The role of the general practictioner in the management of urinary calculi
https://doi.org/10.4081/aiua.2023.12155
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Background: The prevalence of kidney stones tends to increase worldwide due to dietary and climate changes. Disease management involves a high consumption of healthcare system resources which can be reduced with primary prevention measures and prophylaxis of recurrences. In this field, collaboration between general practitioners (GPs) and hospitals is crucial. Methods: a panel composed of general practitioners and academic and hospital clinicians expert in the treatment of urinary stones met with the aim of identifying the activities that require the participation of the GP in the management process of the kidney stone patient. Results: Collaboration between GP and hospital was found crucial in the treatment of renal colic and its infectious complications, expulsive treatment of ureteral stones, chemolysis of uric acid stones, long-term follow-up after active treatment of urinary stones, prevention of recurrence and primary prevention in the general population. Conclusions: The role of the GP is crucial in the management and prevention of urinary stones. Community hospitals which are normally led by GPs in liaison with consultants and other health professional can have a role in assisting multidisciplinary working as extended primary care.
Whitehurst L, Jones P, Somani BK. Mortality from kidney stone disease (KSD) as reported in the literature over the last two decades: a systematic review. World J Urol. 2019; 37:759-776. DOI: https://doi.org/10.1007/s00345-018-2424-2
Trinchieri A. Epidemiological trends in urolithiasis: impact on our health
care systems. Urol Res. 2006; 34:151-6. DOI: https://doi.org/10.1007/s00240-005-0029-x
Prentiss RJ, Mullenix RB, Whisenand JM. The management of ureteral stone; a guide for physicians in general practice. Calif Med. 1952; 77:7-11.
Scott R. Prevalence of calcified upper urinary tract stone disease in a random population survey. Report of a combined study of general practitioners and hospital staff. Br J Urol. 1987; 59:111-7. DOI: https://doi.org/10.1111/j.1464-410X.1987.tb04799.x
Macneil F, Bariol S. Urinary stone disease - assessment and management. Aust Fam Physician. 2011;40:772-5.
Abergel S, Peyronnet B, Seguin P, Bensalah K, Traxer O, Freund Y. Management of urinary stone disease in general practice: A French Delphi study. Eur J Gen Pract. 2016;22:103-10. DOI: https://doi.org/10.3109/13814788.2016.1149568
Cupisti A, Trinchieri A, Lombardi M, Agostini S, Arcidiacono T, Beltrami P, Berri E, Bevilacqua L, Campo S, Cannavò R, Croppi E, Casarrubea G, Caviglioli C, Crisci A, D'Addessi A, Sio M, Fantuzzi A, Fusaro M, Gambaro G, Garofalo M, Micali S, Marangella M, Petrarulo M, Piccinocchi G, Sessa A, Tasca A, Vezzoli G, Vitale C, Zattoni F; Gruppo di Studio Multidisciplinare per la Calcolosi Renale. Percorso diagnostico-terapeutico per il paziente con calcolosi renale: update 2020 [A diagnostic-therapeutic pathway for patients with kidney stone disease: 2020 update]. G Ital Nefrol. 2020; 37(Suppl 75):2020-S75
EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2023. ISBN 978-94-92671-19-6.
Borghi L, Ferretti PP, Elia GF, Amato F, Melloni E, Trapassi MR, Novarini A. Epidemiological study of urinary tract stones in a northern Italian city. Br J Urol. 1990; 65:231-5. DOI: https://doi.org/10.1111/j.1464-410X.1990.tb14716.x
Trinchieri A, Coppi F, Montanari E, Del Nero A, Zanetti G, Pisani E. Increase in the prevalence of symptomatic upper urinary tract stones during the last ten years. Eur Urol. 2000; 37:23-5. DOI: https://doi.org/10.1159/000020094
Serio A, Fraioli A. Epidemiology of nephrolithiasis. Nephron. 1999;81 Suppl 1:26-30. DOI: https://doi.org/10.1159/000046295
Cirillo M, Stellato D, Panarelli P, Laurenzi M, De Santo NG; Gubbio Study Research Group. Cross-sectional and prospective data on urinary calcium and urinary stone disease. Kidney Int. 2003; 63:2200-6. DOI: https://doi.org/10.1046/j.1523-1755.2003.t01-2-00003.x
Croppi E, Ferraro PM, Taddei L, Gambaro G; GEA Firenze Study Group. Prevalence of renal stones in an Italian urban population: a general practice-based study. Urol Res. 2012; 40:517-22. DOI: https://doi.org/10.1007/s00240-012-0477-z
Prezioso D, Illiano E, Piccinocchi G, Cricelli C, Piccinocchi R, Saita A, Micheli C, Trinchieri A. Urolithiasis in Italy: an epidemiological study. Arch Ital Urol Androl. 2014; 86:99-102. DOI: https://doi.org/10.4081/aiua.2014.2.99
Boscolo-Berto R, Dal Moro M, Abate A, Arandjelovic G, Tosato F, Bassi P. Do weather conditions influence the onset of renal colic? A novel approach to analysis. Urol Int 2008; 80:19–25 DOI: https://doi.org/10.1159/000111724
Cervellin G, Comelli I, Comelli D, Meschi T, Lippi G, Borghi L (2012) Mean temperature and humidity variations, along with patient age, predict the number of visits for renal colic in a large urban emergency department: results of a 9-year survey. J Epidemiol Glob Health 2012; 2:31–38 DOI: https://doi.org/10.1016/j.jegh.2012.01.001
Condemi V, Gestro M, Dozio E, Tartaglino B, Corsi Romanelli MM, Solimene U, Meco R. Association with meteo-climatological factors and daily emergency visits for renal colic and urinary calculi in Cuneo, Italy. A retrospective observational study, 2007-2010. Int J Biometeorol. 2015; 59:249-63. DOI: https://doi.org/10.1007/s00484-014-0861-1
Gaziev G, Asimakopoulos AD, Wadhwa K, Topazio L, Germani S, Miano R. The influence of environmental conditions on the incidence of renal colic in Rome. Urology. 2016; 83:77-82 . DOI: https://doi.org/10.5301/uro.5000170
Trinchieri A, Cappoli S, Esposito N, Acquati P. Epidemiology of renal colic in a district general hospital. Arch Ital Urol Androl. 2008; 80:1-4. DOI: https://doi.org/10.1016/j.acpain.2008.05.015
Manfredini R, Gallerani M, Cecilia Ol, Boari B, Fersini C, Portaluppi F. Circadian pattern in occurrence of renal colic in an emergency department: analysis of patients' notes. BMJ extension. 2002; 324:767. DOI: https://doi.org/10.1136/bmj.324.7340.767
Trinchieri A, Maletta A, Simonelli G, Boeri L, De Lorenzis E, Montanari E. Time changes in the spectrum of urinary stone composition: a role for climate variations? BMC Nephrol. 2020; 21:535. DOI: https://doi.org/10.1186/s12882-020-02193-x
Nouvenne A, Ticinesi A, Allegri F, Guerra A, Guida L, Morelli I, Borghi L, Meschi T. Twenty-five years of idiopathic calcium nephrolithiasis: has anything changed? Clin Chem Lab Med. 2014; 52:337-44. DOI: https://doi.org/10.1515/cclm-2013-0618
Cappuccio FP, Strazzullo P, Mancini M. Kidney stones and hypertension: population based study of an independent clinical association. BMJ 1990; 300:1234-6. DOI: https://doi.org/10.1136/bmj.300.6734.1234
Fabris A, Ferraro PM, Comellato G, Caletti C, Fantin F, Zaza G, Zamboni M, Lupo A, Gambaro G. The relationship between calcium kidney stones, arterial stiffness and bone density: unraveling the stone-bone-vessel liaison . J Nephrol. 2015; 28:549-55. DOI: https://doi.org/10.1007/s40620-014-0146-0
Rendina D, D'Elia L, Evangelista M, De Filippo G, Giaquinto A, Barone B, Piccinocchi G, Prezioso D, Strazzullo P. Osteoporosis is a Predictive Factor for Nephrolithiasis in an Adult Free-Living Caucasian Population From Southern Italy : A Longitudinal Retrospective Study Based on a General Practice Database. Calcif Tissue Int. 2020; 107:446-452. DOI: https://doi.org/10.1007/s00223-020-00737-9
Cavalli L, Guazzini A, Cianferotti L, Parri S, Cavalli T, Metozzi A, Giusti F, Fossi C, Black DM, Brandi ML. Prevalence of osteoporosis in the Italian population and main risk factors: results of BoneTour Campaign. BMC Musculoskeletal Disord. 2016;17:396. DOI: https://doi.org/10.1186/s12891-016-1248-8
Trinchieri A, Ostini F, Nespoli R, Rovera F, Montanari E, Zanetti G. A prospective study of recurrence rate and risk factors for recurrence after a first renal stone. J Urol. 1999; 162:27-30. DOI: https://doi.org/10.1097/00005392-199907000-00007
Li S, Iremashvili V, Vernez SL, Penniston KL, Jhagroo RA, Best SL, Hedican SP, Nakada SY. Effect of stone composition on surgical stone recurrence: single center longitudinal analysis. Can J Urol. 2021; 28:10744-10749.
