Profile of the Ammonium Acid Urate Stone Former Based on a Large Contemporary Cohort

Derek J. Lomas, Christopher D. Jaeger, Amy Krambeck

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate and profile ammonium acid urate (AAU) stone formers utilizing a large contemporary cohort. Materials and Methods: A retrospective review of all patients with documented AAU urolithiasis on stone analysis was performed from 1995 to 2013. A stone was considered AAU if it contained at least 10% of the total composition on stone analysis. Results: Of 12,421 stones, a total of 111 AAU stones were identified in 89 patients. Seventy-two patients (81%) had mixed composition stones. Of the 89 AAU patients, 10 (11%) had chronic kidney disease, 12 (13%) had recurrent urinary tract infections, 8 (9%) had diabetes mellitus, 25 (28%) had a history of ileostomy or bowel resection, and 11 (12%) had significant diarrhea or inflammatory bowel disease. Additionally, 20 (22%) had prior prostate surgery with bladder neck contracture and 8 (9%) were managed with a chronic indwelling catheter. Surgical intervention was required in 74 patients (83%). At the median follow-up of 4.9 years, 19 patients (21%) had stone recurrence with a median time to recurrence of 22 months (interquartile range: 10.5-42.0). Conclusion: AAU stones are rare. In addition to previously described risk factors for AAU stone formation, patients with prior prostate surgery and bladder neck contracture or a surgically altered bladder may be at increased risk for formation. Furthermore, the long-term follow-up provided by this large AAU cohort demonstrates a significant risk for stone recurrence.

Original languageEnglish (US)
JournalUrology
DOIs
StateAccepted/In press - Jun 8 2016
Externally publishedYes

Fingerprint

Uric Acid
Urinary Bladder
Contracture
Recurrence
Prostate
Ileostomy
Indwelling Catheters
Urolithiasis
Chronic Renal Insufficiency
Inflammatory Bowel Diseases
Urinary Tract Infections
Diarrhea
Diabetes Mellitus

ASJC Scopus subject areas

  • Urology

Cite this

Profile of the Ammonium Acid Urate Stone Former Based on a Large Contemporary Cohort. / Lomas, Derek J.; Jaeger, Christopher D.; Krambeck, Amy.

In: Urology, 08.06.2016.

Research output: Contribution to journalArticle

@article{81a5efe81b064431993aa0d9468e3ae7,
title = "Profile of the Ammonium Acid Urate Stone Former Based on a Large Contemporary Cohort",
abstract = "Objective: To evaluate and profile ammonium acid urate (AAU) stone formers utilizing a large contemporary cohort. Materials and Methods: A retrospective review of all patients with documented AAU urolithiasis on stone analysis was performed from 1995 to 2013. A stone was considered AAU if it contained at least 10{\%} of the total composition on stone analysis. Results: Of 12,421 stones, a total of 111 AAU stones were identified in 89 patients. Seventy-two patients (81{\%}) had mixed composition stones. Of the 89 AAU patients, 10 (11{\%}) had chronic kidney disease, 12 (13{\%}) had recurrent urinary tract infections, 8 (9{\%}) had diabetes mellitus, 25 (28{\%}) had a history of ileostomy or bowel resection, and 11 (12{\%}) had significant diarrhea or inflammatory bowel disease. Additionally, 20 (22{\%}) had prior prostate surgery with bladder neck contracture and 8 (9{\%}) were managed with a chronic indwelling catheter. Surgical intervention was required in 74 patients (83{\%}). At the median follow-up of 4.9 years, 19 patients (21{\%}) had stone recurrence with a median time to recurrence of 22 months (interquartile range: 10.5-42.0). Conclusion: AAU stones are rare. In addition to previously described risk factors for AAU stone formation, patients with prior prostate surgery and bladder neck contracture or a surgically altered bladder may be at increased risk for formation. Furthermore, the long-term follow-up provided by this large AAU cohort demonstrates a significant risk for stone recurrence.",
author = "Lomas, {Derek J.} and Jaeger, {Christopher D.} and Amy Krambeck",
year = "2016",
month = "6",
day = "8",
doi = "10.1016/j.urology.2016.10.027",
language = "English (US)",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Profile of the Ammonium Acid Urate Stone Former Based on a Large Contemporary Cohort

AU - Lomas, Derek J.

AU - Jaeger, Christopher D.

AU - Krambeck, Amy

PY - 2016/6/8

Y1 - 2016/6/8

N2 - Objective: To evaluate and profile ammonium acid urate (AAU) stone formers utilizing a large contemporary cohort. Materials and Methods: A retrospective review of all patients with documented AAU urolithiasis on stone analysis was performed from 1995 to 2013. A stone was considered AAU if it contained at least 10% of the total composition on stone analysis. Results: Of 12,421 stones, a total of 111 AAU stones were identified in 89 patients. Seventy-two patients (81%) had mixed composition stones. Of the 89 AAU patients, 10 (11%) had chronic kidney disease, 12 (13%) had recurrent urinary tract infections, 8 (9%) had diabetes mellitus, 25 (28%) had a history of ileostomy or bowel resection, and 11 (12%) had significant diarrhea or inflammatory bowel disease. Additionally, 20 (22%) had prior prostate surgery with bladder neck contracture and 8 (9%) were managed with a chronic indwelling catheter. Surgical intervention was required in 74 patients (83%). At the median follow-up of 4.9 years, 19 patients (21%) had stone recurrence with a median time to recurrence of 22 months (interquartile range: 10.5-42.0). Conclusion: AAU stones are rare. In addition to previously described risk factors for AAU stone formation, patients with prior prostate surgery and bladder neck contracture or a surgically altered bladder may be at increased risk for formation. Furthermore, the long-term follow-up provided by this large AAU cohort demonstrates a significant risk for stone recurrence.

AB - Objective: To evaluate and profile ammonium acid urate (AAU) stone formers utilizing a large contemporary cohort. Materials and Methods: A retrospective review of all patients with documented AAU urolithiasis on stone analysis was performed from 1995 to 2013. A stone was considered AAU if it contained at least 10% of the total composition on stone analysis. Results: Of 12,421 stones, a total of 111 AAU stones were identified in 89 patients. Seventy-two patients (81%) had mixed composition stones. Of the 89 AAU patients, 10 (11%) had chronic kidney disease, 12 (13%) had recurrent urinary tract infections, 8 (9%) had diabetes mellitus, 25 (28%) had a history of ileostomy or bowel resection, and 11 (12%) had significant diarrhea or inflammatory bowel disease. Additionally, 20 (22%) had prior prostate surgery with bladder neck contracture and 8 (9%) were managed with a chronic indwelling catheter. Surgical intervention was required in 74 patients (83%). At the median follow-up of 4.9 years, 19 patients (21%) had stone recurrence with a median time to recurrence of 22 months (interquartile range: 10.5-42.0). Conclusion: AAU stones are rare. In addition to previously described risk factors for AAU stone formation, patients with prior prostate surgery and bladder neck contracture or a surgically altered bladder may be at increased risk for formation. Furthermore, the long-term follow-up provided by this large AAU cohort demonstrates a significant risk for stone recurrence.

UR - http://www.scopus.com/inward/record.url?scp=85006791276&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85006791276&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2016.10.027

DO - 10.1016/j.urology.2016.10.027

M3 - Article

C2 - 27789299

AN - SCOPUS:85006791276

JO - Urology

JF - Urology

SN - 0090-4295

ER -