Metabolic syndrome and urinary acid stones

Introducción: Estudios epidemiológicos han puesto de manifiesto la asociación de urolitiasis con una serie de enfermedades de reconocido riesgo cardiovascular como la diabetes mellitus tipo 2, hipertensión arterial y síndrome metabólico. Es nuestro objetivo determinar la frecuencia del síndrome metabólico en una serie de pacientes diagnosticados en nuestro Servicio de cálculos de ácido úrico. Material y métodos: Se incluye un total de 71 pacientes diagnosticados de litiasis de ácido úrico, 46 varones y 25 mujeres, con una edad media de 62,4 años. La lateralidad y localización del cálculo se confirma por ecografía y/o tomografía axial computerizada. Se establece el diagnóstico del síndrome metabólico siguiendo los criterios propuestos por el NCEP-ATP III. Se realiza análisis estadístico con test de chi-cuadrado aplicando corrección de Yates. Resultados: Se observó síndrome metabólico en 49 pacientes (69,0%), muy por encima del 31% de la frecuencia reportada para la población española (p<0.0001). Además se comprobó descenso de HDL-colesterol sérico en 59 pacientes (83,1%), obesidad abdominal en 48 (67,8%), hipertensión arterial en 46 (64,8%), hipertrigliceremia en 39 (54,9%) e hiperglucemia en 31 (43,7%), mostrando todos estos factores diferencias estadísticamente significativas en relación con los datos registrados para la población general española. Conclusiones: Existe una marcada relación entre litiasis de ácido úrico y síndrome metabólico, como también para cada uno de los factores que constituyen el síndrome metabólico, con porcentajes que están muy por encima de su frecuencia poblacional registrada en España.Introduction: Epidemiologic studies have reported association between urolithiasis with cardiovascular diseases as type 2 diabetes, arterial hypertension and metabolic syndrome. This study was conducted to examine the proportion of metabolic syndrome in patients with uric acid stones. Materials and methods: 71 patients with uric acid stones were included, 46 males and 25 females, mean age was 62.4 years. Diagnosis of stone laterality and localization was confirmed by ultrasonography and/or computerized axial tomography. Metabolic syndrome definition was made according of criteria proposed by NCEP-ATP III. Chisquare test with correction of Yates was used to assess the statistical significance of differences. Results: Metabolic syndrome were observed in 49 patients (69.0%), significantly higher than 31% rate reported for Spanish population (p<0.0001). In addition, it was found decrease serum HDL-cholesterol in 59 patients (83.1%), abdominal obesity in 48 (67.8%), high blood pressure in 46 (64.8%), hypertrigliceremia in 39 (54.9%) and hyperglycemia in 31 (43.7%), all of that was significantly more frequent than data reported for Spanish population. Conclusions: Uric acid stones were positively associated with metabolic syndrome, as well as for each of the factors of metabolic syndrome, with rates higher than registered in Spanish population

Renal cell carcinoma with inferior vena cava involvement: Prognostic effect of tumor thrombus consistency on cancer specific survival: Tumor Thrombus Consistency and Survival

Renal cell carcinoma forming a venous tumor thrombus (VTT) in the inferior vena cava (IVC) has a poor prognosis. Recent investigations have been focused on prognostic markers of survival. Thrombus consistency (TC) has been proposed to be of significant value but yet there are conflicting data. The aim of this study is to test the effect of IVC VTT consistency on cancer specific survival (CSS) in a multi-institutional cohort

Renal cell carcinoma with inferior vena cava involvement: Prognostic effect of tumor thrombus consistency on cancer specific survival.

BackgroundRenal cell carcinoma forming a venous tumor thrombus (VTT) in the inferior vena cava (IVC) has a poor prognosis. Recent investigations have been focused on prognostic markers of survival. Thrombus consistency (TC) has been proposed to be of significant value but yet there are conflicting data. The aim of this study is to test the effect of IVC VTT consistency on cancer specific survival (CSS) in a multi-institutional cohort.MethodsThe records of 413 patients collected by the International Renal Cell Carcinoma-Venous Thrombus Consortium were retrospectively analyzed. All patients underwent radical nephrectomy and tumor thrombectomy. Kaplan-Meier estimate and Cox regression analyses investigated the impact of TC on CSS in addition to established clinicopathological predictors.ResultsVTT was solid in 225 patients and friable in 188 patients. Median CSS was 50 months in solid and 45 months in friable VTT. TC showed no significant association with metastatic spread, pT stage, perinephric fat invasion, and higher Fuhrman grade. Survival analysis and Cox regression rejected TC as prognostic marker for CSS.ConclusionsIn the largest cohort published so far, TC seems not to be independently associated with survival in RCC patients and should therefore not be included in risk stratification models. J. Surg. Oncol. 2016;114:764-768. © 2016 Wiley Periodicals, Inc

Renal cell carcinoma with inferior vena cava involvement: Prognostic effect of tumor thrombus consistency on cancer specific survival

Background: Renal cell carcinoma forming a venous tumor thrombus (VTT) in the inferior vena cava (IVC) has a poor prognosis. Recent investigations have been focused on prognostic markers of survival. Thrombus consistency (TC) has been proposed to be of significant value but yet there are conflicting data. The aim of this study is to test the effect of IVC VTT consistency on cancer specific survival (CSS) in a multi-institutional cohort. Methods: The records of 413 patients collected by the International Renal Cell Carcinoma\ue2\u80\u93Venous Thrombus Consortium were retrospectively analyzed. All patients underwent radical nephrectomy and tumor thrombectomy. Kaplan\ue2\u80\u93Meier estimate and Cox regression analyses investigated the impact of TC on CSS in addition to established clinicopathological predictors. Results: VTT was solid in 225 patients and friable in 188 patients. Median CSS was 50 months in solid and 45 months in friable VTT. TC showed no significant association with metastatic spread, pT stage, perinephric fat invasion, and higher Fuhrman grade. Survival analysis and Cox regression rejected TC as prognostic marker for CSS. Conclusions: In the largest cohort published so far, TC seems not to be independently associated with survival in RCC patients and should therefore not be included in risk stratification models. J. Surg. Oncol. 2016;114:764\ue2\u80\u93768. \uc2\ua9 2016 Wiley Periodicals, Inc