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Kidney Week

Abstract: SA-PO309

Suboptimal Identification and Investigations of Renal Stones in a Tertiary Irish Centre: A Retrospective Analysis

Session Information

Category: Bone and Mineral Metabolism

  • 502 Bone and Mineral Metabolism: Clinical

Authors

  • Browne, Emmett, Ireland East Hospital Group, Dublin, Dublin, Ireland
  • Sadlier, Denise M., University College Dublin, Dublin, Ireland
Background

Nephrolithiasis is a common medical problem with 10-20% of men, and 5% of women in Ireland having one kidney stone in their lifetime.
Simple investigations and stone analysis can identify metabolic or structural factors that increase risk, allowing prompt treatment.
There are clinical characteristics that should prompt these investigations, and this often requires multi-disciplineary approach.

Methods

EAU+ AUA recommend in depth metabolic screening for patients with these features:
Young age
Multiple or bilateral stones.
Recurrent stone formers
Structural kidney abnormalities
Metabolic Co-morbidities that increase risk,
Certain Stone Compositions

We performed a retrospective analysis of patients admitted with stone disease between July 2022 and Feb 2023. We collected data on;
Patient demographics
Treatment choice
First stone vs recurrent
Testing of basic biochemistry
Presence of Risk factors as above.

Results

We analysed 214 unique patient identifiers
This consisted of 129 males and 85 female. Average number of stone episodes per month was 30.57.
Mean age of patients was 50.25, with 19 patients under the age of 30yrs ( 9%). Age range 20-95yrs old.

Patient presentation to our service was emergency in 158/214 (74%), 21 were elective admissions (10%), and emergency transfers from secondary hospitals consisted of 35/214 patients (16%).

Inpatient admission with Medical Expulsive Therapy (MET) consisted of 15 of 214 patients (7%)
7 Patients were discharged home with MET (3%)
15 were admitted for ureteric stent placement alone(7%)
177 of the 214 patients were brought for ureteroscopy (83%)

Looking at features as mentioned above that warrant screening, we note this of our population:
25% had recurrent or bilateral stones
9% had stone compositions that were high risk for recurrence
3% had co-morbidities that increase risk of recurrence as detailed above
9% under the age of 30yrs, and 28% under the age of 40.
5.6% had existent structural abnormalities.

Conclusion

There are a large proportion of patients that are at high risk of recurrence and thus a systematic and comprehensive approach is required to identify and investigate these patients. By proactively addressing this gap in patient care, we can enhance patient outcomes, reduce the burden of recurrent renal stones on healthcare systems, and ultimately improve the quality of life for individuals affected by this condition.