National Imaging Trends of Recurrent Pediatric Urolithiasis

Barrick, Lindsey; Cohen, Daniel M.; Schober, Megan S.; Schwaderer, Andrew L.

doi:10.1097/pec.0000000000001320

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…However, for those patients that did have 24 h urine studies we did not find difference between males and females rates of low urine citrate, hypercalciuria, hyperoxaluria, or low urine volume. CTs were obtained on 67% of male patients and 57% of female patients, making limiting future radiation exposure a priority (38). Nephrocalcinosis was noted in two patients who were diagnosed with RTA and hypercalciuria respectively; this was consistent with previous pediatric studies (39, 40).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Risk Factors for Pediatric Kidney Stone Formation: The Effects of Sex

et al. 2019

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Background: Urinary stones are affecting more children, and pediatric stone formers have unique pathophysiology compared to adults. While adult stone formers are most frequently male, children have an age dependent sex prevalence. Under 10 years, a majority of stone formers are boys; adolescent stone formers are mostly female. Previous adult studies have shown that stone composition is influenced by the sex and age of the stone former. Thus, we hypothesize that female and male stone forming children will also have sex and age specific stone phenotypes. Methods: Retrospective chart review of a large pediatric center's stone forming children 6/1/2009 to 6/1/2016. Patients were identified by ICD 9 codes: N20, N20.1, and N20.9. Charts were reviewed for radiographic evidence of stones or documented visualized stone passage. Results: One hundred and thirty six subjects: 54 males and 82 females. Females were older, median age 14 years [interquartile range (IQR): 11, 15] vs. males' median age 12 years (IQR: 11, 14) ( p < 0.01). Females had lower height z -scores, median 0.2 (IQR: −0.8, 0.8) vs. males' median 0.8 (IQR: −0.2, 1.8) ( p < 0.01). Presenting symptoms were similar except flank pain affecting 39% of females vs. 22% of males ( p = 0.04). Leukocyte esterase was positive in more females than males (33 vs. 4%) ( p < 0.001). Males had a higher BUN/Cr ratio, mean ± standard deviation of 19.8 ± 6.3 vs. 16.6 ± 6.5 in females ( p = 0.01). Glomerular hyperfiltration was present in 9% of patients while 35% of patients had estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73 m 2 . Treatment strategies and clinical course were similar except females were told to increase dietary citrate more frequently than males (21 vs. 4%) ( p < 0.01). Conclusion: We have provided a novel analysis and demonstrated that low height z -score and pyuria are more common in female stone formers. We have also shown that 9% of pediatric stone formers have labs consistent with hyperfiltration. Whether high protein intake and/or chronic dehydration are associated with hyperfiltration and long-term renal function in children with kidney stones will be an area for future research.

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Section: Discussionmentioning

confidence: 99%