Abstract
Objectives
Extracorporeal shock wave lithotripsy (ESWL) is a popular treatment for nephrolithiasis.
We took advantage of noncontrast abdominal computed tomography (NCCT) to search the
possible prognostic factors including abdominal fat distribution influencing stone-free
rate.
Methods
From August 2008 to August 2010, 145 patients who had renal calculus and had undergone
ESWL were retrospectively reviewed. All of them received NCCT assessment before ESWL
and were followed up after 1 month for stone clearance. These patients were divided
into two groups: one was the stone-free group and the other was the residual-stone
group. Affecting parameters included stone size, location, stone surface area, Hounsfield
unit density (HU density), skin-to-stone distance (SSD), and abdominal fat area as
analyzed between these two groups.
Results
Of 145 patients, 70 were stone-free and 75 had residual stone after ESWL treatment
and 1-month follow-up. From univariate analysis, stone size, HU density, SSD, and
stone surface area were significant predicting factors for ESWL success. On multivariate
analysis, the important factors influencing ESWL outcomes were HU density and stone
surface area (odds ratio 1.002 vs. 77.18, respectively; P<.05). Abdominal fat accumulation and distribution had no significant difference between
these two groups.
Conclusion
This study revealed that stone size, HU density, SSD, and stone surface area were
associated with stone-free rate after ESWL treatment. Therefore, these factors could
be used to assess the feasibility of ESWL before deciding the treatment strategy.
Abdominal fat distribution had no significant impact on ESWL outcome for renal stones.
Keywords
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References
- Temporal trends in the incidence of kidney stone disease.Kidney Int. 2013; 83: 146-152
- Epidemiology of upper urinary tract stone disease in a Taiwanese population: a nationwide, population based study.J Urol. 2013; 189: 2158-2163
- Epidemiology of stone disease.Urol Clin North Am. 2007; 34: 287-293
- Increase inthe prevalence of symptomatic upper urinary tract stones during the last ten years.Eur Urol. 2000; 37: 23-25
- Evaluation of intrarenal blood flow by Doppler ultrasonography immediately after extracorporeal shock wave lithotripsy on hydronephrotic kidney.Kaohsiung J Med Sci. 2005; 21: 412-417
- Percutaneous nephrostomy for removal of large impacted upper ureteral stones.Kaohsiung J Med Sci. 2007; 23: 412-416
- Perirenal hematomas induced by extracorporeal shock wave lithotripsy (ESWL). Therapeutic management.ScientificWorldJournal. 2007; 7: 1563-1566
- Stone attenuation and skin-to-stone distance on computed tomography predicts for stone fragmentation by shock wave lithotripsy.Urology. 2008; 72: 765-769
- Two-year experience with ureteral stones: extracorporeal shockwave lithotripsy v ureteroscopic manipulation.J Endourol. 1998; 12: 501-504
- Outcomes of shockwave lithotripsy for upper urinary-tract stones: a large-scale study at a single institution.J Endourol. 2005; 19: 768-773
- Extracorporeal shockwave lithotripsy of 2000 urinary calculi with the modulith SL-20: success and failure according to size and location of stones.J Endourol. 2000; 14: 239-246
- Five-year clinical experience with the Dornier Delta lithotriptor.Urology. 2006; 68: 28-32
- Lower pole I: a prospective randomized trial of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis-initial results.J Urol. 2001; 166: 2072-2080
- Shock wave lithotripsy at 60 or 120 shocks per minute: a randomized, double-blind trial.J Urol. 2005; 174: 595-599
- Predictive factors of the outcome of extracorporeal shockwave lithotripsy for ureteral stones.Korean J Urol. 2012; 53: 424-430
- Analysis of stone fragility in vitro and in vivo with piezoelectric shock waves using the EDAP LT-01.J Urol. 1993; 149: 699-702
- Stone fragility–a new therapeutic distinction.J Urol. 1988; 139: 1124-1127
- Guidelines on urolithiasis.Eur Urol. 2001; 40: 362-371
- The association of increasing body mass index and kidney stone disease.J Urol. 2010; 183: 571-575
- A novel technique for the determination of body fat by computed tomography.Int J Obes. 1983; 7: 437-445
- Abdominal fat: standardized technique for measurement at CT.Radiology. 1999; 211: 283-286
- Accuracy of detection and measurement of renal calculi: in vitro comparison of three-dimensional spiral CT, radiography, and nephrotomography.Radiology. 1997; 204: 19-25
- Abdominal fat distribution on computed tomography predicts ureteric calculus fragmentation by shock wave lithotripsy.Eur Radiol. 2012; 22: 1624-1630
- Extracorporeal shock wave lithotripsy success based on body mass index and Hounsfield units.Urology. 2005; 65: 33-36
- Can the degree of hydronephrosis on ultrasound predict kidney stone size?.Am J Emerg Med. 2010; 28: 813-816
- Evaluating the importance of mean stone density and skin-to-stone distance in predicting successful shock wave lithotripsy of renal and ureteric calculi.Urol Res. 2010; 38: 307-313
- Stone attenuation value and cross-sectional area on computed tomography predict the success of shock wave lithotripsy.Korean J Urol. 2013; 54: 454-459
- Pelvicalyceal stone load: a factor affecting the outcome of extracorporeal shockwave lithotripsy for renal pelvic calculi.BJU Int. 2001; 88: 854-857
- Calcium stone fragility is predicted by helical CT attenuation values.J Endourol. 2000; 14: 471-474
- Stone measurement by volumetric three-dimensional computed tomography for predicting the outcome after extracorporeal shock wave lithotripsy.BJU Int. 2009; 103: 524-528
- Staghorn calculi: analysis of treatment results between initial percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy monotherapy with reference to surface area.J Urol. 1992; 147: 1219-1225
- Is measurement of stone surface area necessary for SWL treatment of nonstaghorn calculi?.J Endourol. 2002; 16: 215-220
- Prediction of success rate after extracorporeal shock-wave lithotripsy of renal stones — a multivariate analysis model.Scand J Urol Nephrol. 2004; 38: 161-167
- Infundibulopelvic anatomy and clearance of inferior caliceal calculi with shock wave lithotripsy.J Urol. 2000; 163: 24-27
- Impact of lower pole anatomy on stone clearance after shock wave lithotripsy.Kaohsiung J Med Sci. 2005; 21: 358-364
- SWL in lower calyceal calculi: evaluation of the treatment results in children and adults.Urology. 2011; 78: 1402-1406
- Determination of urinary stone composition using dual-energy spectral CT: initial in vitro analysis.Clin Radiol. 2013; 68: e370-e377
- 5-Year-follow-up of patients with clinically insignificant residual fragments after extracorporeal shockwave lithotripsy.Eur Urol. 2005; 47: 860-864
Article info
Publication history
Published online: April 25, 2015
Accepted:
April 17,
2015
Received in revised form:
March 26,
2015
Received:
December 20,
2014
Footnotes
☆Conflict of interest: The authors declare that they have no conflict of interest.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
