Current guidelines and trends for kidney stone management; advancing care of renal stone disease in the United States – Optimizing surgical outcomes and focusing on prevention

4^th International Conference on Nephrology & Therapeutics

September 14-16, 2015 Baltimore, USA

Julio G Davalos

University of Maryland, USA

Scientific Tracks Abstracts: J Nephrol Ther

Abstract :

Kidney stone disease is a common malady affecting approximately 1 in 11 people in the United States (19% men and 9% women) by age 70 years, with a cost exceeding two billion dollars annually. Prevalence has demonstrated a significant rise over the last 20 years and stones are likely to recur in at least 50% of patients within 10 years of the first occurrence. Renal stone disease is primarily a renal physiologic abnormality and approximately 15% of stones require surgical intervention. Stone disease is one of the primary bridge points between the fields of nephrology and urology. A comprehensive review of the American Urological Association guidelines for initial evaluation, conservative versus surgical intervention, metabolic evaluation and medical treatments, optimal surgical modalities, and suggested follow-up for stone formers will be detailed. Current advancements in the surgical treatment of stone disease including an outlook toward contemporary management and future trends in urological stone treatment will also be reviewed. One recent modification in the endoscopic treatment of stones is the advent of stone dusting. This technique uses commonly available holmium laser technology to fragment stone into minute particles that can easily pass through the urinary tract. We present our current protocol and early experience with this approach to surgical stone management. Percutaneous Nephrolithotomy (PCNL) is a well-established surgical treatment option for large and complex upper urinary tract kidney stones. PCNL has traditionally been performed as an inpatient procedure with the aid of interventional radiology to provide renal access and nephrostomy tube drainage. We present our series of outpatient PCNLs performed with the urologic surgeon obtaining access and without the routine placement of nephrostomy tube for drainage post-operatively.