Presentation Authors: Ravin J. Bastiampillai*, Shuang Li, Kristina L. Penniston, Sara L. Best, Stephen Y. Nakada, Madison, WI
Introduction: Gastrointestinal disease (GID) is an established risk factor for nephrolithiasis. However, few studies have compared this risk between different types of GID; fewer yet have identified whether the need for repeat stone surgery is different by GID. We assessed the need for repeat stone surgery for patients with GID at our institution.
Methods: From our HIPPA-certified surgical stone database, we identified patients with and without GID. Patients who followed up for â‰¥1 year were included. We further categorized patients&[prime] GID into 4 categories: inflammatory bowel disease (IBD), gastric bypass procedures (GP), bowel resection (BR), and &[Prime]other&[Prime] (e.g., IBS, celiac disease, chronic diarrhea). Repeat surgery was defined as the second surgery; planned staged surgery was not considered repeat surgery.
Results: Of 2011 surgical stone patients, 484 had some type of GID. Compared to patients without GID, patients with GID presented with stones at an older age (62.1 Â± 14.5 vs. 58.4 Â± 15.3 y; p < 0.0001, T-test), were more likely to be female (56.2% vs. 46.4%; p < 0.0001, Chi-square), had diabetes (25% vs. 20.5%, p=0.036), hypertension (46.5% vs. 40.7%, p=0.025), and/or history of urinary tract infections (14.7% vs. 9.1%, p < 0.0001). No difference was found between groups for BMI (30.8 Â± 8.5 vs. 31.4 Â± 8.0; p=0.112), follow up time (4.5 Â± 2.5 vs. 4.5 Â± 2.4 y; p=0.854), and whether, in addition to surgical follow-up, they had been seen in our metabolic stone clinic (33.7% vs. 30.4%; p=0.173). Using survival analysis, patients with GID required more repeat stone surgeries compared to patients without GID (hazard ratio 1.509, 95%CI 1.245-1.828; p < 0.0001). Patients with GP, BR, and &[Prime]other&[Prime] GID demonstrated greater risk for repeat stone surgery compared to patients without any GID (see table). Among patients with any type of GID, there was no difference in the need for repeat stone surgeries (p=0.061 for overall comparison between groups).
Conclusions: Surgical stone patients with GID require more subsequent stone surgery and have a higher risk of requiring future stone surgery compared to patients without GID. Among patients with GID, no one particular type was associated with requiring more repeat stone surgery than the others.