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EAU 2018: Detailed Metabolic Evaluation in Primary Stone Formers: Is It Recommended? Comparing Detailed Metabolic Evaluation Outcome Between Primary And Recurrent Stone Formers

Copenhagen, Denmark (UroToday.com) Dr. Vincent, a clinical urologist from the Meenakshi Mission Hospital in Madurai, India, presented his findings on whether or not a metabolic work up is necessary in primary stone formers. It was reported that first time stone formers are estimated to have a 50% rate of stone recurrence within the following 10 years from the initial event. However, there have been few studies detailing significant metabolic abnormalities in these first time stone patients. To fully determine the necessity of work ups in these patients, metabolic evaluations between first time stone formers and recurrent stone formers would need to be analyzed.

For this study, prospective data collection occurred between October 2016 to September 2017. The inclusion criteria consisted of primary and recurrent stone formers between the ages of 18 and 60 years old who were willing to undergo detailed metabolic evaluations. These evaluations consisted of Serum creatinine, calcium, phosphorus, uric acid, electrolytes, urine pH, and 24 hour urine calcium, phosphorus, urate, citrate, oxalate, sodium, and chloride. Patients were excluded from the study in they exhibited elevated renal parameters greater than 1.0 mg/dL.

A total of 114 subjects were enrolled in the study. These patients consisted of 61 primary and 53 recurrent stone formers. Between the two groups, there was no significant difference between demographics. In fact, metabolic abnormality was detected in 90.2% of primary patients and 92.5% of recurrent patients, a value which was much higher than initially estimated. There was a comparable percentage of patients within both groups who suffered no metabolic abnormality, single abnormality, or multiple abnormalities. Additionally, the type of abnormalities experienced between the two groups were comparable. Of the data collected, there was no statistically significant between the two groups in this study.

In conclusion, Dr. Vincent determined that there was no difference in the rate of detection of metabolic abnormalities between primary and recurrent stone formers. Dr. Vincent urged that detailed metabolic evaluations be carried out in first time stone formers due to the high rate of stone recurrence episodes. With a metabolic work up carried out early, the urologist will be better able to target personalized treatment.

Speaker: P. Vincent

Authors: Vincent P. , Konanki V. , Ravichandran R.

Written by: Zachary Valley, Department of Urology, University of California-Irvine, at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark