MP73-01 NON-CONTRAST CT ATTENUATION VALUE OF RENAL PAPILLA IS A NOVEL PREDICTOR FOR RECURRENCE IN KIDNEY STONE DISEASE

Abstract

You have accessJournal of UrologyStone Disease: Evaluation III1 Apr 2014MP73-01 NON-CONTRAST CT ATTENUATION VALUE OF RENAL PAPILLA IS A NOVEL PREDICTOR FOR RECURRENCE IN KIDNEY STONE DISEASE Yasuo Kohjimoto, Akinori Iba, Shinpei Yamashita, Nagahide Matsumura, and Isao Hara Yasuo KohjimotoYasuo Kohjimoto More articles by this author , Akinori IbaAkinori Iba More articles by this author , Shinpei YamashitaShinpei Yamashita More articles by this author , Nagahide MatsumuraNagahide Matsumura More articles by this author , and Isao HaraIsao Hara More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2354AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In idiopathic calcium stone formers (ICSFs), most stones are known to grow attached to Randall′s plaque, which can be identified by measuring computed tomography (CT) attenuation value of renal papilla. The purpose of the present study was to test the hypothesis that CT attenuation value of renal papilla can predict the severity and recurrence of the stone disease. METHODS We retrospectively reviewed the charts of ICSFs who underwent non-contrast CT scan from February 2005 to May 2012. Two observers independently measured the Hounsfield unit (HU) of the renal papilla from the upper pole, middle region and lower pole in both kidneys. Patients were classified into high- and low-HU value groups based on the mean HU values of all papillae. The median value was used for differentiation. Proportions of patients with severe disease (recurrent and/or multiple stones), urine chemistries and recurrence rates were compared between the groups. RESULTS A total of 134 patients, 89 men and 45 women, with at least one-year follow-up, were included in the analysis. Median HU value of all papillae was 49.3. The proportion of patients with recurrent and/or multiple stones was significantly higher in high-HU group compared to low-HU group (94.0% vs. 76.1%, p<0.01). AP (CaOx) index in high-HU group was higher than that in low-HU group, although the difference was marginally significant (p=0.06, Table 1). Recurrence rate in high-HU value group (0.62 person-year) was significantly higher than that of low-HU value group (0.09 person-year, p<0.01). Multivariate analysis revealed that high-HU value was an independent predictor of stone recurrence (OR 8.48, 95% CI 3.45-22.88, Table 2). CONCLUSIONS These results demonstrated that the HU value of renal papilla was correlated with disease severity, AP (CaOx) index and recurrence in ICSFs. This may allow us to identify patients with a higher risk of recurrent stone formations and change the clinical management of these patients if necessary. Table 1. Urine parameters (n=53) Low-HU group (<48.3) High-HU group (>48.3) p= Volume, mL/day 1695±606 1674±841 0.91 Oxalate, mg/day 32.4±15.1 39.5±26.9 0.25 Calcium, mg/day 183.1±108.4 207.8±128.7 0.45 Uric acid, mg/day 585.3±187.3 499.7±223.1 0.14 Magnesium, mg/day 76.4±29.0 81.4±28.9 0.53 Citrate, mg/day 383.9±258.1 554.9±614.9 0.20 AP (CaOx) 0.811±0.494 1.191±0.865 0.06 Table 2. Multivariate analysis of stone recurrence (n=134) Odds ratio 95% confidence interval p= Age 0.95 0.90-0.98 <0.01 Male 1.76 0.68-4.70 0.24 Multiple stones 1.35 0.48-3.87 0.56 Recurrent stone former 0.88 0.31-2.39 0.81 Medication 3.98 1.51-11.07 <0.01 High-HU (≥49.3) 8.48 3.45-22.88 <0.01 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e865 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Yasuo Kohjimoto More articles by this author Akinori Iba More articles by this author Shinpei Yamashita More articles by this author Nagahide Matsumura More articles by this author Isao Hara More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...