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

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

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Resumé

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.

OriginalsprogEngelsk
TidsskriftWorld Journal of Urology
Vol/bind37
Udgave nummer10
Sider (fra-til)2207-2215
ISSN0724-4983
DOI
StatusUdgivet - okt. 2019

Fingeraftryk

Pathology
Kidney
Urine
Population

Citer dette

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title = "Endoscopic observations as a tool to define underlying pathology in kidney stone formers",
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.",
keywords = "Kidney calculi, Micro-computerized tomography, Papillae, Pathology, Randall’s plaque, Ureterorenoscopy",
author = "Pless, {Maria Sloth} and Williams, {James Caldwell} and Andreassen, {Kim Hovgaard} and Jung, {Helene Ulrich} and Osther, {Susanne Sloth} and Christensen, {Dorte Ravnsmed} and Osther, {Palle J{\"o}rn Sloth}",
year = "2019",
month = "10",
doi = "10.1007/s00345-018-02616-3",
language = "English",
volume = "37",
pages = "2207--2215",
journal = "World Journal of Urology",
issn = "0724-4983",
publisher = "Heinemann",
number = "10",

}

Endoscopic observations as a tool to define underlying pathology in kidney stone formers. / Pless, Maria Sloth; Williams, James Caldwell; Andreassen, Kim Hovgaard; Jung, Helene Ulrich; Osther, Susanne Sloth; Christensen, Dorte Ravnsmed; Osther, Palle Jörn Sloth.

I: World Journal of Urology, Bind 37, Nr. 10, 10.2019, s. 2207-2215.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Endoscopic observations as a tool to define underlying pathology in kidney stone formers

AU - Pless, Maria Sloth

AU - Williams, James Caldwell

AU - Andreassen, Kim Hovgaard

AU - Jung, Helene Ulrich

AU - Osther, Susanne Sloth

AU - Christensen, Dorte Ravnsmed

AU - Osther, Palle Jörn Sloth

PY - 2019/10

Y1 - 2019/10

N2 - 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.

AB - 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.

KW - Kidney calculi

KW - Micro-computerized tomography

KW - Papillae

KW - Pathology

KW - Randall’s plaque

KW - Ureterorenoscopy

U2 - 10.1007/s00345-018-02616-3

DO - 10.1007/s00345-018-02616-3

M3 - Journal article

C2 - 30610358

AN - SCOPUS:85059555931

VL - 37

SP - 2207

EP - 2215

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

IS - 10

ER -