2077 NON-CONTRAST CT ATTENUATION VALUE OF RENAL PAPILLA PREDICTS THE SEVERITY AND RECURRENCE OF KIDNEY STONE DISEASE

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You have accessJournal of UrologyStone Disease: Basic Research (I)1 Apr 20132077 NON-CONTRAST CT ATTENUATION VALUE OF RENAL PAPILLA PREDICTS THE SEVERITY AND RECURRENCE OF KIDNEY STONE DISEASE Yasuo Kohjimoto, Akinori Iba, Satoshi Nishizawa, Nagahide Matsumura, and Isao Hara Yasuo KohjimotoYasuo Kohjimoto Wakayama, Japan More articles by this author , Akinori IbaAkinori Iba Wakayama, Japan More articles by this author , Satoshi NishizawaSatoshi Nishizawa Wakayama, Japan More articles by this author , Nagahide MatsumuraNagahide Matsumura Wakayama, Japan More articles by this author , and Isao HaraIsao Hara Wakayama, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2496AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In idiopathic calcium stone formers (ICSFs), most stones are known to grow attached to Randall's plaque, which can be identified by measuring computed tomography (CT) attenuation value of renal papilla. The purpose of the present study was to test the hypothesis that CT attenuation value of renal papilla can predict the severity and recurrence of the stone disease. METHODS We retrospectively reviewed the charts of ICSFs who underwent non-contrast CT scan from May 2010 to April 2011. Two observers independently measured the Hounsfield unit (HU) of the renal papilla from the upper pole, middle region and lower pole in both kidneys. Patients were classified into high- and low-HU value groups based on the mean HU values of all papillae. The median value was used for differentiation. Proportions of patients with severe disease (recurrent and/or multiple stones), urine chemistries and recurrence rates were compared between the groups. RESULTS A total of 80 patients, 50 men and 30 women, were included in the analysis. Median HU value of all papillae was 50.5. The proportion of patients with recurrent and/or multiple stones was significantly higher in high-HU group compared to low-HU group (p<0.01). No significant differences were noted in urine parameters except for urinary uric acid. Recurrence rate in high-HU value group (0.40 person-year) was higher than that of low-HU value group (0.23, p=0.11). CONCLUSIONS These results demonstrated that the HU value of renal papilla was correlated with disease severity and recurrence in ICSFs. This may allow us to identify patients with a higher risk of recurrent stone formations and change the clinical management of these patients if necessary. Low-HU (< 50.5) group High-HU (≥ 50.5) group p= Recurrent and/or multiple stones, % 40 90 < 0.01 U-Volume, mL/day 1694 ± 548 1428 ± 650 0.25 U-oxalate, mg/day 32 ± 19 38 ± 23 0.42 U-calcium, mg/day 190 ± 111 197 ± 108 0.86 U-uric acid, mg/day 621 ± 220 424 ± 141 < 0.01 U-magnesium, mg/day 79 ± 30 79 ± 32 0.94 U-citrate, mg/day 453 ± 314 566 ± 843 0.65 AP(CaOx) 0.80 ± 0.49 1.13 ± 0.71 0.17 Recurrence rate, person-year (95% confidence interval) 0.23 (0.12 - 0.39) 0.40 (0.24 - 0.63) 0.11 © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e852 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yasuo Kohjimoto Wakayama, Japan More articles by this author Akinori Iba Wakayama, Japan More articles by this author Satoshi Nishizawa Wakayama, Japan More articles by this author Nagahide Matsumura Wakayama, Japan More articles by this author Isao Hara Wakayama, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...