Analysis of Nephrolithiasis Treatment in Highest Reference Hospital-Occurrence of Acromegaly in the Study Group.

Autor: Ząbkowski T; Department of Urology, Military Institute of Medicine-National Research Institute, 02-637 Warsaw, Poland., Durma AD; Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine-National Research Institute, 02-637 Warsaw, Poland., Grabińska A; Department of Urology, Military Institute of Medicine-National Research Institute, 02-637 Warsaw, Poland., Michalczyk Ł; Urology Department, District Hospital, 26-900 Kozienice, Poland., Saracyn M; Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine-National Research Institute, 02-637 Warsaw, Poland.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Jun 06; Vol. 12 (12). Date of Electronic Publication: 2023 Jun 06.
DOI: 10.3390/jcm12123879
Abstrakt: Background: Urolithiasis is one of the most common diseases of the urinary system, the incidence of which is assumed to be up to 100,000 cases per million (10% of the population). The cause of it is dysregulation of renal urine excretion. Acromegaly is a very rare endocrine disorder that causes a somatotropic pituitary adenoma producing higher amounts of growth hormone. It occurs approximately in 80 cases per million (about 0.008% of the population). One of the acromegaly complications may be urolithiasis.
Methods: Clinical and laboratory results of 2289 patients hospitalized for nephrolithiasis in the highest reference hospital were retrospectively analyzed, distinguishing a subgroup of patients with acromegaly. Statistical analysis was performed to compare the prevalence of the disease in the analyzed subgroup with the epidemiological results available in up-to-date literature.
Results: The distribution of nephrolithiasis treatment was definitely in favor of non-invasive and minimally invasive treatment. The methods used were as follows: ESWL (61.82%), USRL (30.62%), RIRS (4.15%), PCNL (3.1%), and pyelolithotomy (0.31%). Such a distribution limited the potential complications of the procedures while maintaining the high effectiveness of the treatment. Among two thousand two hundred and eighty-nine patients with urolithiasis, two were diagnosed with acromegaly before the nephrological and urological treatment, and seven were diagnosed de novo. Patients with acromegaly required a higher percentage of open surgeries (including nephrectomy) and also had a higher rate of kidney stones recurrence. The concentration of IGF-1 in patients with newly diagnosed acromegaly was similar to those treated with somatostatin analogs (SSA) due to incomplete transsphenoidal pituitary surgery.
Conclusions: In the population of patients with urolithiasis requiring hospitalization and interventional treatment compared to the general population, the prevalence of acromegaly was almost 50-fold higher ( p = 0.025). Acromegaly itself increases the risk of urolithiasis.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje