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24-Hour Urine Calcium Oxalate Supersaturation Risk Correlates with Computerized Tomography Volumetric Calcium Oxalate
Stanislav Yuzhakov1, Shavano D Steadman1, Brandon J Otto1
1Department of Urology, University of Florida, Gainesville, Florida.
The Journal of Urology
|July 21, 2021
Summary
Higher calcium oxalate (CaOx) supersaturation (SS) in 24-hour urine correlates with increased kidney stone growth in patients with CaOx stones. This finding aids in predicting stone progression and developing new stone simulators.
Area of Science:
- Nephrology
- Urology
- Biochemistry
Background:
- In vitro studies show calcium oxalate (CaOx) supersaturation (SS) drives CaOx crystal formation and growth.
- Understanding the in vivo relationship between urine SS and stone growth is crucial for patient management.
Purpose of the Study:
- To investigate the association between 24-hour urine CaOx SS and in vivo kidney stone growth.
- To evaluate the utility of 3D CT imaging for assessing stone growth over time.
Main Methods:
- Retrospective analysis of 80 patients with >80% CaOx stones undergoing two CT scans and 24-hour urine collection.
- Bilateral 3D stone volume calculated from CT scans; stone growth rate determined.
- Patients categorized into low, medium, and high CaOx SS risk groups.
Main Results:
- Median annual stone growth was 15% (low risk), 71% (medium risk), and 177% (high risk) (p <0.001).
- A moderate correlation (Spearman's rho=0.53, p <0.001) was observed between mean CaOx SS and stone volume growth.
- High inter-reviewer reliability for CT volume measurements was achieved.
Conclusions:
- Increased 24-hour urine CaOx SS risk is linked to accelerated in vivo kidney stone growth in CaOx stone formers.
- 3D CT volumetric analysis offers a noninvasive method to study stone growth dynamics.
- Findings support improved stone risk prediction and potential development of kidney stone simulators.
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