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Kidney StonesNCT02522676

Evaluation of Different Treatment Modalities for Lower Pole and Renal Pelvis Stones

A study testing Endoscopic kidney stone surgery and Non-invasive kidney stone treatment in people with Kidney Stones, run by Selcuk University at 1 site in Turkey (Türkiye).

Suspended

Paused. Enrolment is on hold for now and may resume.

Official record
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Trial summary

It is aimed to evaluate the treatment results, rates of success and complications, and injury given to the kidney by measuring preoperative and postoperative blood urea, creatinine, Cystatin C and Netrin-1 levels and urine Cystatin C and Netrin-1 levels in patients with lower pole or renal pelvis stone(s) undergoing… Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Kidney Stones
What is being tested?
Endoscopic kidney stone surgery and Non-invasive kidney stone treatment
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
300 participants
Where
1 siteTurkey (Türkiye)
Study dates
Jun 2020to Dec 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients planned to undergo either conventional PCNL, mini PCNL, ultra-mini PCNL, micro PCNL, RIRS or ESWL due to kidney stone(s)
  • Patients between 18 and 70 years old

Who cannot join

  • Patients with unregulated diabetes mellitus and diabetic nephropathy
  • Patients with a blood pressure higher than 140/80 mmHg despite use of antihypertensive drug(s) regularly
  • Patients with chronic renal failure who need dialysis
  • Patients who had prerenal, renal or postrenal acute kidney failure during the last 6 months
  • Patients who had acute pyelonephritis during the last 6 months
  • Patients younger than 18 years old or older than 70 years old
Show all 14Show fewer
  • Patients who had kidney surgery during the last 3 months and who have abnormal kidney functions
  • Patients with ureteral stone who are planned to undergo endoscopic stone treatment at the same time
  • Patients with a history of corticosteroid use during enrollment into the study or previous 3 months
  • Patients with uncontrolled thyroid disease
  • Patients who have a disease with rapid cell turn-over (like leukemia, lymphoma, etc.)
  • Patients in whom PCNL/RIRS/ESWL cannot be performed due to any reason and the procedure is terminated
  • Patients who are converted to open surgery due to any reason
  • Patients with missing data

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Selcuk University, School of Medicine, Department of Urology

    Konya, 42075

Other trials in Turkey (Türkiye)

About this study

Official title: Comparison of Success Rates, Complication Rates and Injury to Kidneys of Conventional PCNL, Mini PCNL, Ultra-mini PCNL, Micro PCNL, RIRS and ESWL in the Treatment of Lower Pole and Renal Pelvis Stone(s)

It is aimed to evaluate the treatment results, rates of success and complications, and injury given to the kidney by measuring preoperative and postoperative blood urea, creatinine, Cystatin C and Netrin-1 levels and urine Cystatin C and Netrin-1 levels in patients with lower pole or renal pelvis stone(s) undergoing either one of the treatment modalities including conventional percutaneous nephrolithotripsy (PCNL), mini PCNL, ultra-mini PCNL, micro PCNL, retrograde intrarenal surgery (RIRS) and extracorporeal shock wave lithotripsy (ESWL).

Read the detailed description

In this study, the demographic and preoperative data, imaging data, operative data and postoperative follow-up data will be prospectively recorded according to the patient information forms for the patients with lower pole and/or renal pelvis stone(s) who will undergo either one of the treatment modalities including conventional PCNL, mini PCNL, ultra-mini PCNL, micro PCNL, RIRS and ESWL.

A total of 300 (three hundred) patients, aging between 18 and 70 years, with similar stone size and location are being planned to be enrolled into the study; and will be prospectively randomized into one of six groups with a 1:1 ratio. By this means, conventional PCNL will performed to 50 (fifty) patients, mini PCNL will be performed to 50 (fifty) patients, ultra-mini PCNL will be performed to 50 (fifty) patients, micro PCNL will be performed to 50 (fifty) patients, while 50 (fifty) patients will undergo RIRS and 50 (fifty) patients will undergo ESWL.

Preoperatively, blood Cystatin C and Netrin-1, and urine Neutrophil gelatinase-associated lipocalin (NGAL), Cystatin C and Netrin-1 levels will be measured. After the treatments, blood Cystatin C and Netrin-1 levels at postoperative 6th, 12th, 24th and 48th hours will be recorded. Cystatin C and Netrin-1 levels in urine will be measured at postoperative 12th and 24th hours, while urine NGAL levels will be measured at postoperative 12th and 72nd hours. Besides these, classical kidney function tests, namely blood urea and creatinine levels, will be measured preoperatively and postoperatively at 24th and 48th hours.

