MP16-20 ASYMPTOMATIC SPONTANEOUS STONE PASSAGE IS FREQUENT IN RECURRENT KIDNEY STONE FORMERS: RESULTS OF THE PROSPECTIVE, RANDOMIZED NOSTONE TRIAL

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP16-20 ASYMPTOMATIC SPONTANEOUS STONE PASSAGE IS FREQUENT IN RECURRENT KIDNEY STONE FORMERS: RESULTS OF THE PROSPECTIVE, RANDOMIZED NOSTONE TRIAL Kevin Stritt, Olivier Bonny, Daniel Fuster, Andreas Christe, and Beat Roth Kevin StrittKevin Stritt More articles by this author , Olivier BonnyOlivier Bonny More articles by this author , Daniel FusterDaniel Fuster More articles by this author , Andreas ChristeAndreas Christe More articles by this author , and Beat RothBeat Roth More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003236.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Kidney stones are a common healthcare problem, and both prevalence and incidence are increasing worldwide. Kidney stone recurrences are frequent. Still, a number of kidney stones pass without symptoms and are not noticed by the patient. Data are limited regarding the frequency of asymptomatic spontaneous stone passage. The aim of the study is to evaluate the frequency of asymptomatic spontaneous stone passage and its predictive factors. METHODS: We analyzed the data from the NOSTONE trial, a prospective, multicenter, double-blind, placebo-controlled randomized trial to assess the efficacy of hydrochlorothiazide (HCT) in the prevention of recurrence in patients with recurrent calcium containing kidney stones. We identified all asymptomatic spontaneous stone passages by comparing the total number of kidney stones on low-dose non-intravenous contrast CT imaging at the beginning and at the end of the 3-year follow-up, taking into account the symptomatic spontaneous stone passages and the surgical stone removals. Association of independent variables identified in the data set and the number of asymptomatic spontaneous stone passages using linear regression analyses. RESULTS: A total of 416 patients were randomized and included in the NOSTONE trial, 5 outliers were removed, therefore we analyzed 411 patients. Median follow-up was 35 months (IQR: 29 – 41); median patient age was 49 years (IQR: 39 – 55); 84/411 (20%) patients were female. A total of 476 stone events occurred in 224 of 411 patients (55%); 245/476 (52%) were symptomatic spontaneous stone passages, 73/476 (15%) were surgical stone removals, and 158/476 (33%) were asymptomatic spontaneous stone passages. The median size of asymptomatic stones (2.4 mm; IQR: 1.95-3.4) and the size of symptomatic stones (2.15 mm; IQR: 1.68-2.79) that passed spontaneously were not significantly different (p=0.366). The number of asymptomatic spontaneous stone passages was significantly influenced by a higher number of stones on CT imaging at randomization (p=0.001) and a lower total stone volume (p=0.001). CONCLUSIONS: Stone recurrence in recurrent calcium containing kidney stone formers is high. A relevant number of stones, however, pass spontaneously, many of these being asymptomatic (39%). Predictive factors for asymptomatic spontaneous stone passages are the number and the total volume of stones. Our data presented should encourage urologists to counsel patients about the possibility of a conservative approach if kidney stones are present. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e210 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kevin Stritt More articles by this author Olivier Bonny More articles by this author Daniel Fuster More articles by this author Andreas Christe More articles by this author Beat Roth More articles by this author Expand All Advertisement PDF downloadLoading ...