Moe OW. Kidney stones: pathophysiology and medical management. Lancet. 2006;367: 333-44. DOI: https://doi.org/10.1016/S0140-6736(06)68071-9
Bilezikian JP, Bandeira L, Khan A, Cusano NE. Hyperparathyroidism. Lancet. 2018;391:168-178. DOI: https://doi.org/10.1016/S0140-6736(17)31430-7
La Rochelle JC, Coogan CL. Urological manifestations of sarcoidosis. J Urol. 2012;187:18-24. DOI: https://doi.org/10.1016/j.juro.2011.09.057
Sas DJ, Harris PC, Milliner DS. Recent advances in the identification and management of inherited hyperoxalurias. Urolithiasis. 2019; 47:79-89. DOI: https://doi.org/10.1007/s00240-018-1093-3
Asplin JR. The management of patients with enteric hyperoxaluria. Urolithiasis. 2016; 44:33-43. DOI: https://doi.org/10.1007/s00240-015-0846-5
Fuster DG, Moe OW. Incomplete Distal Renal Tubular Acidosis and Kidney Stones. Adv Chronic Kidney Dis. 2018; 25:366-374. DOI: https://doi.org/10.1053/j.ackd.2018.05.007
Oliveira B, Kleta R, Bockenhauer D, Walsh SB. Genetic, pathophysiological, and clinical aspects of nephrocalcinosis. Am J Physiol Renal Physiol. 2016; 311:F1243-F1252. DOI: https://doi.org/10.1152/ajprenal.00211.2016
Trinchieri A, Montanari E. Biochemical and dietary factors of uric acid stone formation. Urolithiasis. 2018; 46:167-172. DOI: https://doi.org/10.1007/s00240-017-0965-2
Matlaga BR, Shah OD, Assimos DG. Drug-induced urinary calculi. Rev Urol. 2003 Fall;5:227-31.
Bishop K, Momah T, Ricks J. Nephrolithiasis. Prim Care. 2020; 47:661-671. DOI: https://doi.org/10.1016/j.pop.2020.08.005
Wang SC, Hsu YS, Chen KK, Chang LS. Correlation between urinary tract pure stone composition and stone morphology on plain abdominal film. J Chin Med Assoc 2004; 67:235-8.
Gallioli A, De Lorenzis E, Boeri L, Delor M, Zanetti SP, Longo F, Trinchieri A, Montanari E. Clinical utility of computed tomography Hounsfield characterization for percutaneous nephrolithotomy: a cross-sectional study. BMC Urol 2017;17:104 DOI: https://doi.org/10.1186/s12894-017-0296-1
Brown J. Diagnostic and treatment patterns for renal colic in US
emergency departments. Int Urol Nephrol 2006; 38:87-92 DOI: https://doi.org/10.1007/s11255-005-3622-6
Holdgate A, Pollock T. Non-steroidal anti-inflammatory drugs (NSAIDs) versus opioids for acute renal colic. Cochrane Database Syst Rev. 2005;2:CD004137. DOI: https://doi.org/10.1002/14651858.CD004137.pub2
Pearce E, Clement KD, Yallappa S, Aboumarzouk OM. Likelihood of Distal Ureteric Calculi to Pass Spontaneously: Systematic Review and Cumulative Analysis of the Placebo Arm of Randomized-Controlled Trials. Urol Int. 2021;105:71-76. DOI: https://doi.org/10.1159/000510136
Yallappa S, Amer T, Jones P, Greco F, Tailly T, Somani BK, Umez-Eronini N, Aboumarzouk OM. Natural History of Conservatively Managed Ureteral Stones: Analysis of 6600 Patients. J Endourol. 2018; 32:371-379. DOI: https://doi.org/10.1089/end.2017.0848
D, Krambeck A, Miller NL, et al.. Surgical management of stones: American Urological Association/Endourological Society Guideline, Part II. J Urol 2016; 196:1161–1169 DOI: https://doi.org/10.1016/j.juro.2016.05.091
Miller OF, Kane CJ. Time to stone passage for observed ureteral calculi: A guide for patient education. J Urol 1999; 162:688–690; DOI: https://doi.org/10.1097/00005392-199909010-00014
Hübner WA, Irby P, Stoller ML. Natural history and current concepts for the treatment of small ureteral calculi. Eur Urol. 1993; 24:172-6. DOI: https://doi.org/10.1159/000474289
