Presented by: Ilan Klein MD
Carmel Medical Center

Introduction

Cystine and Brushite (C/B) stones are notorious for high recurrency rates. Therefore, follow up of these stone formers should be strict and preventive measures should include specific diet and medications.

Materials

A large Israeli HMO database we created (over 10K stone patients) was used to identify patients with C/B stones treated between 2014 and 2019. A telephone survey was conducted evaluating patient understanding of stone composition, follow up, urine collection, treatment compliance etc. Patients’ data, emergency room (ER) visits, admissions procedures and urologist visits were compared to 100 random Calcium Oxalate patients at the same time period.

Results

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Thirty three Cystine patients out of 62 and 39 Brushite patients out of 84 participated. In the Cystine group 75.7% were aware of their stone type and 27.2% had at least 3 stones passed in the last year but half of them did not see their urologist in the previous year. Medication [YF1] [כק2] compliance was only at 57.5%. The Brushite group had only a 28.2% stone awareness, 43.5% did not visit their urologist in the previous year and only a quarter complied with medication. When comparing ER visits, 14% of the control group had 3 times or more in comparison to 41% of  the C/B group. 37% of C/B group were admitted more than once a year in comparison to only 14% in the control group.

Conclusion

Poor compliance of C/B patients should urge urologists to improve their follow-up in order to reduce recurrent stone events.  

Funding

None

Co-Authors

Alex Blinzovski,
Ruth & Bruce Rappaport faculty of medicine, Technion

Ilona Pilosov Solomon, MD
Carmel Medical Center

Yuval Freifeld, MD
Carmel Medical Center

Rani Zreik, MD
Carmel Medical Center

Mahran Kabaha, MD
Carmel Medical Center

Gazi Fares, MD
Carmel Medical Center

Yoram Dekel, MD
Carmel Medical Center