MP01-20 SHOCKWAVE LITHOTRIPSY IMPAIRS URINE PH: RESULTS OF THE PROSPECTIVE SWISS KIDNEY STONE COHORT REGISTER

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You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation I1 Apr 2017MP01-20 SHOCKWAVE LITHOTRIPSY IMPAIRS URINE PH: RESULTS OF THE PROSPECTIVE SWISS KIDNEY STONE COHORT REGISTER Veronika Skuginna, Nilufar Mohebbi, Daniel Fuster, Min-Jeong Kim, Carsten A. Wagner, Grégoire Wuerzner, Nasser Dhayat, Olivier Bonny, and Beat Roth Veronika SkuginnaVeronika Skuginna More articles by this author , Nilufar MohebbiNilufar Mohebbi More articles by this author , Daniel FusterDaniel Fuster More articles by this author , Min-Jeong KimMin-Jeong Kim More articles by this author , Carsten A. WagnerCarsten A. Wagner More articles by this author , Grégoire WuerznerGrégoire Wuerzner More articles by this author , Nasser DhayatNasser Dhayat More articles by this author , Olivier BonnyOlivier Bonny More articles by this author , and Beat RothBeat Roth More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.095AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urolithiasis is a global health problem with a lifetime risk of up to 15 % in white men and 6 % in women and a recurrence rate of about 50 % in these patients. Over the last three decades (and since the introduction of shock wave lithotripsy [SWL]) there was a change in stone composition observable with an increasing prevalence of calcium phosphate stones. Calcium phosphate crystallization is driven by urinary calcium phosphate supersaturation which rises with elevated urine pH. A recent animal study revealed an increase in urine pH of SWL treated porcine kidneys. We therefore evaluated the effect of SWL on urine pH in the Swiss Kidney Stone Cohort (SKSC), a nationwide, multicenter, prospective register of kidney stone patients. METHODS Of the first 350 patients enrolled in the SKSC register, 170 patients were eligible; 180 patients had to be excluded because of a short follow-up of <6 months, uric acid stone composition and/or incomplete data on previous stone treatment. The patients were grouped into 3 different groups according to their previous treatment: group A: SWL (n=49), group B: endourological treatment (n=67), group C: spontaneous stone passage (control group; n=54). The paired t-test and one-way ANOVA was used to compare the change of urine pH over time within and between the 3 different groups. RESULTS 44/170 (26%) patients were female. Median patient age was 47 years (range: 20-86). Stone composition was available in 57% of patients and did not significantly differ between the three groups (p=0.8). The median urine pH at first visit (≥ 4 weeks post stone passage or intervention) was slightly higher in group A after SWL as compared to the other two groups: pH 5.7 (IQR: 5.1-6.0) in group A; pH 5.5 (IQR: 5.0 -5.9) in group B; pH 5.5 (IQR: 5.1-6.0) in group C; p=0.4. There was a significant rise in urine pH at follow-up visit (3-6 months after initial visit) in group A after SWL treatment whereas no significant change was seen in the non-SWL groups B and C (median pH difference in groups A, B and C: +0.25, -0.19 and -0.005, respectively; p<0.001). CONCLUSIONS There was an increase in urine pH in patients who had undergone SWL while this was not seen in urinary stone patients who were treated endourologically or conservatively. This suggests that SWL may cause tubule cell injury that leads to functional disturbances such as changes of urine pH. Whether this has an impact on the rate of recurrences or future stone composition (increase in calcium phosphate content) will be explored in the further follow-up of these patients. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e9 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Veronika Skuginna More articles by this author Nilufar Mohebbi More articles by this author Daniel Fuster More articles by this author Min-Jeong Kim More articles by this author Carsten A. Wagner More articles by this author Grégoire Wuerzner More articles by this author Nasser Dhayat More articles by this author Olivier Bonny More articles by this author Beat Roth More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...