The annual meeting of the American Urological Association was held from May 18 to 21 in San Francisco and attracted more than 12,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in urology. The conference highlighted recent advances in the prevention, detection, and treatment of urologic conditions, with presentations focusing on the advancement of urologic patient care.
In one study, Will Brubaker, M.D., of Stanford University in California, and colleagues performed a comprehensive analysis of 273 water variables and ZIP code-level kidney stone prevalence, utilizing an environment-wide association study method. The investigators aimed to identify constituents within the California municipal water supply that were associated with clinically significant urinary stone disease.
“The etiology of urinary stone disease is multi-factorial. We have known for decades that environmental factors influence urinary stone disease, including geographic location, temperature, and precipitation,” Brubaker said. “To date, there are few studies that have looked at the constituents in drinking water as potential factors that can influence urinary stone development. Most studies focus on a limited number of variables such as water hardness, calcium, and magnesium.”
Data for patients with urinary stones was obtained from the California Office of Statewide Health Planning and Development dataset from 2010 to 2012. All emergency department encounters with a kidney stone diagnosis and all kidney stone surgeries were combined by ZIP code and normalized by ZIP code population. Then, each ZIP code was given a “stone score,” with higher scores correlating with higher stone burden.
“We identified four water constituents that were associated with being in the top quartile of ZIP codes with significant stone disease, and 20 water constituents inversely associated with being in the top quartile of ZIP codes with significant stone disease,” Brubaker said. “Some of the constituents that we found to be inversely associated, including calcium, magnesium, water hardness, and potassium, have been shown in in-vitro and animal studies to be protective against kidney stone development in certain circumstances.”
According to the researchers, zinc was also found to be associated with the top quartile of ZIP codes by stone score.
“While these associations are compelling, they cannot be taken as evidence of a causal relationship,” Brubaker cautioned. “Our results provide novel environmental exposures that can be studied further to potentially discover a causal relationship or no relationship at all.”
In another study, Joseph R. Wagner, M.D., of Hartford Hospital in Connecticut, and colleagues found that differences exist in favorable prognostic outcomes for prostate cancer obtained from the genomic tests Oncotype DX, Prolaris, and Decipher.