Journal article
Initial Results from the M-STONE Group: A Multi-Center Collaboration to Study Treatment Outcomes in Nephrolithiasis Evaluation
Journal of endourology, Vol.34(9), pp.919-923
09/01/2020
DOI: 10.1089/end.2020.0108
PMID: 32660266
Abstract
Introduction:Despite proven effectiveness of medications in preventing stone recurrence, compliance with pharmacotherapy (PT) is often poor because of cost, side effects, and impact on lifestyle. We sought to compare the risk of stone recurrence between patients managed with conservative therapy (CT)vsPT controlling for aggressiveness of stone disease. Materials and Methods:The Multi-center collaboration to Study Treatment Outcomes in Nephrolithiasis Evaluation (MSTONE) database contains patient data and outcomes from July 2001 to April 2015 across four centers. The database was queried for patients whose stone disease was managed with CT alone (fluid and dietary recommendations)vsPT. Patients were risk stratified according to number of previous passed stones. Within each risk group, we compared CTvsPT with respect to 2-year stone event rate and stone event-free survival (SEFS) using the Kaplan-Meier method. Results:A total of 245 patients, with a median follow-up of 29 months (interquartile range = 16-44), were identified, including 93 on CT and 152 on PT. The overall 2-year stone event rate was 38% for all patients. Stone events at 2 years occurred less frequently in the PT group compared with the CT group (31%vs44%,p = 0.043), with the difference most pronounced in the high-risk group (71%vs32% for CT and PT, respectively,p = 0.058). The 30-month SEFS was significantly higher for PT (58%) than CT (46%) overall. When stratified by risk group, 30-month SEFS was statistically significantly higher for PT than CT in the intermediate risk group (65%vs45% for PT and CT, respectively). Conclusion:Controlling for aggressiveness of stone disease, PT was more effective than CT in reducing and delaying stone-related events. However, CT appeared to be as effective as PT in low-risk patients. PT is best reserved for recurrent stone formers, regardless of metabolic background.
Details
- Title: Subtitle
- Initial Results from the M-STONE Group: A Multi-Center Collaboration to Study Treatment Outcomes in Nephrolithiasis Evaluation
- Creators
- Brett A. Johnson - UT Southwestern Med Ctr, Dept Urol, Dallas, TX USASara L. Best - University of Wisconsin–MadisonStephen Y. Nakada - University of Wisconsin–MadisonChad Tracy - University of IowaRyan L. Steinberg - University of IowaLewis Thomas - University of IowaTracy Marien - Vanderbilt UniversityNicole Miller - Vanderbilt UniversityElly Kolitz - The University of Texas Southwestern Medical CenterAdam Cohen - The University of Texas Southwestern Medical CenterMargaret S. Pearle - Southwestern Medical CenterYair Lotan - Southwestern Medical CenterJodi A. Antonelli - Southwestern Medical Center
- Resource Type
- Journal article
- Publication Details
- Journal of endourology, Vol.34(9), pp.919-923
- Publisher
- Mary Ann Liebert, Inc
- DOI
- 10.1089/end.2020.0108
- PMID
- 32660266
- ISSN
- 0892-7790
- eISSN
- 1557-900X
- Number of pages
- 5
- Language
- English
- Date published
- 09/01/2020
- Academic Unit
- Radiology; Urology
- Record Identifier
- 9984318692902771
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