Evaluating the role of urine chemistry in shock wave lithotripsy outcomes.

IF 2 2区医学 Q2 UROLOGY & NEPHROLOGY Urolithiasis Pub Date : 2024-10-09 DOI:10.1007/s00240-024-01639-3

Erhan Erdoğan, Kemal Sarıca

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Abstract

Aim: Extracorporeal Shock Wave Lithotripsy (ESWL) is a commonly used method for the noninvasive treatment of kidney stones. However, achieving optimal treatment outcomes and minimizing potential damage to the kidney necessitates careful consideration for the total amount of energy utilized. This study aims to investigate whether urine pH and urine specific gravity have an impact on the total amount of energy applied during SWL.

Patients and methods: Between January 2023 and December 2023, 129 patients with renal stones underwent SWL in our department using the Storz Medical Modulith Inline lithotripter. Stone-free rates, complications, and the impact of patient, urine, and stone characteristics on energy use were analyzed. Urine samples were analyzed for pH and specific gravity. Stone characteristics, including size, HU, and skin-to-stone distance, were recorded. The obtained data were evaluated regarding the possible relationship between the total energy amount (determined as a risk factor) and the age, BMI, urine pH, urine specific gravity, stone size, HU, and skin-to-stone distance by using the Pearson correlation coefficient. p-value of < 0.05 was considered statistically significant.

Results: Evaluation of our findings revealed a negative linear relationship between total amount of energy used and the urine pH, indicating a decrease in the total energy amount as urine pH shifts towards alkaline values (p = 0.038; p < 0.05). However, no statistically significant relationship was observed between age, BMI, urine specific gravity, stone size, HU, and skin-to-stone distance and the total energy amount.

Conclusions: Our findings demonstrated a significant relationship between urine pH and the total amount of energy applied during SWL sessions, suggesting the need for further prospective research to better understand the possible association between these two parameters. Such investigations could contribute to the development of more reasonable and effective strategies for kidney stone treatment in an attempt to minimize the potential kidney damage.

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评估尿液化学成分在冲击波碎石术疗效中的作用。

目的：体外冲击波碎石术（ESWL）是一种常用的无创治疗肾结石的方法。然而，要达到最佳治疗效果并将对肾脏的潜在损害降至最低，就必须仔细考虑所使用的能量总量。本研究旨在探讨尿液pH值和尿液比重是否会影响SWL的总能量：2023 年 1 月至 2023 年 12 月期间，129 名肾结石患者在我科接受了使用 Storz Medical Modulith Inline 碎石机进行的体外碎石术。对无结石率、并发症以及患者、尿液和结石特征对能量消耗的影响进行了分析。对尿液样本进行了 pH 值和比重分析。记录了结石的特征，包括大小、HU 和皮肤到结石的距离。利用皮尔逊相关系数对所获得的数据进行了评估，以确定总能量（作为风险因素）与年龄、体重指数、尿液 pH 值、尿液比重、结石大小、HU 值和皮肤到结石的距离之间可能存在的关系：我们的研究结果表明，能量消耗总量与尿液 pH 值呈负线性关系，表明随着尿液 pH 值向碱性值转变，能量消耗总量会减少（p = 0.038；p 结论：我们的研究结果表明，能量消耗总量与尿液 pH 值呈显著的线性关系，表明随着尿液 pH 值向碱性值转变，能量消耗总量会减少：我们的研究结果表明，尿液 pH 值与 SWL 治疗期间使用的能量总量之间存在明显关系，这表明有必要开展进一步的前瞻性研究，以更好地了解这两个参数之间可能存在的关联。这些研究有助于制定更合理、更有效的肾结石治疗策略，以尽量减少潜在的肾损伤。

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来源期刊

Urolithiasis UROLOGY & NEPHROLOGY-

CiteScore

4.50

自引率

6.50%

发文量

期刊介绍： Official Journal of the International Urolithiasis Society The journal aims to publish original articles in the fields of clinical and experimental investigation only within the sphere of urolithiasis and its related areas of research. The journal covers all aspects of urolithiasis research including the diagnosis, epidemiology, pathogenesis, genetics, clinical biochemistry, open and non-invasive surgical intervention, nephrological investigation, chemistry and prophylaxis of the disorder. The Editor welcomes contributions on topics of interest to urologists, nephrologists, radiologists, clinical biochemists, epidemiologists, nutritionists, basic scientists and nurses working in that field. Contributions may be submitted as full-length articles or as rapid communications in the form of Letters to the Editor. Articles should be original and should contain important new findings from carefully conducted studies designed to produce statistically significant data. Please note that we no longer publish articles classified as Case Reports. Editorials and review articles may be published by invitation from the Editorial Board. All submissions are peer-reviewed. Through an electronic system for the submission and review of manuscripts, the Editor and Associate Editors aim to make publication accessible as quickly as possible to a large number of readers throughout the world.