FREQUENCY AND FACTORS EFFECTING NON CLEARANCE OF LOWER POLE RENAL STONES

Authors

  • Amin Ullah Institute of Kidney Diseases and transplant, Hayatabad Medical Complex, Peshawar
  • Mohammad Zubair Institute of Kidney Diseases and transplant, Hayatabad Medical Complex, Peshawar
  • Nouman Khan Institute of Kidney Diseases and transplant, Hayatabad Medical Complex, Peshawar
  • Asif Malik Institute of Kidney Diseases and transplant, Hayatabad Medical Complex, Peshawar

Abstract

Background: Renal stone disease is a major health hazard in Pakistan and extra-corporeal shockwave lithotripsy is one of comprehensive method used to treat these stones. The aim of this study is to determine the frequency of factors affecting the non-clearance of stone fragments of lower pole renal stone after extra corporeal shockwave lithotripsy. The study was done with the objective to determine the frequency the spatial anatomical factors which can influence the non-clearance of lower pole stone fragments after ESWL. Methods: One and nineteen (119) patients with lower pole renal stone less than10mm were subjected to maximum 3 sessions of extracorporeal shock wave lithotripsy. KUB radiographs, ultrasonography and intravenous urography were used as investigative tools for lower pole renal calyceal anatomy. X ray KUB and ultrasound were done after a week for clearance. Data was analysed with the help of SPSS version 10.0 and presented in the forms of tables and graphs. Results: There were 77 (64.71%) males and 42 (35.29%) females. Infundibulo-pelvic angle (IPA)>40º was present in 93 (78.15%), Infundibular length (IL) <22 mm in 107 (89.92%) and Infundibular width (IW) >4 mm was present in 100 (84.03%) patients. The frequency of stone non clearance was noted in 31 (26.05%). Infundibulo-pelvic angle (IPA)>40º (p=0.000), Infundibular length (IL)<22 mm (p=0.001) and Infundibular width (IW)>4 mm (p=0.046) were significant variables affecting stone clearance. Conclusion: The frequency of non-clearance of lower calyx of kidney stone is 26.05%. The clearance of fragments of the lower calyx kidney stones is affected by three spatial anatomical factors, i.e., Infundibulopelvic angle, Infundibular width and infundibular length.Keywords: Extracorporeal shock wave lithotripsy; non clearance of lower pole kidney stones; Infundibulopelvic angle; Infundibular width; infundibular length.

References

Frassetto L, Kohlstadt I. Treatment and prevention of kidney stones: an update. Am Fam Physician 2011;84(11):1234–42.

Heilberg IP, Goldfarb DS. Optimum nutrition for kidney stone disease. Adv Chronic Kidney Dis 2013;20(2):165–74.

Barnela SR, Soni SS, Saboo SS, Bhansali AS. Medical management of renal stone Indian J Endocrinol Metab 2012;16(2):236–9.

Kadlec AO, Greco K, Fridirici ZC, Hart ST, Vellos T, Turk TM. Metabolic syndrome and urinary stone composition: what factors matter most? Urology 2012;80(4):805–10.

Nouvenne A, Ticinesi A, Guerra A, Folesani G, Allegri F, Pinelli S, et al. Influence of lean and fat mass on bone mineral density and on urinary stone risk factors in healthy women. J Transl Med 2013 Oct 7;11:248.

Johri N, Cooper B, Robertson W, Choong S, Rickards D, Unwin R. An update and practical guide to renal stone management. Nephron Clin Pract 2010;116(3):c159–71.

Ranabir S, Baruah M, Ritu Devi K. Nephrolitiasis: Endocrine evaluation. Indian J Endocrinol Metab 2012;16(2):228–35.

Ozturk U, Sener NC, Nalbant I, Karabacak OR, Ulusoy MG, Imamoglu MA. The effect of metabolic syndrome upon the success of varicocelectomy. Scie World J 2012;2012:985201.

Singh O, Gupta SS, Girish G, Aggarwal G, Mathur RK. Influence of prognostic factors on the outcome of extracorporeal shock wave lithotripsy in upper urinary tract stone disease. Intern J Nephrol Urol 2010;2(3):476–480.

Wendt-Nordahl G, Krombach P, Hannak D, Häcker A, Michel MS, Alken P. Prospective evaluation of acute endocrine pancreatic injury as collateral damage of shock-wave lithotripsy for upper urinary tract stones. BJU Int 2007;100(6):1339-43.

Lin C-C, Hsu Y-S, Chen K-K. Predictive factors of lower calyceal stone clearance after extracorporeal shockwave lithotripsy (ESWL): the impact of radiological anatomy. J Chin Med Assoc 2008;71(10):496–501.

Moody JA, Evans AP, Lingeman JE. Extracorp oreal shockwave lithotripsy. In: Weiss RM, George NJR, O’Reilly PH, editors. Comprehensive Urology. Mosby International Limited; 2001. p. 623–36.

Wazir BG, Iftikhar ul Haq M, Faheem ul Haq, Nawaz A, Ikramullah AN, Jamil M. Experience of extracorporeal shockwave lithotripsy for kidney and upper ureteric stones by Aelectromagnetic lithotripter. J Ayub Med Coll Abbottabad 2010;22(2):20–2.

Ashraf HS, Hussain N, Hyder I, Khan MU. Extracorporeal shock wave lithotripsy; outcome in pediatric urolithiasis. Professional Med J 2010;17(4):581–8.

Azab S, Osama A. Factors affecting lower calyceal stone clearance after Extracorporeal shock wave lithotripsy. African J Urol 2013;19:13–17.

Deenari R, Hussain M, Muhammad S, Abro M, Baloch NA. Stone clearance in lower pole nephrolithiasis after extra corporeal shock wave lithotripsy at Chandka medical college hospital, Larkana. Medical Channel 2010;16(1):169–171.

Ather MH, Abid F, Akhtar S, Khawaja K. Stone clearance in lower pole nephrolithiasis after extra corporeal shock wave lithotripsy: the controversy continues. BMC Urol 2003;3:1.

Huang Z, Zhao X, Zhang L, Zhong Z, Xu R, Zhang L. Extracorporeal Shock Wave Lithotripsy for Management of Residual Stones after Ureterolithotripsy versus Mini-Percutaneous Nephrolithotomy: A Retrospective Study PLoS ONE 2013;8(6):e67046.

Sumino Y, Mimata H, Tasaki Y, Ohno H, Hoshino T, Nomura T, et al. Predictors of lower pole renal stone clearance after extracorporeal shock wave lithotripsy. J Urol 2002;168(4 Pt 1):1344–7.

Ruggera L, Beltrami P, Ballario R, Cavalleri S, Cazzoletti L, Artibani W. Impact of anatomical pielocaliceal topography in the treatment of renal lower calyces stones with extracorporeal shock wave lithotripsy. Int J Urol 2005;12(6):525–32.

Sorensen CM, Chandhoke PS. Is lower pole caliceal anatomy predictive of extracorporeal shock wave lithotripsy success for primary lower pole kidney stones? J Urol 2002;168(6):2377–82.

Downloads

Published

2015-06-20