Urological Survey Urolithiasis/Endourology Re: Caffeine Intake and the Risk of Kidney Stones P. M. Ferraro, E. N. Taylor, G. Gambaro and G. C. Curhan Division of Nephrology-Renal Program, Department of Medical Sciences, Catholic University of the Sacred Heart, Rome, Italy, Channing Division of Network Medicine and Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, and Division of Nephrology and Transplantation, Maine Medical Center, Portland, Maine Am J Clin Nutr 2014; 100: 1596e1603.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.02.016 available at http://jurology.com/ Editorial Comment: This analysis of 3 large epidemiological cohorts demonstrated that caffeine consumption is associated with a decreased risk of incident kidney stones. The authors reported that caffeine intake was associated with increased calcium excretion, which supports the findings of others. This outcome is linked to a reduction in sodium reabsorption in the proximal tubule and distal nephron. The benefits may be due to increased urine volume with caffeine intake. Stone formers will be glad to hear these results as they can continue drinking their java! Dean G. Assimos, MD
Suggested Reading Massey LK and Sutton RA: Acute caffeine effects on urine composition and calcium kidney stone risk in calcium stone formers. J Urol 2004; 172: 555.
Re: Dietary and Pharmacologic Management to Prevent Recurrent Nephrolithiasis in Adults: A Clinical Practice Guideline from the American College of Physicians A. Qaseem, P. Dallas, M. A. Forciea, M. Starkey and T. D. Denberg; Clinical Guidelines Committee of American College of Physicians Virginia Tech Carilion School of Medicine, Roanoke, Virginia, and University of Pennsylvania Health System, Philadelphia, Pennsylvania Ann Intern Med 2014; 161: 659e667.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.02.017 available at http://jurology.com/ Editorial Comment: The authors of this guideline for preventing recurrent kidney stones analyzed studies similar to those reviewed in the guidelines generated by the American Urological Association and the American Society of Nephrology. However, the current recommendations are “watered down” compared to those of the latter organizations. If water does not work, pharmacotherapy should be pursued. This report emphasizes the limited quality of studies that have been undertaken assessing the impact of dietary modifications and pharmacotherapy, and the many unanswered questions about the usefulness of metabolic evaluation and followup regimens. Dean G. Assimos, MD
0022-5347/15/1935-1570/0 THE JOURNAL OF UROLOGY® © 2015 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION
1570
j
www.jurology.com
AND
RESEARCH, INC.
http://dx.doi.org/10.1016/j.juro.2015.02.016 Vol. 193, 1570-1571, May 2015 Printed in U.S.A.
UROLITHIASIS/ENDOUROLOGY
1571
Suggested Reading Pearle MS, Goldfarb DS, Assimos DG et al; American Urological Assocation: Medical management of kidney stones: AUA guideline. J Urol 2014; 192: 316. Singh P, Knoedler JJ, Krambeck AE et al: Thiazide diuretic prophylaxis for kidney stones and the risk of diabetes mellitus. J Urol 2014; 192: 1700.
Re: Clinical Outcomes after Ureteroscopic Lithotripsy in Patients Who Initially Presented with Urosepsis: Matched Pair Comparison with Elective Ureteroscopy R. F. Youssef, A. Neisius, Z. G. Goldsmith, M. Ghaffar, M. Tsivian, R. H. Shin, F. Cabrera, M. N. Ferrandino, C. D. Scales, G. M. Preminger and M. E. Lipkin Division of Urology, Comprehensive Kidney Stone Center, Duke University Medical Center, Durham, North Carolina J Endourol 2014; 28: 1439e1443.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.02.018 available at http://jurology.com/ Editorial Comment: The authors report that patients with a history of urosepsis are more prone to complications during elective ureteroscopic stone removal, which may result in longer hospitalization and health care expenditures. Use of an access sheath to decrease intrarenal pressure in such patients is encouraged. In addition, treatment based on culture of collecting system urine is endorsed due to reported discordance with voided specimen cultures. Dean G. Assimos, MD
Suggested Reading Pearle MS, Pierce HL, Miller GL et al: Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol 1998; 160: 1260. Wang HS, Wiener JS, Ferrandino MN et al: Complications of surgical management of upper tract calculi in spina bifida patients: analysis of nationwide data. J Urol 2015; 193: 1270.
Re: Antimicrobial Resistance Patterns in Cases of Obstructive Pyelonephritis Secondary to Stones T. Marien, A. Y. Mass and O. Shah Department of Urology, New York University School of Medicine, New York, New York Urology 2015; 85: 64e68.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.02.019 available at http://jurology.com/ Editorial Comment: These findings suggest that it may be useful to obtain an aliquot of urine for culture from the collecting system in addition to that obtained from the bladder if obstructive pyelonephritis is observed in patients with ureteral stones. Discordance between voided and collecting system cultures has also been reported in patients with renal stones. In addition, knowing your local antibiotic resistance pattern is important when assigning antibiotic therapy in this setting. Dean G. Assimos, MD
Suggested Reading Borofsky MS, Walter D, Li H et al: Institutional characteristics associated with receipt of emergency care for obstructive pyelonephritis at community hospitals. J Urol 2015; 193: 851. Borofsky MS, Walter D, Shah O et al: Surgical decompression is associated with decreased mortality in patients with sepsis and ureteral calculi. J Urol 2013; 189: 946. Viprakasit DP, Sawyer MD, Herrell SD et al: Changing composition of staghorn calculi. J Urol 2011; 186: 2285.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.02.016 available at http://jurology.com/ Editorial Comment: This analysis of 3 large epidemiological cohorts demonstrated that caffeine consumption is associated with a decreased risk of incident kidney stones. The authors reported that caffeine intake was associated with increased calcium excretion, which supports the findings of others. This outcome is linked to a reduction in sodium reabsorption in the proximal tubule and distal nephron. The benefits may be due to increased urine volume with caffeine intake. Stone formers will be glad to hear these results as they can continue drinking their java! Dean G. Assimos, MD
Suggested Reading Massey LK and Sutton RA: Acute caffeine effects on urine composition and calcium kidney stone risk in calcium stone formers. J Urol 2004; 172: 555.
