The management of renal matrix calculi: a single institute experience

Author: 
Ramesh A., Karunamoorthy S., Prakash JVS and Ilamparuthi C

Introduction: Renal matrix stones are also known as fibrinomas, colloid calculi or albumin calculi. Renal matrix stones are uncommon form of urinary stones. In contrast to the normally brittle calcium stones, they are soft, pliable and amorphous. The objective of my study was to define incidence of renal matrix calculi in patients undergoing PCNL and to describe clinical, laboratory and radiological features. We also assessed efficacy of PCNL in treating matrix stones.

Materials and Methods: We retrospectively reviewed records of 800 PCNLs performed at our institute from June 2011 to May 2016, to identify patients having matrix calculi. PCNL was planned for the treatment of large renal calculi. All patients with normal serum creatinine levels had taken CECT KUB for the functional evaluation and to provide anatomical information for surgery. All PCNLs were performed with the patient under general anesthesia. The patients’ clinical, laboratory and radiological features were assessed, and the perioperative outcome and follow-up data analysed.

Results: The mean age group was 44.3 years. 6 patients were male and 10 were female patients.6 patients had stone on right side and 10 patients had stone on left side. Mean stone size was 2.2 cm (1.2 to 3.5). Mean hounsfield unit was 550 HU. 4 renal units needed multiple access tract. No patients required intra or postoperative blood transfusion. One patient developed sepsis and needed an ICU care for 3 days.

Conclusion: Matrix calculi occurred in 1.2% in our study. Although radiolucent, radiopaque shadow was seen in 11 Patients.PCNL was considered as safe and effective in treatment of matrix stone. In future, prospective multicentre studies are necessary to provide insights into the etiopathogenesis of this rare entity.

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