Changes in renal papillary density after hydration therapy in calcium stone formers

Pietro Manuel Ferraro, Matteo Vittori, Giuseppe Macis, Alessandro D'Addessi, Gianmarco Lombardi, Claudia Palmisano, Jacopo Gervasoni, Aniello Primiano, Pierfrancesco Bassi, Giovanni Gambaro

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Previous studies have shown that, compared with non-stone formers, stone formers have a higher papillary density measured with computer tomography (CT) scan. The effect of increased hydration on such papillary density in idiopathic calcium stone formers is not known. METHODS: Patients with recurrent calcium oxalate stones undergoing endourological procedures for renal stones at our Institution from June 2013 to June 2014 were considered eligible for enrolment. Enrolled patients underwent a baseline unenhanced CT scan before the urological procedure; after endoscopic removal of their stones, the patients were instructed to drink at least 2 L/day of a hypotonic, oligomineral water low in sodium and minerals (fixed residue at 180 °C < 200 mg/L) for at least 12 months. Finally, the patients underwent a follow-up unenhanced CT scan during hydration regimen. RESULTS: Twenty-five patients were prospectively enrolled and underwent baseline and follow-up CT scans. At baseline, mean papillary density was 43.2 ± 6.6 Hounsfield Units (HU) (43.2 ± 6.7 for the left kidney and 42.8 ± 7.1 HU for the right kidney). At follow-up and after at least 12 months of hydration regimen, mean papillary density was significantly reduced at 35.4 ± 4.2 HU (35.8 ± 5.0 for the left kidney and 35.1 ± 4.2 HU for the right kidney); the mean difference between baseline and follow-up was - 7.8 HU (95% confidence interval - 10.6 to - 5.1 HU, p < 0.001). CONCLUSIONS: Increased fluid intake in patients with recurrent calcium oxalate stones was associated with a significant reduction in renal papillary density. TRIAL REGISTRATION: NCT03343743 , 15/11/2017 (Retrospectively registered).

Original languageEnglish
Number of pages1
JournalBMC Urology
Volume18
Issue number1
DOIs
Publication statusPublished - Nov 12 2018

Keywords

  • CT scan
  • Hydration therapy
  • Kidney stones
  • Randall’s plaque

ASJC Scopus subject areas

  • Reproductive Medicine
  • Urology

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    Ferraro, P. M., Vittori, M., Macis, G., D'Addessi, A., Lombardi, G., Palmisano, C., Gervasoni, J., Primiano, A., Bassi, P., & Gambaro, G. (2018). Changes in renal papillary density after hydration therapy in calcium stone formers. BMC Urology, 18(1). https://doi.org/10.1186/s12894-018-0415-7