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Balawender K et al, 2017: The impact of pelvicalyceal anatomy on the stone formation in patients with lower pole renal stones.

Balawender K, Orkisz S.
Morphological Sciences Department of Human Anatomy Medical Faculty University of Rzeszów.

Abstract

BACKGROUND: The aim of our study was to determine whether various anatomic factors constitute a predisposition to a lower pole renal stones.
METHODS: We analysed the computed tomography (CT) urography of 75 patients with a single lower pole stone. Measurements were taken of the infundibulopelvic angle (IPA),infundibular width (IW), infundibular length (IL) and calyceopelvic height (CPH).
RESULTS: The mean patient age was 50 years (range 17-79). The mean stone size was 11.9 mm. The mean IPA using Sampaio method in affected kidney was 113.4 ± 15.3o (range 80-139o), 59.5 ± 17.3o using Elbahnasy method. The values of IPA on the contralateral kidney were 119.86 ± 15.37o (range 79-141 ͦ ; p = 0.001) using Sampaio method of measurement and 59.78 ± 12o (range 34-90 ͦ ; p = 0.465) using the method described by Elbahnasy. We reported statistically significant differences between stone-bearing kidney and contralateral kidney in measurement IPA using only Sampaio method. The mean infundibular width was 4.22 ± 1.81 mm on the affected kidney and 3.72 ± 2.5 mm on the contralateral side (p = 0.164). The mean infundibular length was 15.37 ± 4.57 mm on the affected kidney and 14.66 ± 4.35 mm on the unaffected side (p = 0.329).The CPH was 10.19 ± 4.05 mm on the affected kidney and 10.44 ± 3.83 mm on the normal side (p = 0.688).
CONCLUSIONS: Pelvicaliceal morphology of the kidney is one of the factors that determine the risk of developing kidney stones. Out of the analysed morphological parameters of kidney IPA is a statistically significant risk factor to form lower pole kidney stones. Other anatomic parameters did not seem to have a significant role in predisposing to form lower pole kidney stone.

Folia Morphol (Warsz). 2017 Jun 27. doi: 10.5603/FM.a2017.0058. [Epub ahead of print]

 

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Commenti 1

Hans-Göran Tiselius il Martedì, 06 Febbraio 2018 09:23

This report does not deal directly with SWL, but with the possible importance of the geometry of the lower calyx for the risk of stone formation. The observations might nevertheless have some relevance for SWL-treated patients because the geometric properties of the lower calyx system are frequently discussed in relation to fragment clearance.
The clinical significance of the reported result is doubtful inasmuch as the only difference between stone-bearing and stone free kidneys (the contra-lateral kidneys) was the IPA measured according to Sampaio. It should be noted, however, that in addition to the difficulty to accurately measure these geometrical variables the difference was numerically very small.

This report does not deal directly with SWL, but with the possible importance of the geometry of the lower calyx for the risk of stone formation. The observations might nevertheless have some relevance for SWL-treated patients because the geometric properties of the lower calyx system are frequently discussed in relation to fragment clearance. The clinical significance of the reported result is doubtful inasmuch as the only difference between stone-bearing and stone free kidneys (the contra-lateral kidneys) was the IPA measured according to Sampaio. It should be noted, however, that in addition to the difficulty to accurately measure these geometrical variables the difference was numerically very small.
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Martedì, 20 Novembre 2018
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