Re: Dietary and Pharmacologic Management to Prevent Recurrent Nephrolithiasis in Adults: A Clinical Practice Guideline from the American College of Physicians A. Qaseem, P. Dallas, M. A. Forciea, M. Starkey and T. D. Denberg; Clinical Guidelines Committee of American College of Physicians Virginia Tech Carilion School of Medicine, Roanoke, Virginia, and University of Pennsylvania Health System, Philadelphia, Pennsylvania Ann Intern Med 2014; 161: 659e667.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.02.017 available at http://jurology.com/ Editorial Comment: The authors of this guideline for preventing recurrent kidney stones analyzed studies similar to those reviewed in the guidelines generated by the American Urological Association and the American Society of Nephrology. However, the current recommendations are “watered down” compared to those of the latter organizations. If water does not work, pharmacotherapy should be pursued. This report emphasizes the limited quality of studies that have been undertaken assessing the impact of dietary modifications and pharmacotherapy, and the many unanswered questions about the usefulness of metabolic evaluation and followup regimens. Dean G. Assimos, MD
0022-5347/15/1935-1570/0 THE JOURNAL OF UROLOGY® © 2015 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION
1570
j
www.jurology.com
AND
RESEARCH, INC.
http://dx.doi.org/10.1016/j.juro.2015.02.016 Vol. 193, 1570-1571, May 2015 Printed in U.S.A.
UROLITHIASIS/ENDOUROLOGY
1571
Suggested Reading Pearle MS, Goldfarb DS, Assimos DG et al; American Urological Assocation: Medical management of kidney stones: AUA guideline. J Urol 2014; 192: 316. Singh P, Knoedler JJ, Krambeck AE et al: Thiazide diuretic prophylaxis for kidney stones and the risk of diabetes mellitus. J Urol 2014; 192: 1700.
Re: Clinical Outcomes after Ureteroscopic Lithotripsy in Patients Who Initially Presented with Urosepsis: Matched Pair Comparison with Elective Ureteroscopy R. F. Youssef, A. Neisius, Z. G. Goldsmith, M. Ghaffar, M. Tsivian, R. H. Shin, F. Cabrera, M. N. Ferrandino, C. D. Scales, G. M. Preminger and M. E. Lipkin Division of Urology, Comprehensive Kidney Stone Center, Duke University Medical Center, Durham, North Carolina J Endourol 2014; 28: 1439e1443.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.02.018 available at http://jurology.com/ Editorial Comment: The authors report that patients with a history of urosepsis are more prone to complications during elective ureteroscopic stone removal, which may result in longer hospitalization and health care expenditures. Use of an access sheath to decrease intrarenal pressure in such patients is encouraged. In addition, treatment based on culture of collecting system urine is endorsed due to reported discordance with voided specimen cultures. Dean G. Assimos, MD
Suggested Reading Pearle MS, Pierce HL, Miller GL et al: Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol 1998; 160: 1260. Wang HS, Wiener JS, Ferrandino MN et al: Complications of surgical management of upper tract calculi in spina bifida patients: analysis of nationwide data. J Urol 2015; 193: 1270.
Re: Antimicrobial Resistance Patterns in Cases of Obstructive Pyelonephritis Secondary to Stones T. Marien, A. Y. Mass and O. Shah Department of Urology, New York University School of Medicine, New York, New York Urology 2015; 85: 64e68.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.02.019 available at http://jurology.com/ Editorial Comment: These findings suggest that it may be useful to obtain an aliquot of urine for culture from the collecting system in addition to that obtained from the bladder if obstructive pyelonephritis is observed in patients with ureteral stones. Discordance between voided and collecting system cultures has also been reported in patients with renal stones. In addition, knowing your local antibiotic resistance pattern is important when assigning antibiotic therapy in this setting. Dean G. Assimos, MD
Suggested Reading Borofsky MS, Walter D, Li H et al: Institutional characteristics associated with receipt of emergency care for obstructive pyelonephritis at community hospitals. J Urol 2015; 193: 851. Borofsky MS, Walter D, Shah O et al: Surgical decompression is associated with decreased mortality in patients with sepsis and ureteral calculi. J Urol 2013; 189: 946. Viprakasit DP, Sawyer MD, Herrell SD et al: Changing composition of staghorn calculi. J Urol 2011; 186: 2285.
