Study reaches multidisciplinary consensus on imaging for kidney stones
Led by a Yale professor, a team of researchers has engaged in a consensus process to determine when and how CT scans should be used to diagnose renal colic.
ConclusionsWe demonstrate a knowledge gap regarding radiation exposure during CT scans and the limitations of low-dose CT imaging. This gap is wider in non-US-based urologists and in those with over 10 years of experience. However, all urologists would benefit from improved education and clear guidelines regarding radiation exposure in nephrolithiasis patients.
ConclusionA modified imaging protocol is applicable for confirmation of stone presence and location by utilizing very low-dose radiation exposure.
Abstract Point-of-care ultrasonography (POCUS) is performed by a physician at the bedside and is standard practice in obstetric, emergency, and musculoskeletal medicine. When compared with formal sonography, POCUS is equivalent in screening for abdominal aortic aneurysm and as accurate in diagnosing deep venous thrombosis. POCUS has high accuracy for diagnosing pneumonia and detecting acute decompensated heart failure but is less accurate than computed tomography for identifying pulmonary embolism. POCUS confirmation of intrauterine pregnancy rules out an ectopic pregnancy. In the third trimester of high-risk preg...
CT procedure volume has reached an all-time high in the U.S., hitting an estimated...Read more on AuntMinnie.comRelated Reading: Could cold, hard cash reduce unnecessary head CT scans? Concerns grow over CT radiation for kidney stones Emergency CT usage rate soars for urinary stones Head CT offers low diagnostic yield for fainting Adult hospitals overuse CT for appendicitis in kids
Abstract PURPOSE: The aim of the study was to evaluate the predictive value of nephrolithometric scoring systems used to predict the complexity of renal stones for the outcomes of retrograde intrarenal surgery (RIRS). MATERIALS AND METHODS: A total of 81 patients who underwent RIRS for nephrolithiasis between January 2013 and October 2017 were reviewed in this retrospective study. Guy's Stone Score (GSS), the S.T.O.N.E., Clinical Research Office of the Endourologic Society (CROES), and Seoul National University Renal Stone Complexity (S-ReSC) nephrolithometry scores were assessed by same researcher for each p...
Conclusion: The 3D-guided approach to PNL facilitates the preoperative planning of the puncture with better knowledge of the renal anatomy and may be helpful to reduce operative time and improve the learning curve.
CONCLUSIONS: The incidence of de novo nephrolithiasis in ESRD patients on HD was 10.5%. Increased serum uric acid, decreased serum magnesium and ionized calcium, and absence of hypertension were associated with increased stone-formation in ESRD patients on HD. PMID: 31793861 [PubMed - as supplied by publisher]
This article describes a patient who was found to have a renocolic fistula on antegrade percutaneous nephrostogram. The patient was treated with a laparoscopic nephrectomy and minimally invasive colon repair and recovered.
AbstractPurposeTo investigate the accuracy of rapid kV-switching single-source dual-energy computed tomography (rsDECT) for prediction of classes of non-uric-acid stones.Materials and methodsNon-uric-acid renal stones retrieved via percutaneous nephrolithotomy were prospectively collected between January 2017 and February 2018 in a single institution. Only stones ≥ 5 mm and with pure composition (i.e., ≥ 80% composed of one component) were included. Stone composition was determined using Fourier Transform Infrared Spectroscopy. The stones were scanned in 32-cm-wide anthropomorphic wh...
We thank the authors of this editorial for their very thoughtful comments. They are correct that the use of low dose CT (LDCT) scan can significantly reduce the radiation dose associated with kidney stone management. The sensitivity of LDCT for nephrolithiasis is well-established and comparable to that of standard dose CT scan (SDCT), especially in nonobese patients.1 Unfortunately, while the technology is available, limited evidence exists that widespread adoption of LDCT has occurred, especially in the emergency department setting where a significant percentage of imaging for nephrolithiasis is performed.