Calcification of ureteral stents: a determinant factor in renal function deterioration in patients with urolithiasis
DOI:
https://doi.org/10.18203/2349-2902.isj20251166Keywords:
Urolithiasis, Calcified ureteral stent, Chronic kidney disease, Renal functionAbstract
Background: Ureteral stents play a crucial role in managing urinary tract obstructions, significantly advancing urological care. However, complications such as stent calcification present significant challenges.
Methods: This retrospective case-control study included 72 patients with ureteral stents placed for urolithiasis between 2020 and 2023. Patients were divided into two groups: calcified stents (n=36) and non-calcified stents (n=36). Data on demographics, comorbidities, stent duration, and renal function parameters were collected. Statistical analyses included Mann-Whitney, Fisher, and Chi-squared tests, with odds ratios (OR) calculated for associations (p<0.05). Ethical approval was obtained from the hospital’s ethics committee.
Results: Calcified stents were strongly associated with chronic kidney disease (CKD) (OR=2.667, 95% CI: 1.093–6.507) and renal function deterioration (OR=2.200, 95% CI: 0.804–6.018). Prolonged stent durations (>3 months) significantly increased calcification risk (OR=4.375, 95% CI: 2.322–8.243), while durations <3 months were protective (OR=0.156, 95% CI: 0.062–0.396). CKD prevalence was significantly higher in the calcified group (38.9%) compared to controls (11.1%) (p=0.006).
Conclusions: Stent calcification is associated with CKD and renal function decline. Timely removal (<3 months) is critical. Further research with larger cohorts is necessary to confirm these findings and guide preventive strategies.
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References
Finney RP. Experience with new double J ureteral catheter stent. J Urol. 1978;120:678-81. DOI: https://doi.org/10.1016/S0022-5347(17)57326-7
Zimskind PD, Fetter TR, Wilkerson JL. Clinical use of long-term indwelling silicone rubber ureteral splints inserted cystoscopically. J Urol. 1967;97:840-4. DOI: https://doi.org/10.1016/S0022-5347(17)63130-6
Lee J, Katz M, Shah O. Developments in ureteral stent technology. Front Surg. 2021;8:1-5. DOI: https://doi.org/10.3389/fsurg.2021.764167
Mosayyebi A, Manes C, Carugo D, Somani BK. Advances in ureteral stent design and materials. Curr Urol Rep. 2018;19:1-5. DOI: https://doi.org/10.1007/s11934-018-0779-y
Bhardwaj M, Ingole N. Application, advancement, and complication of ureteral stent and encrustation: A major complication. Cureus. 2022;14:10-4. DOI: https://doi.org/10.7759/cureus.28639
Lange D, Bidnur S, Hoag N, Chew BH. Ureteral stent-associated complications—where we are and where we are going. Nat Rev Urol. 2015;12:17-25. DOI: https://doi.org/10.1038/nrurol.2014.340
Amitay-Rosen T, Dror I, Shilo Y, Berkowitz B. Imaging and chemical analysis of external and internal ureteral stent encrustation. Res Rep Urol. 2022;14:159-66. DOI: https://doi.org/10.2147/RRU.S364336
Torrecilla C, Fernández-Concha J, Cansino JR, Mainez JA, Amón JH, Costas S, et al. Reduction of ureteral stent encrustation by modulating the urine pH and inhibiting the crystal film with a new oral composition: A multicenter, placebo-controlled, double-blind, randomized clinical trial. BMC Urol. 2020;20:1-12. DOI: https://doi.org/10.1186/s12894-020-00633-2
Thangavelu M, Abdallah MY, Isola OJ, Kotb A. Management of encrusted ureteral stents: Two center experience. Arch Ital Urol Androl. 2022;94:305-10. DOI: https://doi.org/10.4081/aiua.2022.3.305
Iglesias Lopes RI, Perrella R, Watanabe CH, Beltrame F, Danilovic A, Murta CB, et al. Patients with encrusted ureteral stents can be treated by a single session combined endourological approach. Int Braz J Urol. 2021;47:574-83. DOI: https://doi.org/10.1590/s1677-5538.ibju.2020.0511
Acosta-Miranda AM, Milner J, Turk TMT. The FECal double-J: A simplified approach in the management of encrusted and retained ureteral stents. J Endourol. 2009;23:409-15. DOI: https://doi.org/10.1089/end.2008.0214
Lin TF, Lin WR, Chen M, Yang TY, Hsu JM, Chiu AW. The risk factors and complications of forgotten double-J stents: A single-center experience. J Chin Med Assoc. 2019;82:767-71. DOI: https://doi.org/10.1097/JCMA.0000000000000161
De Grazia A, Somani BK, Soria F, Carugo D, Mosayyebi A. Latest advancements in ureteral stent technology. Transl Androl Urol. 2019;8:S436-41. DOI: https://doi.org/10.21037/tau.2019.08.16
Tomer N, Garden E, Small A, Palese M. Ureteral stent encrustation: Epidemiology, pathophysiology, management and current technology. J Urol. 2021;205:68-77. DOI: https://doi.org/10.1097/JU.0000000000001343
Juliebø-Jones P, Pietropaolo A, Æsøy MS, Ulvik Ø, Beisland C, Bres-Niewada E, et al. Endourological management of encrusted ureteral stents: An up-to-date guide and treatment algorithm. Cent Eur J Urol. 2021;74:571-8.
Abbasi A. Forgotten double J stent: An avoidable complication. Rawal Med J. 2019;44:517-20.
Moshinsky M. Encuesta Nacional de Salud y Nutrición 2020 sobre COVID-19. Nucl Phys. 2021;13:1-192.
Yoshida T, Takemoto K, Sakata Y, Matsuzaki T, Koito Y, Yamashita S, et al. A randomized clinical trial evaluating short-term results of ureteral stent encrustation in urolithiasis patients undergoing ureteroscopy: Micro-computed tomography evaluation. Sci Rep. 2021;11:1-8. DOI: https://doi.org/10.1038/s41598-021-89808-x
Ibilibor C, Grand R, Daneshfar C, DeRiese W, Smith C. Impact of retained ureteral stents on long-term renal function. Urol Pract. 2019;6:107-11.
Zahran MH, Harraz AM, Taha DE, El-Nahas AR, Elshal A, Shokeir AA. Studying morbidity and renal function outcomes of missed internal ureteral stents: A matched-pair analysis. J Endourol. 2015;29:1070-5. DOI: https://doi.org/10.1089/end.2015.0047
Lombardo R, Tubaro A, De Nunzio C. Ureteral stent encrustation: Epidemiology, pathophysiology, management and current technology. J Urol. 2022;207:248-9. DOI: https://doi.org/10.1097/JU.0000000000001678
Borboroglu PG, Kane CJ. Current management of severely encrusted ureteral stents with a large associated stone burden. J Urol. 2000;164:648-50. DOI: https://doi.org/10.1097/00005392-200009010-00007
Sancaktutar AA, Söylemez H, Bozkurt Y, Penbegül N, Atar M. Treatment of forgotten ureteral stents: How much does it really cost? A cost-effectiveness study in 27 patients. Urol Res. 2012;40:317-25. DOI: https://doi.org/10.1007/s00240-011-0409-3
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