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欧洲和非欧洲中心的肾结石管理实践模式:来自欧洲肾脏结石网络(ERSN)的深入调查。

Practice patterns of kidney stone management across European and non-European centers: an in-depth investigation from the European Renal Stone Network (ERSN).

机构信息

U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.

Università Cattolica del Sacro Cuore, Rome, Italy.

出版信息

J Nephrol. 2021 Aug;34(4):1337-1346. doi: 10.1007/s40620-020-00854-6. Epub 2020 Sep 12.

Abstract

RATIONALE AND OBJECTIVE

Kidney stones are a common condition in the general population, however, high-quality evidence for its management is scarce. We propose the creation of an international network with the aim of sharing practice patterns and patient data towards an improvement of our knowledge of the disease.

STUDY DESIGN

Cross-sectional survey.

SETTING AND PARTICIPANTS

An online survey was circulated through several scientific societies. Items were grouped into six domains. Each center's overall score (OS) was also calculated.

ANALYTICAL APPROACH

Chi square and Mann-Whitney tests were performed for differences across centers.

RESULTS

The countries that contributed most were Italy (8.6%), Turkey (6.6%), France and Spain (6.1%). Some type of nutritional work-up was implemented in 62% of centers. A DEXA scan was performed by 46% of centers, whereas some kind of acidification test was performed by 25% of centers. Most centers (80%) implemented blood investigations at least at baseline. With regard to 24-h urine exams, 7 out of 16 were performed by at least 50% of centers. Information on stone composition was collected by 58% of centers. The OS was significantly higher among higher-volume centers compared with lower-volume centers (p = 0.002). Significant differences between EU and non-EU centers were found.

LIMITATIONS

Cross-sectional design; no validation on information.

CONCLUSIONS

Our survey highlights the potential for the creation of a network of centers that could share information in a common database for observational research and for enrollment of patients in interventional trials.

摘要

背景与目的

肾结石在普通人群中较为常见,但针对其管理的高质量证据却很少。我们拟创建一个国际性网络,旨在共享实践模式和患者数据,从而增进我们对该疾病的认识。

研究设计

横断面调查。

设置与参与者

通过多个科学协会在线发布了一份调查问卷。项目被分为六个领域。每个中心的总得分(OS)也进行了计算。

分析方法

采用卡方检验和曼-惠特尼检验比较各中心间的差异。

结果

贡献最多的国家是意大利(8.6%)、土耳其(6.6%)、法国和西班牙(6.1%)。62%的中心进行了某种形式的营养评估。46%的中心进行了 DEXA 扫描,而 25%的中心进行了某种酸化试验。80%的中心至少在基线时进行了血液检查。关于 24 小时尿液检查,有 7 个中心至少有 50%的中心进行了该检查。58%的中心收集了结石成分信息。与低容量中心相比,高容量中心的 OS 明显更高(p=0.002)。发现欧盟和非欧盟中心之间存在显著差异。

局限性

横断面设计;未对信息进行验证。

结论

我们的调查结果表明,有可能创建一个中心网络,该网络可以在一个共同的数据库中共享信息,以进行观察性研究,并为干预性试验招募患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d99/8357688/4639648fd20f/40620_2020_854_Fig1_HTML.jpg

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