Drug-Induced Urolithiasis in Pediatric Patients

Drug-induced nephrolithiasis is a rare condition in children. The involved drugs may be divided into two different categories according to the mechanism involved in calculi formation. The first one includes poorly soluble drugs that favor the crystallization and calculi formation. The second category includes drugs that enhance calculi formation through their metabolic effects. The diagnosis of these specific calculi depends on a detailed medical history, associated comorbidities and the patient's history of drug consumption. There are several risk factors associated with drug-induced stones, such as high dose of consumed drugs and long duration of treatment. Moreover, there are some specific risk factors, including urinary pH and the amount of fluid consumed by children. There are limited data regarding pediatric lithogenic drugs, and hence, our aim was to perform a comprehensive review of the literature to summarize these drugs and identify the possible mechanisms involved in calculi formation and discuss the management and preventive measures for these calculi

Three-dimensional virtual reconstruction with DocDo: A novel interactive tool to score renal mass complexity

The pre-operative knowledge of the complexity of a renal mass is the cornerstone to plan a partial nephrectomy(PN) [1]. Given the multiple issues characterizing it - size, protrusion out from renal parenchyma, longitudinal and coronal location, proximity to the hilum - nephrometric scoring systems have been proposed during the last decade[2, 3]; RENAL and PADUA classifications are the mostly used [4-6]

En-bloc resection of bladder tumors (ERBT) for pathological staging: the value of lateral margins analysis

In endoscopic resection of colorectal tumours, the pathological assessment of the lateral margins is a strong predictor of tumor recurrence after resection. The aims of the current study are to evaluate the value of the peritumoral margins assessment in ERBT on tumor recurrence

External validation of a nomogram for outcome prediction in management of medium-sized (1-2 cm) kidney stones

BACKGROUND: Stone nomogram by Micali et al. , able topredict treatment failure of shock-wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) in the management of single 1-2 cm renal stones, was developed on 2605 patients and showed a high predictive accuracy, with an area under ROC curve of 0.793 at internal validation. The aim of the present study is to externally validate the model to assess whether it displayed a satisfactory predictive performance if applied to different populations. METHODS: External validation was retrospectively performed on 3025 patients who underwent an active stone treatment from December 2010 to June 2021 in 26 centers from four countries (Italy, USA, Spain, Argentina). Collected variables included: age, gender, previous renal surgery, preoperative urine culture, hydronephrosis, stone side, site, density, skin-to-stone distance. Treatment failure was the defined outcome (residual fragments >4 mm at three months CT-scan). RESULTS: Model discrimination in external validation datasets showed an area under ROC curve of 0.66 (95% 0.590.68) with adequate calibration. The retrospective fashion of the study and the lack of generalizability of the tool towards populations from Asia, Africa or Oceania represent limitations of the current analysis. CONCLUSIONS: According to the current findings, Micali's nomogram can be used for treatment prediction after SWL, RIRS and PNL; however, a lower discrimination performance than the one at internal validation should be acknowledged, reflecting geographical, temporal and domain limitation of external validation studies. Further prospective evaluation is required to refine and improve the nomogram findings and to validate its clinical value. ( Cite this article as: Sighinolfi MC, Calcagnile T, Ticonosco M, Kaleci S, Di Bari S, Assumma S, et al. External validation of a nomogram for outcome prediction in management of medium-sized (1-2 cm) kidney stones. Minerva Urol Nephrol 2024 May 10. DOI: 10.23736/S2724-6051.24.05672-6