Comprehensive Nomogram for Prediction of the Uric Acid Composition of Ureteral Stones as a Part of Tailored Stone Therapy.
Eur Urol Focus
; 8(1): 291-296, 2022 Jan.
Article
in En
| MEDLINE
| ID: mdl-33589393
ABSTRACT
BACKGROUND:
Oral chemolitholysis is a noninvasive therapy for uric acid (UA) stones. Proper patient selection is crucial for success of the therapy.OBJECTIVE:
To develop a nomogram for prediction of UA stones using parameters gathered during emergency work-up for flank pain. DESIGN, SETTING, ANDPARTICIPANTS:
A single-center cohort (459 patients) with singular ureteral stones and available stone analysis was retrospectively reviewed for radiological, urinary, and serological findings indicating UA stones. OUTCOME MEASUREMENTS AND STATISTICALANALYSIS:
A Mann-Whitney U test or Kruskal-Wallis test was applied for univariate analysis. Categorical variables were compared using a χ2 test. Binary logistic regression of significant parameters was performed to design the nomogram. RESULTS ANDLIMITATIONS:
Univariate analysis revealed statistically significant differences in parameters between predominantly UA and non-UA groups, including median age (60 yr, interquartile range [IQR] 51.5-70.5 vs 51 yr, IQR 39-62; p < 0.001), body mass index (30.0 kg/m2, IQR 27.25-35.0 vs 26.6 kg/m2, IQR 24.0-30.467; p < 0.001), stone density (435.0 HU, IQR 329.0-528.0 vs 750.0 HU, IQR 548.0-995.0; p < 0.001), serum UA (437.5 µmol/l, IQR 374.25-478.0 vs 321.0 µmol/l, IQR 273.0-377.0; p < 0.001), and urine pH (5.5, IQR 5.0-5.5 vs 6.0, IQR 5.5-6.5; p < 0.001). Radiolucency was more frequent in the predominantly UA group (88.60% vs 32.70%; p < 0.001). Multivariate binary logistic regression confirmed age, body mass index, stone density, serum UA, urine pH, and radiolucency as independent predictors of UA stones and these parameters were used to design the nomogram.CONCLUSIONS:
We present a nomogram for the prediction of uric acid stones. PATIENTSUMMARY:
We developed a nomogram as a simple tool with potential to be useful in patient counseling regarding chemolitholysis as a tailored stone treatment for uric acid urinary stones.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ureteral Calculi
/
Urinary Calculi
/
Nephrolithiasis
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Eur Urol Focus
Year:
2022
Type:
Article
Affiliation country:
Germany