Clinical audit of kidney stone formers in Southern Tasmania
Nejatian, A and Patel, A and Jose, M, Clinical audit of kidney stone formers in Southern Tasmania, 55th Australian and New Zealand Society of Nephrology (ANZSN), 30 November - 02 December, Online, pp. 59-59. ISSN 1320-5358 (2020) [Conference Extract]
Aim: To investigate the number, type, and metabolic profile of recurrent kidney stone formers (KSF) referred to a tertiary hospital renal unit.
Background: Up to 15% of adults are affected by kidney stones at some
point during their life. For people who have their first stone, up to half will
experience a second. Complete metabolic assessment of KSF in the Tasmanian population might allow more effective preventative strategies to be put
Methods: This retrospective clinical audit reviewed adult KSF referred to the
Royal Hobart Hospital renal unit between 2009 and 2019.
Results: We only identified 39 adults (18 (46%) women) mean age
52 ± 16.9 years. Overall, 85% of these patients had a previous admission for
kidney stones. All patients had pre-existing comorbidities, including hypertension (62%), diabetes (36%) and 46% had a smoking history. Of those
with a known BMI, 95% were overweight or obese.
On stone analysis, 21% were calcium oxalate, 13% were staghorn, 8% were
urate, 5% were cysteine and the rest (51%) were not recorded. Biochemically, 18% had low serum bicarbonate, 68% had low eGFR, 5% had hypercalcaemia, 14% hyperphosphatemia, 9% had hypophosphatemia, 25% had
hyperuricemia and 18% had hypomagnesaemia. Sixteen of 39 (40%)
patients had a 24-hour urine assessment where most (56%) had <2 L urine volume. Of those tested, 40% had hyperoxaluria (2 of 5), 33% had
hypocitraturia (2 of 6) and none had hypercalciuria (0 of 6).
Conclusion: This audit shows stone analysis is underperformed, referral to
renal physicians uncommon and there is inconsistent metabolic assessment.
A consistent management approach could possibly help improve preventative
strategies and reduce future episodes of renal colic or hospital admissions.