Obesity: a Delicate Issue Choosing the Eswl Treatment for Patients with Kidney and Ureteral Stones?
| Autor: | George Daniel Radavoi, Viorel Jinga, C. Pricop, D Puia, C Vechiu |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Waist Endocrine and Autonomic Systems business.industry Endocrinology Diabetes and Metabolism medicine.medical_treatment Incidence (epidemiology) 030232 urology & nephrology Urology Context (language use) Overweight Lithotripsy medicine.disease Obesity Notes & Comments 03 medical and health sciences 0302 clinical medicine Endocrinology Ureter medicine.anatomical_structure 030220 oncology & carcinogenesis medicine medicine.symptom business Calculus (medicine) |
| Zdroj: | Acta Endocrinologica (Bucharest). 15:133-138 |
| ISSN: | 1843-066X 1841-0987 |
| DOI: | 10.4183/aeb.2019.133 |
| Popis: | CONTEXT: Urolithiasis and obesity are now public health problems with an increased incidence worldwide. Management of urolithiasis in patients with morbid obesity is usually associated with higher morbidity and mortality compared to non-obese patients. ESWL is a nonsurgical procedure for the treatment of lithiasis. In obese patients the ESWL efficacy is influenced by the skin-to-stone distance or poorer detection of the calculus because of the fatty tissue. OBJECTIVE: To highlight the overweight or obese lithiasic patient profile that could be best treated by ESWL. SUBJECTS AND METHODS: We evaluated ESWL results in 1393 patients with kidney or ureteral stones between 5 and 20 mm. They were divided into 4 groups according to the BMI: Group A-overweight (BMI=25-30 kg/m(2)); Group B-grade I obesity (BMI=30-35 kg/m(2)); Group C-grade II obesity (BMI=35-40 kg/m(2)) and a control group of normal weight (BMI=18-25 kg/m(2)). RESULTS: Patients with a higher BMI required a greater number of ESWL sessions. A statistically significant greater number of patients with a waist circumference of >102 cm required more than 2 SWL sessions (p=0.007). Location of the stones in the pelvic ureter had the highest rate of success for obese patients (p=0.00001). The ESWL success rate in overweight and obese patients can be negatively influenced by BMI, abdominal circumference over 102 cm, and hardness of calculi reflected in the radiopacity on KUB. CONCLUSIONS: In patients with grade II obesity, pyelocaliceal calculus and increased hardness, other urological alternatives to lithiasis should be considered from the beginning. |
| Databáze: | OpenAIRE |
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