Parameters listed below will be also recorded and evaluated:

  1. Preoperative general evaluation data: Age, height, weight, body-mass index, concomitant comorbidities, prescriptions used, history of operation(s), American Society of Anesthesiologists (ASA) score
  2. Preoperative urological evaluation data: History of ESWL/PCNL/ureterorenoscopy (URS)/RIRS/open surgery, whole blood count, kidney function tests, automatic urine test, urine culture, preoperative imaging modality (KUB, US, CT), number-dimensions-localization-composition of stone(s), existence of hydronephrosis
  3. Operative data: Access fluoroscopy duration, total access duration, total fluoroscopy duration, operation duration, use of double-J stent, preoperative complications
  4. Number of previous ESWL seance, total duration of ESWL, number of shots during ESWL (if any)
  5. Follow-up data: Urethral catheterization time, hospitalization time, need of any other treatment for being stone-free, time to full stone-free, duration to removal of double-J stent, existence of residual stone(s), formation of new stone(s), complications in late time, medical prophylaxis
  6. Stone analysis
Conditions
Kidney Stones
Being tested
Endoscopic kidney stone surgery, Non-invasive kidney stone treatment
Keywords
kidney stone, percutaneous nephrolithotripsy, retrograde intrarenal surgery, extracorporeal shock wave lithotripsy, mini PCNL, ultra-mini PCNL, micro PCNL
Medical subject headings
Kidney Calculi

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Endoscopic kidney stone surgeryProcedure or surgery

    Conventional PCNL will be performed.

  • Endoscopic kidney stone surgeryProcedure or surgery

    Mini PCNL will be performed.

  • Endoscopic kidney stone surgeryProcedure or surgery

    Ultra-mini PCNL will be performed.

  • Endoscopic kidney stone surgeryProcedure or surgery

    Micro PCNL will be performed.

  • Endoscopic kidney stone surgeryProcedure or surgery

    Retrograde intrarenal surgery will be performed.

  • Non-invasive kidney stone treatmentProcedure or surgery

    Extracorporeal shock wave will be performed.

Study groups in NCT02522676
Study groupRoleWhat they receive
Conventional PCNLActive comparatorEndoscopic kidney stone surgery: Patients will undergo conventional percutaneous nephrolithotripsy.
Receives: Procedure: Endoscopic kidney stone surgery
Mini PCNLActive comparatorEndoscopic kidney stone surgery: Patients will undergo mini percutaneous nephrolithotripsy.
Receives: Procedure: Endoscopic kidney stone surgery
Ultra-mini PCNLActive comparatorEndoscopic kidney stone surgery: Patients will undergo ultra-mini percutaneous nephrolithotripsy.
Receives: Procedure: Endoscopic kidney stone surgery
Micro PCNLActive comparatorEndoscopic kidney stone surgery: Patients will undergo micro percutaneous nephrolithotripsy.
Receives: Procedure: Endoscopic kidney stone surgery
Retrograde intrarenal surgeryActive comparatorEndoscopic kidney stone surgery: Patients will undergo retrograde intrarenal surgery.
Receives: Procedure: Endoscopic kidney stone surgery
Extracorporeal shock wave lithotripsyActive comparatorNon-invasive kidney stone treatment: Patients will undergo extracorporeal shock wave lithotripsy.
Receives: Procedure: Non-invasive kidney stone treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Stone-free rate

    Determination of any residual stone in the collecting system by using one of imaging modalities.

    Measured: Within the first 30 days after surgery/procedure

Secondary outcomes (6)
  1. Complication rate

    Determination of any complications related to the surgery/procedure.

    Measured: Within the first 30 days after surgery/procedure

  2. Blood Cystatin C level (mg/L)

    Determination of any impairment in renal function after the surgery/procedure by measuring blood Cystatin C level.

    Measured: Within the first 48 hours after surgery/procedure

  3. Blood Netrin-1 level (pg/mL)

    Determination of any impairment in renal function after the surgery/procedure by measuring blood Netrin-1 level.

    Measured: Within the first 48 hours after surgery/procedure

  4. Urine NGAL level (ng/mL)

    Determination of any impairment in renal function after the surgery/procedure by measuring urine NGAL level.

    Measured: Within the first 72 hours after surgery/procedure

  5. Urine Cystatin C level (mg/L)

    Determination of any impairment in renal function after the surgery/procedure by measuring urine Cystatin C level.

    Measured: Within the first 24 hours after surgery/procedure

  6. Urine Netrin-1 level (pg/mL)

    Determination of any impairment in renal function after the surgery/procedure by measuring urine Netrin-1 level.

    Measured: Within the first 24 hours after surgery/procedure

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Aug 2015 (estimated)
  2. Study startJun 2020 (estimated)
  3. Primary completionJun 2023 (estimated)
  4. Study completionDec 2023 (estimated)

Why it stopped: Due to surgeons' unwillingness to randomize patients into different treatments

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
300 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02522676
Sponsor's protocol ID
SU-PCNL-LPRPS-01
Status last verified
Nov 2019
First submitted
9 Aug 2015
Last updated
19 Nov 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Skolarikos A, Straub M, Knoll T, Sarica K, Seitz C, Petrik A, Turk C. Metabolic evaluation and recurrence prevention for urinary stone patients: EAU guidelines. Eur Urol. 2015 Apr;67(4):750-63. doi: 10.1016/j.eururo.2014.10.029. Epub 2014 Nov 20.

    PubMed 25454613
  • de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, Tefekli A; CROES PCNL Study Group. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. J Endourol. 2011 Jan;25(1):11-7. doi: 10.1089/end.2010.0424.

