Kidney stone disease.

Kidney stone disease is rapidly increasing with a strong relationship to metabolic syndrome. This review gives a brief overview of the current state and current treatment modalities. Increasing use of CT and ultrasound scans leads to increased diagnosis of asymptomatic kidney stones, which rarely require treatment. The trend in stone treatment goes towards endoscopic lithotripsy which together with ESWL enables a personalised approach. Obstructive stones with infection require urgent intervention to reduce mortality. Increased fluid intake, dietary changes as well as potassium citrate supplements are the most important elements in stone prevention in the common idiopathic stone disease.

Initial experience with hand-assisted laparoscopic donor nephrectomy: a single-centre experience over 5 years.

OBJECTIVE: The objective of this study was to evaluate outcome after hand-assisted live donor nephrectomy with a retroperitoneal approach during a 5 year period. MATERIALS AND METHODS: All donor nephrectomies at Odense University Hospital, Denmark, from January 2008 to December 2012 were identified retrospectively, and the medical records were examined. RESULTS: In total, 108 patients were enrolled: 68 females, with a median age of 50 years (range 24-68 years), and 40 males, with a median age of 51 years (32-70 years). The median body mass index (BMI) was 25 kg/m² (19-33 kg/m²) in females and 27 kg/m² (21-38 kg/m²) in males. The median intraoperative bleeding was 175 ml. The median warm ischaemia time was 3.2 min (1.5-6.7 min). The median operative time was 230 min (161-360 min). The median hospital stay was 4 days (2-10 days). Thirty donors (28%) had 34 early complications. Six donors (6%) needed reoperation. Late complications were seen in seven (7%). Sixteen donors (15%) were obese (BMI ≥30 kg/m²), which was associated with significant complications (p < .0001). There was a significantly higher complication rate in donors who were smokers and ingested alcohol above the Danish recommended limits (p < .0001). Fifteen donors (13%) developed hypertension postoperatively within the first year. There was no mortality. A total of 104 (96%) of the recipients had a functional transplant after 1 year. CONCLUSION: Hand-assisted donor nephrectomy is a safe procedure. Potential candidates should be advised to stop smoking and to avoid alcohol before surgery, especially those with a BMI of 30 kg/m² or higher.