You have accessJournal of UrologyCME1 Apr 2023MP05-03 DIFFERENCES IN PAPILLARY MORPHOLOGY BETWEEN BLACK AND WHITE STONE FORMERS Luke Reynolds, Clark Judge, Julia Margason, India Skinner, Elaine Worcester, Frederick Coe, and Anna Zisman Luke ReynoldsLuke Reynolds More articles by this author , Clark JudgeClark Judge More articles by this author , Julia MargasonJulia Margason More articles by this author , India SkinnerIndia Skinner More articles by this author , Elaine WorcesterElaine Worcester More articles by this author , Frederick CoeFrederick Coe More articles by this author , and Anna ZismanAnna Zisman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003216.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nephrolithiasis is common and incidence is increasing faster among Blacks (B) compared to Whites (W). Recent evidence suggests that many stone formers (SF) form calcium oxalate stones on the base of a Randall plaque (RP), but this has only been studied in W SF. We sought to compare the renal papillary anatomy of B and W to improve our understanding of stone pathogenesis in the two groups. METHODS: SF undergoing ureteroscopy for the treatment of symptomatic and asymptomatic stone disease were prospectively enrolled. Patients with a systemic or anatomic cause for stone disease were excluded. Race was self-identified. Two blinded independent reviewers who had undergone standardized training on papillary grading used digital videos from ureteroscopy to assign scores of 0, 1, or 2 for plugging, plaque, pitting, and loss of contour. Scores were averaged across all papillae graded per kidney for each category, as well as the combined total score, and compared using Mann-Whitney U test. ANCOVA models were used to evaluate differences in these scores with adjustments for sex, age, BMI, and recurrence status (RS). RESULTS: Thirty-three B and 47 W patients were enrolled. Age was similar between groups but B had higher BMI (Table 1). The majority of patients were recurrent SF (66% W/83% B). B had significantly lower scores for plugging and plaque, as well as lower total scores (Table 1, Figure 1). In multivariate models, race was the only significant factor contributing to RP score, while race, age, and RS were significant for plugging. For total score, race and RS were significant contributors, and there was no interaction between race and RS. CONCLUSIONS: This study is the first to describe the papillary anatomy of B SF. Compared to W SF, B have significantly less RP and tubular plugging, suggesting potentially different mechanisms for stone formation. Source of Funding: P01 DK056788 (Worcester, Coe, Zisman) © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e44 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luke Reynolds More articles by this author Clark Judge More articles by this author Julia Margason More articles by this author India Skinner More articles by this author Elaine Worcester More articles by this author Frederick Coe More articles by this author Anna Zisman More articles by this author Expand All Advertisement PDF downloadLoading ...
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Oct 14, 2024
Matthew Uy + 1
Open Access