Role of urinary supersaturation in the evaluation of children with urolithiasis

Lande, Marc B.; Varade, William S.; Erkan, Elif; Niederbracht, Yvonne; Schwartz, George J.

doi:10.1007/s00467-004-1779-3

Cited by 52 publications

(28 citation statements)

References 15 publications

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“…Urine flow equal to or higher than 1 mL/kg was shown by Lande et al [72] to be efficacious as protector against kidney stone formation. This water intake should be distributed throughout the 24 h, and should not exceed two liters.…”

Section: Management Of Acute Pediatric Ulmentioning

confidence: 99%

“…Free urinary flux and adequate hydric ingestion compose the mainstay of urine supersaturation avoidance. It must be ensured a urinary flow at least 1.0 mL/kg per hour to reduce the urinary concentration [72] but ideally 2.0 to 3.0 mL/kg per hour. If there are higher expenses (insensitive and sweating loss), there should be an increase of this intake.…”

Section: Management Of Non-acute Pediatric Ulmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric primary urolithiasis: Symptoms, medical management and prevention strategies

Penido

Tavares

2015

WJN

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In the past few decades pediatric urolithiasis has become more frequent. The reason for this increase is not completely clear but has been attributed to changes in climate, nutritional habits and possibly other environmental factors. Although less frequent than adult stone disease, urolithiasis in the pediatric age group is also related to significant morbidity, particularly since stones tend to recur, and, thus, should not be underestimated. Most children with idiopathic stone disease have an underlying metabolic abnormality substantiating the importance of metabolic evaluation already following initial diagnosis of urolithiasis. Identification of the metabolic abnormality allows for more specific prescription of non pharmacological and pharmacological interventions aimed at preventing recurrent stone formation. A better understanding of the causes of kidney stone disease will provide better strategies for stone prevention in children.

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Section: Management Of Acute Pediatric Ulmentioning

confidence: 99%

Section: Management Of Non-acute Pediatric Ulmentioning

confidence: 99%

Pediatric primary urolithiasis: Symptoms, medical management and prevention strategies

Penido

Tavares

2015

WJN

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“…Recent guidelines from American Urological Association recommended sufficient fluid intake to maintain urine volume in adults of 2.0-2.5 L [4]. In children, diuresis above 1 ml/kg per h, almost eliminated the risk of supersaturation for calcium oxalate, calcium phosphate and uric acid, thus protecting from the formation of the corresponding kidney stones [5].…”

Section: Introductionmentioning

confidence: 99%

Upper metastable limit osmolality of urine as a predictor of kidney stone formation in children

et al. 2018

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High fluid intake has been universally recommended for kidney stone prophylaxis. We evaluated 24-h urine osmolality regarded as the best biomarker of optimal hydration and upper metastable limit osmolality after water evaporation from urine sample to the onset of spontaneous crystallization and its usefulness as a new risk index that would describe an individual lithogenic potential. We collected 24-h urine from 257 pediatric patients with kidney stones and 270 controls. After volume and osmolality assessment, the urine samples were subjected to volume reduction in vacuum rotavapor continued to the onset of an induced urinary crystallization. The upper metastable limit osmolality of urine sample was calculated based on its initial osmolality value and the amount of water reduction. Pediatric stone formers presented with higher urine volume and lower urine osmolality than healthy controls. Despite that, their urine samples required much lower volume reduction to induce the spontaneous crystallization than those of controls. The ROC analysis revealed an AUC for the upper metastable limit osmolality of 0.9300 (95% CI 0.9104-0.9496) for distinguishing between stone formers and healthy subjects. At the cutoff of 2696 mOsm/kg, the test provided sensitivity and specificity of 0.8638 and 0.8189, respectively. 24-h urine osmolality provided the information about current hydration status, whereas evaporation test estimated the urinary potential to crystalize dependent on urine composition. Upper metastable limit osmolality may estimate the individual lithogenic capability and identify people at risk to stone formation when exposed to dehydration.

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“…The prevalence of symptomatic kidney stones among the general population is between 5 and 10%, with a slight male predominance [1,2]. In the USA, it is estimated that kidney stones account for 1 per 1,000 to 1 per 7,600 pediatric hospital admissions each year [3].…”

Section: Introductionmentioning

confidence: 99%

Body fat composition and occurrence of kidney stones in hypercalciuric children

2011

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In the last 10 years, the incidence of kidney stones has increased in the pediatric population, and this rise has been paralleled by a significant increase in pediatric obesity rates in the USA. The purpose of this study was to evaluate percentage body fat (%BF) measured by dual energy X-ray absorptiometry (DXA) in hypercalciuric children with and without kidney stones. A retrospective chart review was performed on children with idiopathic hypercalciuria based on a 24-h urine calcium excretion of >4 mg/kg/day or >200 mg/day who had undergone DXA scanning. Patients were then classified by sex and by %BF (3 categories; normal: <27% girls, <21% boys; at risk for obesity: 27-36% girls, 21-30% boys; obese: >36% girls, >30% boys). The 2003-2004 NHANES data were used as a control. Fifty patients (24 males) were analyzed, of whom 26% were assessed as having a normal %BF, 44% as being at risk for obesity, and 30% as being obese. Children with an increased %BF had a significantly higher occurrence of kidney stones (p = 0.03) than those with a normal %BF. No significant differences were noted in 24-h urine chemistries between the groups. In conclusion, an increased %BF was associated with an increased occurrence of kidney stones in children with idiopathic hypercalciuria.

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Role of urinary supersaturation in the evaluation of children with urolithiasis

Cited by 52 publications

References 15 publications

Pediatric primary urolithiasis: Symptoms, medical management and prevention strategies

Pediatric primary urolithiasis: Symptoms, medical management and prevention strategies

Upper metastable limit osmolality of urine as a predictor of kidney stone formation in children

Body fat composition and occurrence of kidney stones in hypercalciuric children

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