2018, Number 4
<< Back Next >>
Rev Mex Urol 2018; 78 (4)
Evaluation of a nomogram for predicting successful kidney stone treatment through extracorporeal shock wave lithotripsy
Avendaño-Bastidas SA, Alcaraz-Gutiérrez M, Medrano-Sánchez J, Ríos-Melgarejo C, Guillén-Rodríguez J, Pulido-Contreras E, García-Padilla MÁ
Language: Spanish
References: 28
Page: 273-282
PDF size: 314.96 Kb.
ABSTRACT
Objective: To analyze the predictive performance of a nomogram and identify other
predictive variables of stone-free rate, as well as to evaluate the current status of extracorporeal
shock wave lithotripsy in the treatment of kidney stones.
Materials and Methods: The prospective evaluation of the Kim nomogram as a
predictive tool for stone-free rate after extracorporeal shock wave lithotripsy in patients
previously assessed through computed tomography was carried out. Stone status was
determined 3 weeks after treatment. The predictive yield of the Kim nomogram
versus
the reference study (computed tomography) was evaluated for predicting stone-free
status. Bayesian statistics were performed to calculate the prevalence of stones after
the test and the ROC curve analysis was carried out to determine the area under the
curve for all values, as well as to report the 95% CI.
Results: A total of 110 patients were included in the study. Extracorporeal lithotripsy
showed a general efficacy of 69% and the nomogram analysis produced an area under
the curve of 0.627. The number of stones and the maximum diameter were statistically
significant variables for achieving the stone-free rate. Stone volume and Hounsfield
units were also predictive in the final treatment result.
Conclusions: Extracorporeal shock wave lithotripsy is still an effective treatment for
kidney stones. A better selection of patients that are candidates for said treatment can
be made utilizing the predictive variables identified.
REFERENCES
Türk C, et al. Guidelines on urolithiasis. EAU 2017 [en línea]. Dirección URL: http://uroweb.org/guideline/urolithiasis/
Wein A, et al. Campbell-Walsh Urology. 11th ed. Philadelphia: Saunders; 2016.
Otero F, et al. Las enfermedades renales en el instituto mexicano del seguro social (1982-1989). Rev Asoc Med IntMex 1995;44 (6):21-29.
http://www.hgm.salud.gob.mx/descargas/pdf/area_medica/ urolo/3litiasis_renal.pdf
Chaussy C, et al. Extracorporeal shockwave lithotripsy (ESWL): a chronology. DOI: https://doi.org/10.1089/ end.2007.9880
Williams J, et al. Variability of renal stone fragility in shock wave lithotripsy. Urology 2003;61(6):1092-1096.
Bhojani N, Lingeman J. Shockwave lithotripsy-new concepts and optimizing treatment parameters. DOI: https://doi. org/10.1016/j.ucl.2012.09.001
Pareek G, et al. Shock wave lithotripsy success determined by skin-to-stone distance on computed tomography. DOI: https://doi.org/10.1016/j.urology.2005.05.011
Wiesenthal J, et al. Evaluating the importance of mean stone density and skin-to-stone distance in predicting successful shock wave lithotripsy of renal and ureteric calculi. Urol Res 2010;38(4):307-313.
Wang L, et al. Predictions of outcomes of renal stones after extracorporeal shock wave lithotripsy from stone characteristics determined by unenhanced helical computed tomography: A multivariate analysis. Eur Radiol 2005;15(11):2238-2243.
Bandi G, et al. Stone measurement by volumetric threedimensional computed tomography for predicting the outcome after extracorporeal shock wave lithotripsy. DOI: https://doi.org/10.1111/j.1464-410X.2008.08069.x
Jain PM, et al. Efficacy and safety of the Healthtronics LitthoTron lithotripter. DOI: https://doi.org/10.1089/ end.2004.18.P1
Sahinkanat T, et al. Evaluation of the effects of relationships between main spatial lower pole calyceal anatomic factors on the success of shock-wave lithotripsy in patients with lower pole kidney stones. DOI: https://doi.org/10.1016/j. urology.2007.11.052
Preminger GM. Management of lower pole renal calculi: shock wave lithotripsy versus percutaneous nephrolithotomy versus flexible ureteroscopy. Urol res 2006;34(2):108-111.
Pearle M, et al. Prospective, randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole calicial calculi 1 cm or less. DOI: https://doi.org/10.1097/01. ju.0000158458.51706.56
Manikandan R, et al. Do anatomic factors pose a significant risk in the formation of lower pole stones? DOI: https:// doi.org/10.1016/j.urology.2007.01.005
Hyams E, et al. Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm: a multiinstitutional experience. https://doi.org/10.1089/end.2009.0629
Riley J, et al. Retrogadeureteroscopy for renal stones larger than 2.5 cm. DOI: https://doi.org/10.1089/end.2009.0391
Aboumarzouk O, et al. Extracorporeal shock wave lithotripsy (ESWL) versus ureteroscopic management for ureteric calculi. DOI: 10.1002/14651858.CD006029.pub4
Srisubat A, et al. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarrenal surgery (RIRS) for kidney stones. DOI: 10.1002/14651858.CD007044.pub3
Tailly T, et al. Multicenter external validation and comparison of stone scoring systems in predicting outcomes after percutaneous nephrolithotomy. DOI: https://doi. org/10.1089/end.2015.0700
Kanao K, et al. Preoperative nomograms for predicting stone-free rate after extracorporeal shock wave lithotripsy. DOI: https://doi.org/10.1016/j.juro.2006.06.089
Dhar M, Denstedt J. Imaging in diagnosis, treatment, and follow-up of stone patients. Adv chronic kidney dis. DOI: https://doi.org/10.1053/j.ackd.2008.10.005
Wiesenthal J, et al. A clinical nomogram to predict the successful shock wave lithotripsy of renal and ureteral calculi. DOI: https://doi.org/10.1016/j.juro.2011.03.109
Niwa N, et al. Simple and practical nomograms for predicting the stone-free rate after shock wave lithotripsy in patients with a solitary upper ureteral stone. World J Urol 2017;35(9):1455-1461.
Timothy Y, et al. Triple D score is a reportable predictor of shockwave lithotripsy stone-free rates. DOI: https://doi. org/10.1089/end.2014.0212
Kim J, et al. Clinical nomograms to predict stone-free rates after shock-wave lithotripsy: Development and internal-validation. DOI: https://doi.org/10.1371/journal. pone.0149333
Wiesenthal J, et al. A clinical nomogram to predict the successful shockwave lithotripsy of renal and ureteral calculi. European urology supplements. DOI: https://doi. org/10.1016/j.juro.2011.03.109