📃 Paper Title: Long-term renal fate and prognosis after staghorn calculus management
🧍 Author: Teichman
🕒 Year: 1995
📚 Journal: Journal of Urology
🌎 Country: U.S.
ㅤContext to the study:
Can you tell me a paper outlining the natural history of staghorn stones?
ㅤ✅ Take-home message of study:
Patients with staghorn stones are at risk of renal deterioration, and this study stresses the importance of preserving renal function in these patients.
Strategies include maximizing stone-free rates, metabolic work-up, treatment of voiding dysfunction, control of hypertension.
ㅤ Retrospective case series
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Study participants:
112 (of 177 consecutive cases) staghorn calculus patients
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Key study outcomes:
Mean follow-up = 7.7 years
Rate of renal deterioration = 28%
(Deterioration defined as eGFR < 40, increase CrCl >30%, dialysis, or increase creatinine >1.2mg%)
Patients with solitary kidneys at high risk of deterioration (77% vs. 21%)
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Study Limitations:
Single center, retrospective series
Old study (in era of dornier lithotripter, large tracts, incl. open pyelolithotomies)
Many staghorns treated with EWSL (modern guidelines favour PCNL).
Missing data for 36% of patients
Did not control for key risk factors (such as diabetes, ethnicity)
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