MP16-10 EFFECTS OF 24-HOUR URINARY CALCIUM OXALATE SUPERSATURATION LEVELS ON STONE GROWTH AND NEW STONE FORMATION: WHEN TO WORRY, WHEN TO NOT?

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP16-10 EFFECTS OF 24-HOUR URINARY CALCIUM OXALATE SUPERSATURATION LEVELS ON STONE GROWTH AND NEW STONE FORMATION: WHEN TO WORRY, WHEN TO NOT? Antonio R. H. Gorgen, Kalon L. Morgan, Andrei D. Cumpanas, Minh-Chau Vu, Jenny Liu, Seyed Amiryaghoub M. Lavasani, Kelvin Vo, Allen Rojhani, Zachary E. Tano, Sohrab N. Ali, Pengbo Jiang, Roshan M. Patel, Jaime Landman, and Ralph V. Clayman Antonio R. H. GorgenAntonio R. H. Gorgen More articles by this author , Kalon L. MorganKalon L. Morgan More articles by this author , Andrei D. CumpanasAndrei D. Cumpanas More articles by this author , Minh-Chau VuMinh-Chau Vu More articles by this author , Jenny LiuJenny Liu More articles by this author , Seyed Amiryaghoub M. LavasaniSeyed Amiryaghoub M. Lavasani More articles by this author , Kelvin VoKelvin Vo More articles by this author , Allen RojhaniAllen Rojhani More articles by this author , Zachary E. TanoZachary E. Tano More articles by this author , Sohrab N. AliSohrab N. Ali More articles by this author , Pengbo JiangPengbo Jiang More articles by this author , Roshan M. PatelRoshan M. Patel More articles by this author , Jaime LandmanJaime Landman More articles by this author , and Ralph V. ClaymanRalph V. Clayman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003236.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Medical management for calcium oxalate (CaOx) urolithiasis commonly focuses on reducing CaOx supersaturation (SS). Using sequential computed tomography (CT) calculated 3D stone volume in conjunction with 24-hour CaOx SS levels, we sought to define CaOx SS thresholds for stable vs. increasing stone volume. METHODS: Thirty-four patients with a stone composition ≥50% CaOx and without interval stone passage or treatment, underwent 3D segmentation renal stone volume determinations based on two sequential CT scans a median of 406 days apart (range 98 to 2563 days) with at least 2 corresponding 24-hour urine analyses (i.e., Litholink™), obtained within 4 months of each CT scan. Increased stone volume was defined as ≥15% increase from baseline. T test and logistic regression were performed to evaluate CaOx SS levels among patients with and without a change in stone volume. RESULTS: An increase in stone volume occurred in 26 patients (76.5%); these individuals had a CaOx SS that was significantly higher for mean of baseline (SS 6.96 vs. 4.45), average (SS 6.79 vs. 4.12) and maximum (SS 9.20 vs. 5.45) (Figure 1); overall, there was a positive relationship between increase in CaOx SS and increased stone volume (p=0.043, p=0.014, p=0.024, respectively). The best predictor of an increase in stone volume was average CaOx SS (OR: 1.57, 95% CI 1.08 to 2.44). CONCLUSIONS: Among patients with CaOx kidney stones, 24-hour urine CaOx SS was positively associated with an increase in stone volume. CaOx SS below 3 appears favorable, whereas levels over 5 are concerning. Each additional point rise in average CaOx SS was associated with a three-fold higher risk of increased stone volume. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e206 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Antonio R. H. Gorgen More articles by this author Kalon L. Morgan More articles by this author Andrei D. Cumpanas More articles by this author Minh-Chau Vu More articles by this author Jenny Liu More articles by this author Seyed Amiryaghoub M. Lavasani More articles by this author Kelvin Vo More articles by this author Allen Rojhani More articles by this author Zachary E. Tano More articles by this author Sohrab N. Ali More articles by this author Pengbo Jiang More articles by this author Roshan M. Patel More articles by this author Jaime Landman More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement PDF downloadLoading ...