Kidney Stones

“There are a lot of people using this technology now, but it is not mainstream by any means,” says Ojas Shah, MD.

“These are key, because right now our sepsis rates following ureteroscopy are, quite frankly, unacceptable,” says Jordan L. Allen, MD.

As the year comes to a close, we revisit some of this year’s top content on kidney stones.

"If the diversity and robust functional potential of the healthy human microbiome is repeatedly assaulted by the average Westernized lifestyle via antibiotic exposure, diet, and other environmental factors, kidney stone prevalence will continue to increase," the authors write.

“We found that these genetic proxies of thiazide diuretics were associated with a 15% lower risk of kidney stones,” says Jefferson Triozzi, MD.

"We need improved efficiency. Part of that is being as optimal in our settings and in our techniques that we can," says Smita De, MD, PhD.

"I think there have been a lot of what I would consider incremental improvements over the past few years," Smita De, MD, PhD.

"I think that overall, one should do what one is comfortable with, within the scope of your practice and your resources," says Smita De, MD, PhD.

"[The findings] certainly made me a lot less anxious for those patients who do need to continue their aspirin," says Smita De, MD, PhD.

"We did not find that there were any clotting or thrombotic complications in those who did stop their aspirin," says Smita De, MD, PhD.

Data showed that plasma oxalate levels were maintained through 24 months of treatment with lumasiran.

Cleveland Clinic is the first to investigate photonic nanoparticles as a potential kidney stone treatment.

The approval is supported by findings from the phase 2 PHYOX2 trial and interim data from the phase 3 PHYOX3 extension study.

“I think the key to remember for a lot of what we're doing is that kidney stone disease is complicated. It's a really heterogenous patient population,” says Nicholas L. Kavoussi, MD.

Proper coding for percutaneous nephrolithotomy includes code 50081.

“There's going to be new techniques that we're not even aware of yet to try and break up the stones in a better fashion, but in a less invasive way for patients,” says Ben H. Chew, MD, MSc, FRCSC.

"We're currently doing a multicenter, prospective study using the new Boston Scientific scope to measure intrarenal pressure for every ureteroscopy that we perform to get more data and to be able to identify these patients earlier, before they get septic," says Naeem Bhojani, MD, FRCSC.

"What we found was that if during ureteroscopy your intrarenal pressure remains below 30 mm of mercury, there shouldn't be any infectious complications," says Naeem Bhojani, MD, FRCSC.

A multidisciplinary team at the Vanderbilt Institute for Surgery and Engineering is collaborating on a 3D navigational system to help limit kidney stone fragments that remain after surgery.

"[Our study] suggests that limiting added sugar intake may help to prevent the formation of kidney stones,” says Shan Yin, MD.

In total, 73% of patients showed an increase in 24-hour urine volume from baseline to the end of the 1-month trial period.

"As a result of this work, we came to the conclusion that maybe if you are going to stent someone, you should try and keep the stent time at a minimum of 4 or 5 days," says Khurshid R. Ghani, MD.

"Prescription alkali therapy is very costly; it has a lot of side effects, and the compliance is very low," says Brett Johnson, MD.

"CPT codes 50080 and 50081 describe the antegrade approach to stone removal requiring lithotripsy through a nephrostomy tract, with 50080 being reported for stones less than 2 cm in size in a single location, whereas 50081 would be reported for large or complex stones, stones in multiple locations, or stones in the ureter (such as in the example provided)," write Jonathan Rubenstein, MD, and Mark Painter.

"The main advantage of the Lithovue Elite is that it allows for intrarenal and intraureteral pressure monitoring," says Ravi Munver, MD.

The data were presented at the 2023 American Urological Association Annual Meeting in Chicago, Illinois.

The trial assessed outcomes in patients who had kidney stones between 1 to 2 cm.

“Our data indicate that usage of a PCNL equipment whiteboard led to significant improvements in team perception of inter-disciplinary communication and case item selection accuracy," says Jenny N. Guo, MD.

"We unfortunately did not find any difference in pain scores [after ureteroscopy] at day 1, 2, or 3. We also didn't find any difference in use of rescue medication and rescue narcotic medication," says Karen L. Stern, MD.

"While CBD oil appears safe, it does not seem to reduce pain or discomfort during the typically brief recovery period after this common procedure,” says Karen Stern, MD.