Mp10-07 24-hour urine correlates to increasing stone burden in cystinuric patients

You have accessJournal of UrologyCME1 Apr 2023MP10-07 24-HOUR URINE CORRELATES TO INCREASING STONE BURDEN IN CYSTINURIC PATIENTS Ukrit Rompsaithong, Heiko Yang, Wilson Sui, Rei Unno, David Bayne, Justin Ahn, Marshall Stoller, and Thomas Chi Ukrit RompsaithongUkrit Rompsaithong More articles by this author , Heiko YangHeiko Yang More articles by this author , Wilson SuiWilson Sui More articles by this author , Rei UnnoRei Unno More articles by this author , David BayneDavid Bayne More articles by this author , Justin AhnJustin Ahn More articles by this author , Marshall StollerMarshall Stoller More articles by this author , and Thomas ChiThomas Chi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003225.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stone growth and recurrence in cystinuric patients is a challenging issue to manage. Controlling 24-hour urine parameters may be the key to preventing kidney stone formation in this population. This study aimed to determine the association between 24-hour urine and stone burden in cystinuric patients. METHODS: We conducted a retrospective study on consecutive patients diagnosed with cystinuria from the Registry for Stones of the Kidney and Ureter (ReSKU) between 2017 and 2022. Patients were classified as having either stable or increased stone burden during clinic visits. An increasing stone burden was defined as an increasing stone number or growth ≥ 3 mm from prior imaging. 24-hour urine specimens were collected every 4-6 months. Clinical characteristics, stone-related symptoms and surgeries, and the average of the 24-hour urine parameters from all visits were compared between the two groups. We performed a longitudinal analysis using the generalized estimating equation to determine the marginal model for the 24-hour urine and increasing stone burden at each visit. The chi-square goodness-of-fit test was applied to evaluate the model. RESULTS: There were 20 patients in the increased stone burden and 24 in the stable group. The median initial stone burden in the increased and stable groups was 13 and 4.5 mm, respectively. Fifty symptomatic stone events were observed in the increased burden group and 16 for the stable group (p=0.014). There were 28 surgical events in the increased burden group and 5 in the stable group (p=0.007). We did not detect a significant difference in the average 24-hour cystine capacity between the two groups (p=0.053). However, in longitudinal analysis, the marginal model demonstrated that urine citrate ≤ 500 mg/d (OR 5.57, 95% CI 2.47–12.53) and a negative value of cystine capacity (OR 4.70, 95% CI 1.48–14.91) were significantly correlated with increasing stone burden at each visit (Table 1). CONCLUSIONS: In cystinuric patients, the 24-hour urine citrate and cystine capacity were highly associated with an increasing stone burden. In addition to general stone prevention advice, maintaining the values of these parameters within the normal range may be important to prevent the formation of kidney stones in this population. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e116 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ukrit Rompsaithong More articles by this author Heiko Yang More articles by this author Wilson Sui More articles by this author Rei Unno More articles by this author David Bayne More articles by this author Justin Ahn More articles by this author Marshall Stoller More articles by this author Thomas Chi More articles by this author Expand All Advertisement PDF downloadLoading ...