Abstract
One hundred consecutive patients referred for active stone removal responded to a number of questions regarding their attitude to metabolic risk evaluation and recurrence prevention. Of the 74 men and 26 women all but one were interested in the cause of their disease. While 95% of the patients were motivated to change their dietary habits, only 71% were interested in pharmacological treatment. Collection of 24-h urine for risk evaluation in one or five fractions was acceptable to 94 and 84% of the patients, respectively. Only 79% wanted to collect urine during more than one 24-h period. Given the option of a recurrence prevention programme or active stone removal when or if a stone appeared, approximately half of our patients (52%) chose the first, and about one-third (29%) of them chose the second alternative, whereas as many as 19% of the patients did not express any opinion. A programme for regular follow-up in order to detect new stones early was appreciated by only 81 patients. These results show that biochemical risk evaluation and recurrence prevention is generally met with a positive attitude by most patients and that medical recurrence prevention appears to be appreciated by more than half of the patients.
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References
Ahlstrand C, Tiselius HG (1990) Recurrences during a 10-year follow-up after first renal stone episode. Urol Res 18:397–399
Tiselius HG (2000) Stone incidence and prevention. Braz J Urol 26:453–462
Trinchieri A, Ostini F, Nespoli R, Revera F, Montanari E, Zanetti G (1999) A prospective study of recurrence rate and risk factors for recurrence after first renal stone. J Urol 162:27–30
Strohmaier WL (2004) Course of renal stone disease—an epidemiological view. In: Gohel MDI, Wt Au D (eds) Kidney stones: inside and out. Proceedings of the 10th international symposium on urolithiasis. The Hong Kong Polytechnic University, Hong Kong (MDI Gohel), pp 377–385
Robertson WG, Peacock M, Nordin BEC (1968) Activity products in stone-forming and non-stone forming urine. Clin Sci 34:579–594
Finlayson B (1974) Renal lithiasis in review. Urol Clin North Am 1:181–211
Nancollas GH (1976) The kinetics of crystal growth and renal stoneformation. In: Fleisch H, Robertson WG, Smith LH, Vahlensieck W (eds) Urolithiasis research. Plenum, New York, pp 5–23
Smith LH (1989) Medical aspects of urolithiasis: overview. J Urol 141:707–710
Baumann M (1990) Physico-chemical aspects of calcium stone formation. Urol Res 18:25–30
Hess B, Tiselius HG (2002) Physical–chemical processes in kidney stone formation. In: Coe FL, Favus MJ (eds) Disorders of bone and mineral metabolism (2 edn) Williams & Wilkins, Lippincott, pp 619–628
Tiselius HG (2000) Comprehensive metabolic evaluation of stone formers is cost effective. In: Rodgers AL, Hibbert BE, Hess B, Khan SR, Preminger G (eds) Urolithiasis 2000. Proceedings of the 9th international symposium on urolithiasis. University of Cape Town, Cape Town, pp 349–355
Tiselius HG (2004) Routine metabolic evaluation of patients with stone disease—aspects on its cost effectiveness. In: Gohel MDI, Wt Au D (eds) Kidney stones: inside and out. Proceedings of the 10th international symposium on urolithiasis, The Hong Kong Polytechnic University, Hong Kong, (MDI Gohel), pp 372–376
Tiselius HG, Advisory Board of European Urolithiasis Research EAU Health Care Office Working Party for Urolithiasis (2001) Possibilities for preventing recurrent calcium stone formation: principles for the metabolic evaluation of patients with calcium stone disease. BJU Int 88:1–16
Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Callucci M (2001) Guidelines on urolithiasis. (Abbreviated version). Eur Urol 40:362–371
Jendle-Bengten C, Tiselius HG (2000) Long-term follow-up of stone formers treated with a low dose of sodium potassium citrate. Scand J Urol Nephrol 34:36–41
