2300 CHANGING STONE COMPOSITION PROFILE OF CHILDREN WITH NEPHROLITHIASIS

Abstract

You have accessJournal of UrologyStone Disease: Basic Research II1 Apr 20122300 CHANGING STONE COMPOSITION PROFILE OF CHILDREN WITH NEPHROLITHIASIS Kyle Wood, Irina Stanasel, Ross Holmes, Steve Hodges, Patrick Mufarrij, Gordon McLorie, and Dean Assimos Kyle WoodKyle Wood Winston-Salem, NC More articles by this author , Irina StanaselIrina Stanasel Winston-Salem, NC More articles by this author , Ross HolmesRoss Holmes Winston-Salem, NC More articles by this author , Steve HodgesSteve Hodges Winston-Salem, NC More articles by this author , Patrick MufarrijPatrick Mufarrij Winston-Salem, NC More articles by this author , Gordon McLorieGordon McLorie Winston-Salem, NC More articles by this author , and Dean AssimosDean Assimos Winston-Salem, NC More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2480AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES An increasing number of adult patients with nephrolithiasis have calcium phosphate stones. This is further accentuated in those who are recurrent stone formers. We performed a retrospective study to determine if similar trends are present in children. METHODS We reviewed records of 179 patients managed from 1992-2010 (0.2 to 18 year olds) for whom stone analysis data were available. Demographic and metabolic data were reviewed. A comparison of patients managed from 1992-2000 (period 1–P1) and 2001-2010 (period 2–P2) was undertaken. Statistical analysis included non-parametric Chi-square and Student's t-Test. RESULTS The overall average age of manifestation did not differ between the periods (10.6 years in P1 and 11.1 years in P2). Mean age of males was 9.2 for P1 and 10.1 for P2. Mean age for females was 12.0 for P1 and 12.1 for P2. Males comprised a significantly higher proportion of the patients who developed stones during the first decade of life, with a male:female ratio of 1.9:1. This trend was similar in P1 and P2. In contrast, females comprised a significantly higher proportion of the patients who developed stones during the second decade of life, with a female:male ratio of 1.7:1. This trend was also similar in P1 and P2. There were significant differences in stone composition between P1 and P2. A higher percentage of patients had calcium oxalate stones (CaOx) in P1 compared to P2 (60% versus 47%, p= 0.0019). There was a significant increase in the percentage of patients having calcium phosphate stones (CaP) in P2 compared to P1 (27% versus 18.5 %, p=0.008). Twenty-seven patients had recurrent stones. A comparison of the compositions of the first and last stones of patients within this group demonstrated an increase in the proportion of brushite stones (3.7% versus 11.1 %, p=0.04). Twenty four hour urine testing was undertaken in 62 children with calcium containing stones (49 CaOx and 13CaP). There were no statistically significant differences in the urinary parameters of patients with CaOx stones compared with patients with CaP stones. CONCLUSIONS An increasing number of children with kidney stones have CaP calculi. Brushite stones are more prevalent in children with recurrent stone events. The impetus of these shifts is not readily apparent and requires further investigation. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e928 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kyle Wood Winston-Salem, NC More articles by this author Irina Stanasel Winston-Salem, NC More articles by this author Ross Holmes Winston-Salem, NC More articles by this author Steve Hodges Winston-Salem, NC More articles by this author Patrick Mufarrij Winston-Salem, NC More articles by this author Gordon McLorie Winston-Salem, NC More articles by this author Dean Assimos Winston-Salem, NC More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...