MP10-08 PHENOTYPING PATIENTS WITH NEPHROLITHIASIS: CAN WE PREDICT ABNORMAL 24-HOUR URINE PARAMETERS BASED ON INITIAL STONE PRESENTATION?

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP10-08 PHENOTYPING PATIENTS WITH NEPHROLITHIASIS: CAN WE PREDICT ABNORMAL 24-HOUR URINE PARAMETERS BASED ON INITIAL STONE PRESENTATION? Kevin Chang, Wilson Sui, Heiko Yang, Kevin Shee, Rei Unno, Ukrit Rompsaithong, Marshall Stoller, and Tom Chi Kevin ChangKevin Chang More articles by this author , Wilson SuiWilson Sui More articles by this author , Heiko YangHeiko Yang More articles by this author , Kevin SheeKevin Shee More articles by this author , Rei UnnoRei Unno More articles by this author , Ukrit RompsaithongUkrit Rompsaithong More articles by this author , Marshall StollerMarshall Stoller More articles by this author , and Tom ChiTom Chi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003225.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The American Urologic Association defines high risk stone formers as those with medical conditions predisposing to stone formation, solitary kidneys, repeated stone episodes or those who present with multiple stones initially. How the initial radiographic stone configuration is related to 24-hour urine test outcomes is unknown. We hypothesized that those with small, unilateral stones may have different 24-hour urine parameters than those with bilateral or larger stone burdens. METHODS: The Registry for Stones of the Kidney and Ureter (ReSKU) database was queried for all patients who underwent 24-hour urine testing between 2015 and 2022. In addition to demographic characteristics and medical history, the initial presenting stone characteristics were identified and characterized according to laterality, stone count, overall stone burden and location. These patients were then categorized by presenting phenotype, and their 24-hour urine characteristics were compared using ANOVA for continuous variables and chi-square for categorical variables. RESULTS: 511 patients met our inclusion criteria and were categorized into one of six phenotypes - based on laterality, stone size and number of stones (Figure 1). The mean age for the entire cohort was 55 years, 51% male and for 90% of patients this was their first stone. In comparing the 24-hour urinary analytes as continuous variables across all six phenotypes, there were no differences. Rates of abnormal urinary analytes were tabulated (Figure 1) and no significant differences in rates of hypovolemia (≤2L, p = 0.725), hypercalciuria (>250mmol/day for males, >200mmol/day for females, p = 0.372), hyperoxaluria (>40mg/day, p = 0.746) or hypocitraturia (<450mmol/day for males, <550mmol/day for females, p = 0.422) or hyperuricosuria (>0.8 mmol/day for males, >0.750mmol/day for females, p = 0.659) were noted. CONCLUSIONS: There was no difference when comparing values of 24-hour urine analytes based on initial stone configuration, including stone multiplicity and/or volume, which calls into question the utility of recommending 24-hour testing for high volume stone formers. Further research should focus on novel methods to identify patients at high risk for stone recurrence or metabolic abnormalities. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e117 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kevin Chang More articles by this author Wilson Sui More articles by this author Heiko Yang More articles by this author Kevin Shee More articles by this author Rei Unno More articles by this author Ukrit Rompsaithong More articles by this author Marshall Stoller More articles by this author Tom Chi More articles by this author Expand All Advertisement PDF downloadLoading ...