Hess B, Mauron H, Ackermann D, Jaeger Ph (1999) Effects of a “common sense diet” on urinary composition and supersaturation in patients with idiopathic calcium urolithiasis. Eur Urol 1999 36:136–143
Pattras JG, Moore RG (1999) Citrate in the management of urolithiasis. J Endourol 13:687–691
Ettinger B, Pak CYC, Citron JT, Thomas C, Adams-Huet B, Vangessel A (1997) Potassium–magnesium citrate is an effective prophylaxis against recurrent calcium oxalate nephrolithiasis. J Urol 158:2069–2073
Lee YH, Huang WC, Tsai JY, Hung JK (1999) The efficacy of potassium citrate based medical prophylaxis for preventing upper urinary tract calculi: a midterm follow-up study. J Urol 161:1453–1457
Hofbauer J, Höbarth K, Szabo N, Marberger M (1994) Alkali citrate prophylaxis in idiopathic recurrent calcium oxalate nephrolithiasis—a prospective randomized study. Br J Urol 73:362–365
Hess B, Hasler-Strub U, Ackermann D, Jaeger Ph (1997) Metabolic evaluation of patients with recurrent idiopathic calcium nephrolithiasis. Nephrol Dial Transplant 12:1362–1368
Höbarth K, Hofbauer J, Szabo N (1994) Value of repeated analyses of 24-hour urine in recurrent calcium urolithiasis. Urology 44:20–25
Tiselius HG (1994) Investigation of single and recurrent stone formers. Miner Electrolyte Metab 20:321–327
Bek-Jensen H, Tiselius HG (1998) Repeated urine analysis in patients with calcium stone disease. Eur Urol 33:323–332
Tiselius HG (1997) Metabolic evaluation of patients with stone disease. Urol Int 59:131–141
Parks JH, Goldfisher E, Asplin JR, Coe FL (2002) A single 24-hour urine collection is inadequate for the medical evaluation of nephrolithiasis. J Urol 167:1607–1612
Grampsas SA, Moore M, Chandhoke PS (2000) 10-year experience with extracorporeal shockwave lithotripsy in the state of Colorado. J Endourol 14:711–714
Laerum E (1984) Recurrent urolithiasis: a general-practice study of risk factors and clinical consequences. Scand J Urol Nephrol 18:67–70
Ettinger B, Citron JT, Livermore B, Dolman LI (1988) Chlorthiazide reduces calcium oxalate calculus recurrences but magnesium hydroxide does not. J Urol 139:679–684
Ohkawa M, Tokunaga S, Nakashima T, Orito M, Hisazumi H (1992) Thiazide treatment for calcium urolithiasis in patients with idiopathic hypercalciuria. Br J Urol 69:571–576
Borghi L, Meschi T, Guerra A, Novanni A (1993) Randomized prospective study of a nonthiazide diuretic, indapamide, in preventing calcium stone recurrences. J Cardiovasc Pharmacol 22(suppl 6):78–86
Ahlstrand C, Sandwall K, Tiselius HG (1996) Prophylactic treatment of calcium stone formers with hydrochlorothiazide and magnesium. In: Tiselius HG (eds) Renal stones—aspects on their formation, removal and prevention. Proceedings of the Sixth European Symposium on Urolithiasis 1995. Akademitryck AB, Edsbruk, pp 195–197
Barcelo P, Wuhl O, Servitge E, Rousaud A, Pak CYC (1993) Randomized double-blind study of potassium citrate in idiopathic hypocitraturic calcium nephrolithiasis. J Urol 150:1761–1764
Tuncel A, Biri H, Küpeli B, Tan Ö, Sen I (2003) Efficiency of long-term potassium citrate treatment in patients with calcium oxalate stone disease. In: Sarica K, Kyagci F, Erbagci A, Inal Y (eds) Proceedings of the 2nd Eurolithiasis Society Meeting. Abstract. ReTa offset publishing, Gaziantep, p 273
Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Gallucci M, Knoll T (2006) Guidelines on Urolithiasis. European Association of Urology (EAU Guidelines office)
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The assistance by Monica Bollvik, Marita Fredriksson, Elsie-Marie Jonason and Kristina Sjöström in completing this study is highly appreciated.
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Tiselius, HG. Patients’ attitudes on how to deal with the risk of future stone recurrences. Urol Res 34, 255–260 (2006). https://doi.org/10.1007/s00240-006-0056-2
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DOI: https://doi.org/10.1007/s00240-006-0056-2