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Thought Leadership

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Osteoporosis Patients and Kidney Stones

Osteoporosis patients are typically treated with Denosumab injections (e.g. Prolia), which can cause hypocalcemia. As such, patients are often prescribed calcium and vitamin D supplements. However, these supplements can promote stone formation*, and some patients in our community have developed more stones as a result.

*Source:
Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: US Preventive Services Task Force Recommendation Statement

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Helping Pediatric Kidney Stone Patients Get the Right Care

Kidney stones in children are often an indication of serious anatomical and blood disorders. Worried parents in our community have been consulting multiple specialists about their children’s kidney stones!

A recent study by Önal et al found that various disciplines adopt different approaches when presented with pediatric kidney stones. This results in conflicting decisions that may impede therapeutic outcomes. Urologists, it may be helpful to develop a multi-disciplinary team for your pediatric patients!

Read more here: Different approaches among physicians to treat pediatric stone disease: a survey-based study

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Genetic Influences in Kidney Stone Formation

Genetic influences play a major role in kidney stone formation, especially for recurrent stone formers. A recent study published in Nature Reviews Urology highlighted that 30% of chronic kidney stone patients develop stones as a result of their monogenetic disorders!

Currently, the genetic drivers of this disease remain unknown. However, with the rapid advancements in genomic studies, urologists can look forward to novel diagnoses and treatment measures for kidney stones in the near future.

Read more here: Genetics of kidney stone disease

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PROMIS Assessment Suggests Opioids May Be Ineffective in Relieving Stent Pain

Many kidney stone patients rely on opioids to ease stent pain, but a new study published in the AUA Journals suggests that they may not be effective at relieving post-operative pain!

Researchers used a PROMIS assessment to determine the effectiveness of opioids in easing stent pain. Surprisingly, patients on opioids experienced the same level of pain intensity and interference as those who were not.

With the U.S. surpassing 100,000 drug-related deaths in 20201, many urologists are exploring alternative pain management protocols to avoid prescribing opioids. Advise patients to opt for opioid-free treatments, they are safer and more effective!

Read more here: The impact of ureteral stent omission and an opiate-free protocol on patient reported outcomes following ureteroscopy

  1. 100,000 Americans died of drug overdoses in 12 months during the pandemic
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To Lower Stone Recurrence Rates, Comply With Stone Management Guidelines

Despite rapid advancements in kidney stone treatments, stone recurrence rates remain high. Assts Prof Kyle Wood, M.D., attributes this phenomenon to urologists’ low levels of compliance with treatment guidelines.

“We’re very good at surgically treating stones,” Asst. Prof Wood, M.D., said. “But we’ve done a pretty poor job as a practice at managing kidney stones. I think the biggest issue is we haven’t even followed our guidelines.”

Read more here: Stone management often falls short

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