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Increased kidney stone risk following total pancreatectomy with islet autotransplantation.
Avula, Nandini; Hodges, James S; Beilman, Gregory; Chinnakotla, Srinath; Freeman, Martin L; Ramanathan, Karthik; Schwarzenberg, Sarah Jane; Trikudanathan, Guru; Bellin, Melena D; Downs, Elissa M.
Afiliación
  • Avula N; University of Minnesota Medical School, Minneapolis, MN, USA. Electronic address: avula010@umn.edu.
  • Hodges JS; Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
  • Beilman G; Department of Surgery, University of Minnesota, Minneapolis, MN, USA; Schulze Diabetes Institute, University of Minnesota, Minneapolis, MN, USA.
  • Chinnakotla S; Department of Surgery, University of Minnesota, Minneapolis, MN, USA; Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
  • Freeman ML; Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
  • Ramanathan K; Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
  • Schwarzenberg SJ; Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
  • Trikudanathan G; Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
  • Bellin MD; Schulze Diabetes Institute, University of Minnesota, Minneapolis, MN, USA; Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
  • Downs EM; Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Pancreatology ; 2024 Sep 12.
Article en En | MEDLINE | ID: mdl-39271374
ABSTRACT
BACKGROUND/

OBJECTIVES:

Chronic pancreatitis (CP) is associated with increased risk of calcium-oxalate kidney stones, likely due to enteric hyperoxaluria. However, the risk of kidney stones for patients with CP after total pancreatectomy with islet autotransplantation (TPIAT) is unknown. We aimed to evaluate kidney stone risk in patients with CP after TPIAT.

METHODS:

A retrospective analysis of 629 patients who underwent TPIAT was conducted to identify patients who developed kidney stones post-TPIAT. Kaplan-Meier analysis estimated time to first event. An Anderson-Gill proportional-hazards analysis of all kidney stone events described key clinical associations.

RESULTS:

Mean age at TPIAT was 33 years (SD 15.3, range 3-69); 69.8 % (n = 439) were female. The estimated chance of any kidney stone episodes by 5 years post-TPIAT was 12.8 % (95 % CI 8.8-16.6 %); by 10 years, 23.2 % (CI 17.5-28.6 %); by 15 years, 29.4 % (CI 21.8-36.2 %). Significant associations with kidney stones post-TPIAT included older age (HR 1.25 per 10 years), smoking history (HR 1.72), mild chronic kidney disease (HR 1.96), renal cysts (HR 3.67), pre-TPIAT kidney stones (HR 4.06), family history of kidney stones (HR 4.10), and Roux-en-Y reconstruction (HR 2.68). Of the 77 patients who developed kidney stones, 34 (44.1 %) had recurrent episodes. Of 143 total kidney stone events, 35 (24.5 %) required stone removal, 79 (55.2 %) resolved spontaneously, and 29 (20.3 %) were missing this data.

CONCLUSIONS:

Patients with CP post-TPIAT commonly have kidney stones nearly 3 in 10 have ≥1 kidney stone episodes within 15 years. Clinicians should be aware of this risk and counsel patients on prevention.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pancreatology Asunto de la revista: ENDOCRINOLOGIA / GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pancreatology Asunto de la revista: ENDOCRINOLOGIA / GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Suiza