Symptomatic recurrence rate of upper urinary tract calculi in children after endourological procedures.

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  • Author(s): Wang X;Wang X; Zhang Y; Zhang Y; Zhao F; Zhao F; Li J; Li J; Yian Y; Yian Y
  • Source:
    Journal of pediatric urology [J Pediatr Urol] 2022 Apr; Vol. 18 (2), pp. 141.e1-141.e7. Date of Electronic Publication: 2021 Oct 02.
  • Publication Type:
    Journal Article; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: England NLM ID: 101233150 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4898 (Electronic) Linking ISSN: 14775131 NLM ISO Abbreviation: J Pediatr Urol Subsets: MEDLINE
    • Publication Information:
      Original Publication: Kidlington, Oxford, UK : Elsevier, c2005-
    • Subject Terms:
      Calculi* ; Kidney Calculi* ; Urinary Calculi*/epidemiology ; Urinary Calculi*/surgery ; Urinary Tract* ; Urolithiasis*/surgery; Adolescent ; Child ; Humans ; Recurrence ; Retrospective Studies
    • Abstract:
      Introduction: The recurrence rate of paediatric urolithiasis was less reported, especially in Asians. Our aim was to verify the symptomatic recurrence rate of Chinese paediatric urolithiasis and to determine the predictive factors for stone recurrence.
      Materials and Methods: We performed a retrospective review of children who presented with first upper urinary tract calculi from June 2014 to September 2019. For the follow-up, we generated Kaplan-Meier plots with time to stone recurrence and Cox proportional hazard regression analyses were applied. The recurrence was defined as a new symptomatic stone on ultrasound and/or computerized tomography.
      Results: A total of 230 children with a median age of 5 yr (IQR 4-8) were included. Calcium oxalate was found in 72% of stones, and calcium apatite was found in 32% of stones. After a median follow-up of 39.5 months, 34 (14.8%) children had stone recurrence. Median time to stone recurrence was 31 months. Among them, 31 (91.2%) required surgical intervention. Older children (P < 0.01), higher BMI (HBM) (P < 0.01) and higher stone burden (P < 0.01) were shown to be associated with stone recurrence in the univariate analysis. The multivariate Cox regression analysis showed that children with stone burden > 2 cm 3 had a higher risk of recurrence (HR 4.84, 95%CI 2.28-10.3). Children with HBM had an increased recurrence rate compared to normal BMI children (HR 2.99, 95%CI 1.36-6.56).
      Conclusions: The symptomatic recurrence rate of paediatric urolithiasis in Chinese is not as high as that reported in Caucasians. HBM and higher stone burden are associated with higher recurrence rates.
      Competing Interests: Conflicts of interest We confirm that there are no known conflicts of interest associated with this publication; We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed.
      (Copyright © 2021. Published by Elsevier Ltd.)
    • Contributed Indexing:
      Keywords: Pediatric; Recurrence; Urolithiasis
    • Publication Date:
      Date Created: 20220318 Date Completed: 20220603 Latest Revision: 20220711
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.jpurol.2021.09.025
    • Accession Number:
      35300915