    PubMed 21247286
  • Kamphuis GM, Baard J, Westendarp M, de la Rosette JJ. Lessons learned from the CROES percutaneous nephrolithotomy global study. World J Urol. 2015 Feb;33(2):223-33. doi: 10.1007/s00345-014-1367-5. Epub 2014 Aug 7.

    PubMed 25100624
  • Bader MJ, Gratzke C, Seitz M, Sharma R, Stief CG, Desai M. The "all-seeing needle": initial results of an optical puncture system confirming access in percutaneous nephrolithotomy. Eur Urol. 2011 Jun;59(6):1054-9. doi: 10.1016/j.eururo.2011.03.026. Epub 2011 Apr 1.

    PubMed 21477921
  • Desai MR, Sharma R, Mishra S, Sabnis RB, Stief C, Bader M. Single-step percutaneous nephrolithotomy (microperc): the initial clinical report. J Urol. 2011 Jul;186(1):140-5. doi: 10.1016/j.juro.2011.03.029. Epub 2011 May 14.

    PubMed 21575966
  • Hatipoglu NK, Tepeler A, Buldu I, Atis G, Bodakci MN, Sancaktutar AA, Silay MS, Daggulli M, Istanbulluoglu MO, Karatag T, Gurbuz C, Armagan A, Caskurlu T. Initial experience of micro-percutaneous nephrolithotomy in the treatment of renal calculi in 140 renal units. Urolithiasis. 2014 Apr;42(2):159-64. doi: 10.1007/s00240-013-0631-2. Epub 2013 Dec 13.

    PubMed 24337646
  • Desai J, Solanki R. Ultra-mini percutaneous nephrolithotomy (UMP): one more armamentarium. BJU Int. 2013 Nov;112(7):1046-9. doi: 10.1111/bju.12193. Epub 2013 Jul 11.

    PubMed 23841665
  • Resorlu B, Unsal A, Gulec H, Oztuna D. A new scoring system for predicting stone-free rate after retrograde intrarenal surgery: the "resorlu-unsal stone score". Urology. 2012 Sep;80(3):512-8. doi: 10.1016/j.urology.2012.02.072. Epub 2012 Jul 26.

    PubMed 22840867
  • Cepeda M, Amon JH, Mainez JA, Rodriguez V, Alonso D, Martinez-Sagarra JM. Flexible ureteroscopy for renal stones. Actas Urol Esp. 2014 Nov;38(9):571-5. doi: 10.1016/j.acuro.2014.03.014. Epub 2014 Jun 2. English, Spanish.

    PubMed 24881777
  • Gao X, Peng Y, Shi X, Li L, Zhou T, Xu B, Sun Y. Safety and efficacy of retrograde intrarenal surgery for renal stones in patients with a solitary kidney: a single-center experience. J Endourol. 2014 Nov;28(11):1290-4. doi: 10.1089/end.2014.0295. Epub 2014 Aug 6.

    PubMed 24892920
  • Palmero JL, Miralles J, Garau C, Nuno de la Rosa I, Amoros A, Benedicto A. Retrograde intrarenal surgery (RIRS) in the treatment of calyceal diverticulum with lithiasis. Arch Esp Urol. 2014 May;67(4):331-6. English, Spanish.

    PubMed 24892394
  • Aboumarzouk OM, Monga M, Kata SG, Traxer O, Somani BK. Flexible ureteroscopy and laser lithotripsy for stones >2 cm: a systematic review and meta-analysis. J Endourol. 2012 Oct;26(10):1257-63. doi: 10.1089/end.2012.0217. Epub 2012 Jul 30.

    PubMed 22642568
  • Wong KA, Sahai A, Patel A, Thomas K, Bultitude M, Glass J. Is percutaneous nephrolithotomy in solitary kidneys safe? Urology. 2013 Nov;82(5):1013-6. doi: 10.1016/j.urology.2013.06.034. Epub 2013 Aug 16.

    PubMed 23958507
  • De S, Autorino R, Kim FJ, Zargar H, Laydner H, Balsamo R, Torricelli FC, Di Palma C, Molina WR, Monga M, De Sio M. Percutaneous nephrolithotomy versus retrograde intrarenal surgery: a systematic review and meta-analysis. Eur Urol. 2015 Jan;67(1):125-137. doi: 10.1016/j.eururo.2014.07.003. Epub 2014 Jul 23.

    PubMed 25064687
  • Bas O, Bakirtas H, Sener NC, Ozturk U, Tuygun C, Goktug HN, Imamoglu MA. Comparison of shock wave lithotripsy, flexible ureterorenoscopy and percutaneous nephrolithotripsy on moderate size renal pelvis stones. Urolithiasis. 2014 Apr;42(2):115-20. doi: 10.1007/s00240-013-0615-2. Epub 2013 Oct 27.

    PubMed 24162954

Questions about this trial

What is this clinical trial studying?

A study testing Endoscopic kidney stone surgery and Non-invasive kidney stone treatment in people with Kidney Stones, run by Selcuk University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: paused, as of the sponsor's last update on 19 Nov 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Stone-free rate (time frame: Within the first 30 days after surgery/procedure). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02522676, which also lists 17 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Nov 2019.

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