Kevin Fitzgerald

Radical Retropubic Prostatectomy: Limited Benefit of Autologous Blood Donation

PURPOSEnWe determine whether autologous blood donation significantly decreases the need for homologous transfusions after radical prostatectomy.nnnMATERIALS AND METHODSnThe effects of estimated blood loss and autologous donation on the rate of homologous transfusions were analyzed in 3 groups of 100 consecutive patients treated between 1983 and 1992.nnnRESULTSnOverall, donors were less likely than nondonors to receive homologous blood. As median estimated blood loss decreased from 1,200 to 800 cc from groups 1 to 3 (p < 0.05), the incidence of nondonors requiring homologous blood decreased from 62 to 11% and that of autologous units transfused decreased from 96 to 19%.nnnCONCLUSIONSnWith decreasing blood loss, safe but stringent criteria for transfusion and improved safety of the blood supply, autologous donation is an inefficient method to lower the slight risk of complications following homologous transfusion during radical prostatectomy.

MP34-04 INHIBITION OF GLYCOLATE OXIDASE REDUCES URINARY OXALATE EXCRETION IN A MOUSE MODEL OF PRIMARY HYPEROXALURIA TYPE 1

INTRODUCTION AND OBJECTIVES: Cumulative evidences indicate a tight association between urinary stone and dyslipidemia. Statins are widely used in clinical treatment of dyslipidemia. It is interesting and also important to know whether statin use can reduce the risk of upper urinary tract stone in patients with dyslipidemia. METHODS: We used data sourced from Longitudinal Health Insurance Database, which consists of one million randomly selected subjects from the National Health Insurance Research Database of Taiwan. Health Insurance System of Taiwan covers approximately 23 million people (98% of population). From 1997 to 2001, a total of 11785 subjects, 5926 males and 5859 females, with age 18-year-old or older were identified as dyslipidemia. All subjects did not have previous diagnosis of urinary stone. A cohort of 23570 (2 for each subject with dyslipidemia) age and gender matched subjects without the diagnosis of dyslipidemia and urinary stone were enrolled as the control group. All subjects were followed up to the end of 2009 with a minimal follow-up of 8 years. Multi-variables, including statin use, hypertension, and diabetes mellitus (DM), were taken into account. A Cox proportional hazard regression model was used to calculate the risk of upper urinary tract stone in study and control groups. RESULTS: At the end of follow-up, 1817 (15.4%) of the 11785 dyslipidemia subjects and 2445 (10.4%) of the 23570 control subjects developed upper urinary tract stones. After adjusting for age, gender, hypertension and DM, dyslipidemia was associated with a significantly increased risk of urinary stone (hazard ratio 2.086, 95% confidence interval, 1.929 2.256, p< 0.0001). The dyslipidemia subjects were further stratified into statin user group and non-statin user group. Nine hundred and sixty eight (15.1%) of the 6401 statin users and 849 (15.8%) of the 5384non-statin users developedupper urinary tract stones.Dyslipidemia patients who received statin treatment were not less likely to develop upper urinary tract stone than the patients who never used statin (hazard ratio 1.074, 95% confidence interval, 0.976 1.181, p 1⁄4 0.1430). CONCLUSIONS: Dyslipidemia is an independent risk factor for upper urinary tract stone. The findings of this study suggest that the use of statin cannot reduce the risk of upper urinary tract stone in patients with dyslipidemia.