The following is a summary of “Incidence of metabolic syndrome in patients with unilateral or bilateral staghorn renal stones and its impact on percutaneous nephrolithotomy outcomes,” published in the July 2024 issue of Urology by Shen et al.
This study aimed to assess the incidence of metabolic syndrome (MetS) among patients with unilateral and bilateral staghorn calculi (SC) and to evaluate its impact on the outcomes of percutaneous nephrolithotomy (PCNL). Researchers conducted a retrospective analysis of clinical data from patients who underwent PCNL for SC between 2019 and 2022. The SC cases were categorized into unilateral and bilateral groups, and investigators compared the incidence of MetS between these groups while evaluating its influence on PCNL outcomes. A total of 1,778 patients underwent PCNL during the study period, with 379 confirmed to have SC based on computed tomography screening.
Ultimately, 310 patients with complete follow-up data were included in the analysis, comprising 84 patients with bilateral SC and 226 with unilateral SC. The findings indicated that patients with bilateral SC exhibited significantly higher body mass index (BMI) and greater prevalence of complete staghorn stones and MetS. Specifically, higher BMI, hypertension, diabetes mellitus, hyperlipidemia, and MetS were present in 62.58%, 44.84%, 21.94%, 60.65%, and 27.42% of patients, respectively. Notably, the number of MetS components was significantly associated with bilateral SC; as the number of components increased from 0 to 3-4, the likelihood of developing bilateral staghorn calculi increased by 21.967. Furthermore, patients classified as MetS-positive (n=85) experienced a significantly higher overall complication rate (34.12% vs. 14.46%, P < 0.001) compared to those without MetS, despite achieving comparable stone-free rates.
Multivariable analysis identified hyperlipidemia (P = 0.044, odds ratio [OR] = 1.991, 95% CI 1.020–3.888) and MetS (P = 0.005, OR = 2.427, 95% CI 1.316–4.477) as independent risk factors for overall complications following PCNL. In conclusion, the study demonstrates a significant correlation between MetS and the formation of bilateral staghorn calculi, establishing MetS as a key predictor of complications arising from PCNL, particularly low-grade complications (I-II). This underscores the importance of metabolic health assessment in patients undergoing surgical intervention for staghorn calculi.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01526-4
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