Endoscopic observations as a tool to define underlying pathology in kidney stone formers

Maria Sloth Pless, James Williams, Kim Hovgaard Andreassen, Helene Ulrich Jung, Susanne Sloth Osther, Dorte Ravnsmed Christensen, Palle Jörn Sloth Osther

Research output: Contribution to journalArticle

Abstract

Purpose: Advancements in endoscopy offer the possibility of inspection of intrarenal anatomy and pathology. The aim of the study was to evaluate renal papillary appearance in kidney stone formers and to correlate papillary findings with stone type and patient metabolic data. Materials and methods: A consecutive cohort of 46 kidney stone formers undergoing retrograde intrarenal surgery was enrolled. During surgery, renal papillae were characterized in the domains of ductal Plugging (DP), surface Pitting, Loss of papillary contour, and Amount of Randall’s plaque (RP, PPLA scoring). Stone material was analyzed using micro-CT and infrared spectroscopy, and blood and urine were collected for metabolic evaluation. Results: In all patients, renal papillae had changes in at least one of the domains of the PPLA score. Examining the total population, it was evident that patients with predominantly plugging (DP > 0) all had very low RP scores. There were no significant trends between mean PPLA scores and urinary analytes for the total group. Conclusion: Efforts to prevent renal stone formation have so far been insufficient in majority of patients. Digital endoscopy reveals that kidney stone formers have different and distinct papillary morphologies that seem to be linked to specific stone-forming pathways. Since renal papillary abnormalities may be easily identified during endoscopy, this may in the future prove to be an important method for tailoring prevention strategies in kidney stone patients.

Original languageEnglish (US)
JournalWorld Journal of Urology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Kidney Calculi
Pathology
Kidney
Endoscopy
Spectrum Analysis
Anatomy
Urine
Population

Keywords

  • Kidney calculi
  • Micro-computerized tomography
  • Papillae
  • Pathology
  • Randall’s plaque
  • Ureterorenoscopy

ASJC Scopus subject areas

  • Urology

Cite this

Pless, M. S., Williams, J., Andreassen, K. H., Jung, H. U., Osther, S. S., Christensen, D. R., & Osther, P. J. S. (Accepted/In press). Endoscopic observations as a tool to define underlying pathology in kidney stone formers. World Journal of Urology. https://doi.org/10.1007/s00345-018-02616-3

Endoscopic observations as a tool to define underlying pathology in kidney stone formers. / Pless, Maria Sloth; Williams, James; Andreassen, Kim Hovgaard; Jung, Helene Ulrich; Osther, Susanne Sloth; Christensen, Dorte Ravnsmed; Osther, Palle Jörn Sloth.

In: World Journal of Urology, 01.01.2019.

Research output: Contribution to journalArticle

Pless, Maria Sloth ; Williams, James ; Andreassen, Kim Hovgaard ; Jung, Helene Ulrich ; Osther, Susanne Sloth ; Christensen, Dorte Ravnsmed ; Osther, Palle Jörn Sloth. / Endoscopic observations as a tool to define underlying pathology in kidney stone formers. In: World Journal of Urology. 2019.
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