Practice patterns of kidney stone management across European and non-European centers: an in-depth investigation from the European Renal Stone Network (ERSN)

Pietro Manuel Ferraro,Olivier Bonny,Giovanni Gambaro,Robert Unwin

doi:10.1007/s40620-020-00854-6

Abstract

Rationale and objectiveKidney stones are a common condition in the general population, however, high-quality evidence for its management is scarce. We propose the creation of an international network with the aim of sharing practice patterns and patient data towards an improvement of our knowledge of the disease.Study designCross-sectional survey.Setting and participantsAn online survey was circulated through several scientific societies. Items were grouped into six domains. Each center’s overall score (OS) was also calculated.Analytical approachChi square and Mann–Whitney tests were performed for differences across centers.ResultsThe countries that contributed most were Italy (8.6%), Turkey (6.6%), France and Spain (6.1%). Some type of nutritional work-up was implemented in 62% of centers. A DEXA scan was performed by 46% of centers, whereas some kind of acidification test was performed by 25% of centers. Most centers (80%) implemented blood investigations at least at baseline. With regard to 24-h urine exams, 7 out of 16 were performed by at least 50% of centers. Information on stone composition was collected by 58% of centers. The OS was significantly higher among higher-volume centers compared with lower-volume centers (p = 0.002). Significant differences between EU and non-EU centers were found.LimitationsCross-sectional design; no validation on information.ConclusionsOur survey highlights the potential for the creation of a network of centers that could share information in a common database for observational research and for enrollment of patients in interventional trials.

Highlights

Kidney stones are increasingly common in the general population [1, 2]
The overarching aims of this project would be to: (a) characterize areas of heterogeneity in the management of patients with kidney stones that could be potentially resolved through consensus and/or production of high-quality evidence (b) identify a core of centers which could contribute highly detailed, patient-level clinical and laboratory information as well as biological samples in order to effectively establish a paradigm of precision medicine in the field of kidney stones by integrating phenotypical and “omics” data (c) create a platform for the development of future observational and interventional clinical research in the field of kidney stones
This study expands on our previous work in which we surveyed 24 medical centers from Europe about their current practice patterns in the management of patients with kidney stones [12]

Summary

Introduction

Kidney stones are increasingly common in the general population [1, 2] Despite their high recurrence rates and costs [3,4,5], and their association with severe conditions such as end-stage renal disease and cardiovascular disease [6,7,8,9,10,11], systematic efforts to standardize their evaluation and follow-up have been scarce. We reported on the preliminary results of a survey aimed at investigating practice patterns of kidney stone management across centers in Europe with a renowned interest in kidney stones [12]. We report on the main results of our survey aimed at investigating current practice patterns across European centers. Since we obtained a rather high number of responses from non-European centers, we report information from those centers as well

Materials and methods

Results

Discussion

Compliance with ethical standards