MP26-17 CHARACTERISTICS OF PEDIATRIC STONE FORMERS WITH POSITIVE FAMILY HISTORY- SINGLE CENTER EXPERIENCE

Abstract

You have accessJournal of UrologyPediatrics: Testis, Varicocele & Stones1 Apr 2014MP26-17 CHARACTERISTICS OF PEDIATRIC STONE FORMERS WITH POSITIVE FAMILY HISTORY- SINGLE CENTER EXPERIENCE Necole M. Streeper, Kristina L. Penniston, and Stephen Y. Nakada Necole M. StreeperNecole M. Streeper More articles by this author , Kristina L. PennistonKristina L. Penniston More articles by this author , and Stephen Y. NakadaStephen Y. Nakada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.905AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nephrolithiasis is more common in patients with a family history (FH). The aim of this study was to characterize the demographics, degree of FH, clinical features and metabolic risk factors of pediatric stone patients at our institution. METHODS Pediatric patients with a history of calcium-based nephrolithiasis and positive FH were sequentially identified from our pediatric stone clinic from 2007-2013. FH was parent-reported and was not documented for all patients seen. With approval, we evaluated number of episodes of stone recurrence, evidence of metabolic abnormality on 24-h urine evaluation, frequency of surgical intervention and medical management of stone prevention. RESULTS Pediatric patients (n=30; age 12.2±4.6; female 60%) were identified at a clinic visit. The average BMI was 21.5; 16.7% were obese. In the cohort, 53.3% had first-degree FH and 53.3% had second-degree FH. For first-degree FH, 15% of patients had a father with history of stones, whereas only 9% identified a mother. Evaluation of available 24-hour urine analyses (n=27) revealed the following prevalence of risk factors: low volume 59.3%, hypocitraturia 44.4%, hypercalciuria 37.0%, hyperoxaluria 14.8%, hypernatriuria 11.1%, and hyperuricosuria 7.4%. There were more than one risk factors identified for 63.0% of the patients. Three patients were identified as having etiologies other than genetic, including renal tubular acidosis (n=1) and use of Topamax (n=2). Patients had an average of 1.3±0.53 stone episodes with 0.67±0.76 undergoing surgical intervention. Pharmacologic therapy was prescribed for 33.3% of patients for stone prevention, and all underwent nutrition evaluation. CONCLUSIONS In this cohort, pediatric stone patients with a positive FH had equal prevalence of first-degree and second-degree FH. The majority of the patients had more than one risk factor identified in their 24-hour urine analyses, with the most common including: low volume, hypocitraturia, and hypercalciuria. One-third of the patients required pharmacologic treatment for stone prevention; therefore, it is important to identify patients with a positive FH and for these patients to undergo metabolic risk evaluation with a 24-hour urine. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e258 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Necole M. Streeper More articles by this author Kristina L. Penniston More articles by this author Stephen Y. Nakada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...