Titre
Oral chemolysis is an effective, non-invasive therapy for urinary stones suspected of uric acid content.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Tsaturyan, A.
Auteure/Auteur
Bokova, E.
Auteure/Auteur
Bosshard, P.
Auteure/Auteur
Bonny, O.
Auteure/Auteur
Fuster, D.G.
Auteure/Auteur
Roth, B.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
2194-7236
Statut éditorial
Publié
Date de publication
2020-12
Volume
48
Numéro
6
Première page
501
Dernière page/numéro d’article
507
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Despite the possible benefit from avoiding stone surgery with all its possible complications, oral chemolysis is rarely performed in patients with urinary stones suspected of uric acid content. Among the reasons for its limited use is the sparse and low-quality data on its efficacy and the lack of reliable factors predicting its outcome. We thus performed a retrospective single-center cohort study of 216 patients (median patient age 63 years) with 272 renal (48%) and/or ureteral (52%) stones treated with oral chemolysis from 01/2010 to 12/2019. Patients with low urine pH (< 6), low stone density upon non-contrast enhanced computed tomography (NCCT), radiolucent urinary stones on plain radiography, and/or a history of uric acid urolithiasis were included. Potassium citrate and/or sodium/magnesium bicarbonate were used for alkalization (target urine pH 6.5-7.2). Median stone size was 9 mm, median stone density 430 Hounsfield Units. Patients with ureteral stones < 6 mm were excluded since stones this small are very likely to pass spontaneously. The stone-free status of each patient was evaluated after 3 months using NCCT. Oral chemolysis was effective with a complete and partial response rate of stones at 3 months of 61% and 14%, respectively; 25% of stones could not be dissolved. Lower stone density (OR = 0.997 [CI 0.994-0.999]; p = 0.008) and smaller stone size (OR = 0.959 [CI 0.924-0.995]; p = 0.025) significantly increased the success rate of oral chemolysis in multivariate logistic regression analysis. More precise stone diagnostics to exclude non-uric-acid stones could further improve outcome.
PID Serval
serval:BIB_E50A8E7F7606
PMID
Open Access
Oui
Date de création
2020-08-17T08:46:57.474Z
Date de création dans IRIS
2025-05-21T05:19:05Z
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Nom
32770255_BIB_E50A8E7F7606.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
841.93 KB
Format
Adobe PDF
PID Serval
serval:BIB_E50A8E7F7606.P001
URN
urn:nbn:ch:serval-BIB_E50A8E7F76060
Somme de contrôle
(MD5):bc438f7a5e29475fef2aee9da77d3a85