Evaluation and Comparison of Metabolic Disorders between Patients with Unilateral and Bilateral Staghorn Renal Stones
Vol. 16 No. 3 (2019),
17 June 2019
Purpose: Metabolic disorders are common in patients with staghorn renal stones. Aim of this study was to evaluate and compare the metabolic disorders in patients with unilateral and bilateral staghorn stones.
Materials and Methods: In this cross sectional study, 78 patients who underwent percutaneous nephrolithotomy (PCNL) for staghorn renal stones were included. The urine volume, the level of calcium, oxalate, uric acid, phosphate, sodium, citrate, creatinine, and cystine from 24 hour urine collection as well as the serum levels of calcium, phosphorus, magnesium, creatinine, blood urea nitrogen (BUN), parathyroid hormone (PTH) and uric acid were recorded and compared among the two groups with unilateral and bilateral renal stones.
Results: 56 patients (71.8%) had unilateral and 22 (28.2%) had bilateral renal stones. At least one abnormal metabolic factor was found in 32 (57.1%) and 15 (68.2%) patients with unilateral and bilateral renal stones, respectively (P = .044). Cystine urine levels and serum levels of BUN were higher in cases with bilateral compared to unilateral renal stones (36.4% vs. 12.5%, P = .025 and 27.3% vs. 1.8%, P = .002, respectively).
Conclusion: Metabolic factors are strongly correlated with the formation of staghorn renal stones specially bilateral ones. In our study among different metabolic factors, cystine urine levels and serum levels of BUN were significantly higher in patients with bilateral renal stones. Proper metabolic assessments are recommended in patients with staghorn urolithiasis.
How to Cite
Romero V, Akpinar H, Assimos DG. Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol. 2010 Spring;12(2-3):e86-96.
Safarinejad MR. Adult urolithiasis in a population-based study in Iran: prevalence, incidence and associated risk factors. Urol Res. 2007 Apr;35(2):73-82.
Rieu P. Infective lithiasis. Ann Urol (Paris). 2005; 39(1): 16-29.
Amaro CR, Goldberg J, Agostinho AD, Damasio P, Kawano PR, Fugita OE, et al. Metabolic investigation of patients with Staghorn Calculus: Is it necessary? Int Braz J Urol. 2009 Nov-Dec;35(6):658-61; discussion 662-3.
Amaro CR, Goldberg J, Amaro JL, Padovani CR. Metabolic assessment in patients with urinary lithiasis. Int Braz J Urol. 2005; 31: 29-33.
Skolarikos A, Straub M, Knoll T, Sarica K, Seitz C, Petřík A, et al. Metabolic Evaluation and Recurrence Prevention for Urinary Stone Patients: EAU Guidelines. Eur Urol. 2015 Apr;67(4):750-63.
Resnick MI, Boyce WH. Bilateral staghorn calculi-patient evaluation and management. J Urol. 1980 Mar;123(3):338-41.
Viprakasit Dp, Sawyer Md, Herrell Sd, Miller Nl. Changing composition of staghorn calculi. J Urol. 2011 Dec;186(6):2285-90.
Wall I, Hellgren E, Larsson L, Tiselius HG. Biochemical risk factors in patients with renal staghorn stone disease. Urology. 1986 Nov;28(5):377-80.
Akagashi K, Tanda H, Kato S, Ohnishi S, Nakajima H, Nanbu A, et al. Characteristics of patients with staghorn calculi in our experience. Int J Urol. 2004; 11: 276-81.
Takeuchi H, Tomoyoshi T. [Formation of the staghorn calculi]. Hinyokika Kiyo. 1985 Aug;31(8):1381-5
Tanthanuch M. Staghorn calculi in southern Thailand. J Med Assoc Thai. 2006 Dec;89(12):2086-90.
Ali SH, Rifat UN. Etiological and clinical patterns of childhood urolithiasis in Iraq. Pediatr Nephrol. 2005; 20: 1453-7.
Preminger GM, Assimos DG, Lingeman JE, Nakada SY, Pearle MS, Wolf JS Jr; AUA Nephrolithiasis Guideline Panel). Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol. 2005 Jun;173(6):1991-2000.
Borghi L, Nouvenne A, Meschi T. Nephrolithiasis and urinary tract infections: 'the chicken or the egg' dilemma? Nephrol Dial Transplant. 2012 Nov;27(11):3982-4.
Mandel N, Mandel I, Fryjoff K, Rejniak T, Mandel G. Conversion of calcium oxalate to calcium phosphate with recurrent stone episodes. J Urol. 2003 Jun;169(6):2026-9.
Mohebbi I, Saadat S, Aghassi M, Shekari M, Matinkhah M, Sehat S. Prevalence of metabolic syndrome in Iranian professional drivers: results from a population based study of 12,138 men. PLoS One. 2012;7(2):e31790.
Wong YV, Cook P, Somani BK. The association of metabolic syndrome and urolithiasis. Int J Endocrinol. 2015;2015:570674.
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