. The cost of medical prophylaxis was compared with the cost of clinically managing recurrent stone episodes, and the stone recurrence rate without prophylaxis (stone frequency) at which these 2 treatment approaches became cost equivalent was determined.

Comparison of intravenous sedation versus general anesthesia on the efficacy of the Doli 50 lithotriptor.

Purpose: We compared the impact of intravenous sedation versus general anesthesia on the efficacy of extracorporeal shock wave lithotripsy.

Materials And Methods: From November 1997 to May 1998, 295 patients with a single renal or upper ureteral radioopaque stone of less than 2 cm. were treated with the Doli 50 lithotriptor (Dornier Medical Systems, Marietta, Georgia).

A randomized outcomes trial of ureteral stents for extracorporeal shock wave lithotripsy of solitary kidney or proximal ureteral stones.

Purpose: Routine use of ureteral stents before extracorporeal shock wave lithotripsy of kidney stones between 10 and 20 mm. is controversial. We conducted a prospective randomized clinical trial to evaluate the outcome of ureteral stents for treating solitary kidney stones between 10 and 20 mm.