Chen HW, Chen YC, Lee JT, Yang FM, Kao CY, Chou YH, Chu TY, Juan YS, Wu WJ. Prediction of the Uric Acid Component in Nephrolithiasis Using Simple Clinical Information about Metabolic Disorder and Obesity: A Machine Learning-Based Model. Nutrients. 2022; 14:1829. DOI: https://doi.org/10.3390/nu14091829
Moore J, Nevo A, Salih S, Abdul-Muhsin H, Keddis M, Stern K, Humphreys M. Outcomes and rates of dissolution therapy for uric acid stones. J Nephrol. 2022; 35:665-669. DOI: https://doi.org/10.1007/s40620-021-01094-y
Tsaturyan A, Bokova E, Bosshard P, Bonny O, Fuster DG, Roth B. Oral chemolysis is an effective, non-invasive therapy for urinary stones suspected of uric acid content. Urolithiasis. 2020; 48:501-507. DOI: https://doi.org/10.1007/s00240-020-01204-8
Salem SM, Sultan MF, Badawy A. Oral dissolution therapy for renal radiolucent stones, outcome, and factors affecting response: A prospective study. Urol Ann. 2019; 11:369-373. DOI: https://doi.org/10.4103/UA.UA_20_19
Elbaset MA, Hashem A, Eraky A, Badawy MA, El-Assmy A, Sheir KZ, Shokeir AA. Optimal non-invasive treatment of 1-2.5 cm radiolucent renal stones: oral dissolution therapy, shock wave lithotripsy or combined treatment-a randomized controlled trial. World J Urol. 2020; 38:207-212. DOI: https://doi.org/10.1007/s00345-019-02746-2
Gridley CM, Sourial MW, Lehman A, Knudsen BE. Medical dissolution therapy for the treatment of uric acid nephrolithiasis. World J Urol. 2019; 37:2509-2515. DOI: https://doi.org/10.1007/s00345-019-02688-9
Elsawy AA, Elshal AM, El-Nahas AR, Elbaset MA, Farag H, Shokeir AA. Can We Predict the Outcome of Oral Dissolution Therapy for Radiolucent Renal Calculi? A Prospective Study. J Urol. 2019; 201:350-357. DOI: https://doi.org/10.1016/j.juro.2018.09.027
Blanco LT, Socarras MR, Montero RF, Diez EL, Calvo AO, Gregorio SAY, Cansino JR, Galan JA, Rivas JG. Renal colic during pregnancy: Diagnostic and therapeutic aspects. Literature review. Cent European J Urol. 2017; 70: 93-100.
Bookstaver PB, Bland CM, Griffin B, Stover KR, Eiland LS, McLaughlin M. A Review of Antibiotic Use in Pregnancy. Pharmacotherapy. 2015; 35:1052-62. DOI: https://doi.org/10.1002/phar.1649
Piana A, Basile G, Masih S, Bignante G, Uleri A, Gallioli A, Prudhomme T, Boissier R, Pecoraro A, Campi R, Di Dio M, Alba S, Breda A, Territo A; en representación del grupo de trabajo de trasplante renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU). Kidney stones in renal transplant recipients: A systematic review. Actas Urol Esp (Engl Ed). 2023:S2173-5786(23)00101-4. DOI: https://doi.org/10.1016/j.acuroe.2023.08.003
Tzelves L, Geraghty R, Lombardo R, Davis NF, Petřík A, Neisius A, Gambaro G, Türk C, Thomas K, Somani B, Skolarikos A. Duration of Follow-up and Timing of Discharge from Imaging Follow-up, in Adult Psatients with Urolithiasis After Surgical or Medical Intervention: A Systematic Review and Meta-analysis from the European Association of Urology Guideline Panel on Urolithiasis. Eur Urol Focus. 2022: S2405-4569(22)00146-8. DOI: https://doi.org/10.1016/S0302-2838(22)01124-1
Skolarikos A, Laguna MP, Alivizatos G, Kural AR, de la Rosette JJ. The role for active monitoring in urinary stones: a systematic review. J Endourol. 2010; 24:923-30. DOI: https://doi.org/10.1089/end.2009.0670
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