Abstract
BackgroundPrevious studies have shown that, compared with non-stone formers, stone formers have a higher papillary density measured with computer tomography (CT) scan. The effect of increased hydration on such papillary density in idiopathic calcium stone formers is not known.MethodsPatients with recurrent calcium oxalate stones undergoing endourological procedures for renal stones at our Institution from June 2013 to June 2014 were considered eligible for enrolment. Enrolled patients underwent a baseline unenhanced CT scan before the urological procedure; after endoscopic removal of their stones, the patients were instructed to drink at least 2 L/day of a hypotonic, oligomineral water low in sodium and minerals (fixed residue at 180 °C < 200 mg/L) for at least 12 months. Finally, the patients underwent a follow-up unenhanced CT scan during hydration regimen.ResultsTwenty-five patients were prospectively enrolled and underwent baseline and follow-up CT scans. At baseline, mean papillary density was 43.2 ± 6.6 Hounsfield Units (HU) (43.2 ± 6.7 for the left kidney and 42.8 ± 7.1 HU for the right kidney). At follow-up and after at least 12 months of hydration regimen, mean papillary density was significantly reduced at 35.4 ± 4.2 HU (35.8 ± 5.0 for the left kidney and 35.1 ± 4.2 HU for the right kidney); the mean difference between baseline and follow-up was − 7.8 HU (95% confidence interval − 10.6 to − 5.1 HU, p < 0.001).ConclusionsIncreased fluid intake in patients with recurrent calcium oxalate stones was associated with a significant reduction in renal papillary density.Trial registrationNCT03343743, 15/11/2017 (Retrospectively registered).
Highlights
Previous studies have shown that, compared with non-stone formers, stone formers have a higher papillary density measured with computer tomography (CT) scan
Renal papillary density values were evaluated on baseline and follow-up CT scans and recorded as Hounsfield Unit (HU) values
In our study, we found that a course of hydration with oligomineral water after urological procedures of stone removal was associated with a significant reduction in renal papillary density as assessed with CT scan in a group of patients with recurrent calcium oxalate stones
Summary
Previous studies have shown that, compared with non-stone formers, stone formers have a higher papillary density measured with computer tomography (CT) scan. The effect of increased hydration on such papillary density in idiopathic calcium stone formers is not known. Kidney stones are an increasingly common condition, with an estimated prevalence in the United States of about 10%; [1] similar figures have been reported in European populations. [2] This condition is characterized by a relatively high frequency of recurrence [3] and elevated direct and indirect costs. [4] Kidney stones are most commonly composed of calcium; [5] a frequently seen lesion in calcium stone formers is the presence of suburothelial deposits of calcium phosphate known as Randall’s plaques, which are thought to be the precursor. Kidney stones are an increasingly common condition, with an estimated prevalence in the United States of about 10%; [1] similar figures have been reported in European populations. [2] This condition is characterized by a relatively high frequency of recurrence [3] and elevated direct and indirect costs. [4] Kidney stones are most commonly composed of calcium; [5] a frequently seen lesion in calcium stone formers is the presence of suburothelial deposits of calcium phosphate known as Randall’s plaques, which are thought to be the precursor
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