struvite and Staghorn-Calculi

To define risk factors and perioperative outcomes for matrix stones and compare these outcomes with struvite and calcium stone cohorts.. A retrospective cohort study comparing matrix stones (n=32), struvite stones (n=23) and a matched, calcium stone control group (n=32) was performed. Two-way ANOVA was used to compare the groups for continuous variables. Chi-square tests were used to compare categorical variables. Significance was set at P <.05. All statistical tests were performed using R (v1.73).. We identified no differences in age, gender, or BMI between the three groups. Matrix and struvite stones were more likely to have a history of prior stone surgery and recurrent UTIs compared to calcium stones (P=.027 and P <.001, respectively). Struvite stones were more likely to present as staghorn calculi compared to matrix or calcium stones (56.5% vs 21.7% vs 18.8%, P=.006). There were no significant differences in postoperative stone free rates (P=.378). No significant differences in postoperative infectious complications were identified. Matrix stones were more likely to have Candida on stone culture compared to the struvite or calcium stones (P <.0001).. Matrix and struvite stones were more likely have a history of stone surgery and preoperative recurrent UTIs. Struvite stones were more likely to present as staghorn calculi. Matrix stones were more likely to have Candida present in stone cultures. However, no difference in postoperative infectious outcomes or stone free rates were identified. Further study with larger cohorts is necessary to distinguish matrix stone postoperative outcomes from struvite and calcium stones.

Topics: Calcium; Female; Humans; Kidney Calculi; Male; Phosphates; Postoperative Complications; Retrospective Studies; Staghorn Calculi; Struvite; Uric Acid

We sought to investigate the association between renal stone composition and percutaneous nephrolithotomy outcomes in pediatric patients and define the characterization of the stone composition.. The data of 1157 children who underwent percutaneous nephrolithotomy between 1991 and 2012 were retrieved from the multicenter database of the Turkish Pediatric Urology Society. The study population comprised 359 children (160 girls, 199 boys) with stone analyses. Patients were divided into five groups according to the stone composition [group 1: calcium oxalate; group 2: calcium phosphate; group 3: infection stones (magnesium ammonium phosphate, ammonium urate); group 4: cystine; group 5: uric acid, xanthine stones].. Patient characteristics, perioperative, postoperative, and stone characteristics were compared considering the stone composition. There were no significant differences between the groups concerning age, sex, side involved, preoperative hematocrit levels, and solitary renal unit. Patients with cystine stones were more likely to have a history of stone treatment. Groups 2 and 5 had mostly solitary stones. However, group 3 had staghorn stone more often, and group 4 frequently had multiple stones. Overall stone-free rate (79.4%) was similar among the groups. Although stone composition was related to blood transfusion and prolonged operative and fluoroscopy screening times on univariate analysis, it was not a significant predictor of them on multivariate analysis.. Stone composition was not a predictor of outcomes of pediatric percutaneous nephrolithotomy. However, cystine and infection stones, which are larger and filled multiple calyxes due to the nature of stone forming, were more challenging cases that need multiple tracts.

Topics: Adolescent; Blood Transfusion; Calcium Oxalate; Calcium Phosphates; Child; Child, Preschool; Cystine; Databases, Factual; Female; Fluoroscopy; Humans; Infant; Kidney Calculi; Kidney Calices; Male; Multivariate Analysis; Nephrolithotomy, Percutaneous; Operative Time; Retrospective Studies; Staghorn Calculi; Struvite; Treatment Outcome; Turkey; Uric Acid; Xanthine

During the excavation of the 19th century Peoria City Cemetery (Peoria, Illinois), a skeleton of a female, aged 20-30 years old, was found with large, bilateral calcified masses in the abdominal region. The masses were analyzed by Fourier transform infrared (FTIR) spectroscopy, and the results compared to published clinical data in an effort to determine the etiology of the stones. The calcified masses were determined to be staghorn struvite uroliths, which commonly result from chronic urinary tract infection and likely impacted the overall health of this individual.

Topics: Adult; Age Determination by Skeleton; Biomarkers; Cemeteries; Female; History, 19th Century; Humans; Illinois; Sex Determination by Skeleton; Spectroscopy, Fourier Transform Infrared; Staghorn Calculi; Struvite

Topics: Acidosis, Renal Tubular; Antirheumatic Agents; Female; Humans; Middle Aged; Obesity; Recurrence; Rituximab; Sjogren's Syndrome; Staghorn Calculi; Struvite

The composition of renal stones varies widely among populations. The aim of our study was to determine the composition of staghorn renal stones using Fourier transform infrared (FTIR) spectroscopy in a cohort of Sri Lankan patients. Forty two staghorn calculi removed from kidneys of adult patients during open surgery were analysed. There were 32 men. Nineteen (45%) were calcium oxalate monohydrate (whewellite) stones. Stones containing a mixture of calcium oxalate and calcium hydroxyl phosphate (apatite) were found in 16 (38%). Only 4 (10%) staghorn calculi were coposed of struvite. Three (7%) were uric acid stones. So most staghorn renal stones in Sri Lanka are calcium oxalate. Contrary to the traditional view based on studies done in the western world, only 10% of staghorn calculi removed from patients in Sri Lanka are struvite or infection stones. This could be the reason for kidneys with staghorn calculi in Sri Lanka to retain their function.

Topics: Adult; Aged; Calcium Oxalate; Female; Humans; Hydroxyapatites; Male; Middle Aged; Spectroscopy, Fourier Transform Infrared; Sri Lanka; Staghorn Calculi; Struvite; Uric Acid