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Open Access 01-10-2019 | Ureterorenoscopy | Original Article

Endoscopic observations as a tool to define underlying pathology in kidney stone formers

Authors: Maria Sloth Pless, James Caldwell Williams Jr., Kim Hovgaard Andreassen, Helene Ulrich Jung, Susanne Sloth Osther, Dorte Ravnsmed Christensen, Palle Jörn Sloth Osther

Published in: World Journal of Urology | Issue 10/2019

Abstract

Purpose

Advancements in endoscopy offer the possibility of inspection of intrarenal anatomy and pathology. The aim of the study was to evaluate renal papillary appearance in kidney stone formers and to correlate papillary findings with stone type and patient metabolic data.

Materials and methods

A consecutive cohort of 46 kidney stone formers undergoing retrograde intrarenal surgery was enrolled. During surgery, renal papillae were characterized in the domains of ductal Plugging (DP), surface Pitting, Loss of papillary contour, and Amount of Randall’s plaque (RP, PPLA scoring). Stone material was analyzed using micro-CT and infrared spectroscopy, and blood and urine were collected for metabolic evaluation.

Results

In all patients, renal papillae had changes in at least one of the domains of the PPLA score. Examining the total population, it was evident that patients with predominantly plugging (DP > 0) all had very low RP scores. There were no significant trends between mean PPLA scores and urinary analytes for the total group.

Conclusion

Efforts to prevent renal stone formation have so far been insufficient in majority of patients. Digital endoscopy reveals that kidney stone formers have different and distinct papillary morphologies that seem to be linked to specific stone-forming pathways. Since renal papillary abnormalities may be easily identified during endoscopy, this may in the future prove to be an important method for tailoring prevention strategies in kidney stone patients.

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Title: Endoscopic observations as a tool to define underlying pathology in kidney stone formers
Authors: Maria Sloth Pless
James Caldwell Williams Jr.
Kim Hovgaard Andreassen
Helene Ulrich Jung
Susanne Sloth Osther
Dorte Ravnsmed Christensen
Palle Jörn Sloth Osther
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Keywords: Ureterorenoscopy
Endoscopy
Pathology
Published in: World Journal of Urology / Issue 10/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-02616-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Endoscopic observations as a tool to define underlying pathology in kidney stone formers

Abstract

Purpose

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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