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Urinary metabolic evaluations in solitary and recurrent stone forming children.
J Urol 2008; 179(6):2369-72JU

Abstract

PURPOSE

We have previously reported a high rate of urinary metabolic abnormalities in stone forming children compared to normal controls. At our institution a 24-hour urine evaluation is initiated after the first stone episode in children, to measure stone risk indices. The purpose of this study was to determine which children are at the greatest risk for recurrent stone formation.

MATERIALS AND METHODS

A retrospective cohort study was performed to assess urinary metabolic profiles in children with urolithiasis. In all patients 24-hour urine collections were performed and evaluated elsewhere. Urine chemistry assessments such as calcium and citrate were adjusted for creatinine and weight. Calcium oxalate supersaturation was measured. Patients were stratified as solitary or recurrent stone formers based on review of the medical record. Univariate analysis between means was performed with a 2-tailed t test.

RESULTS

A total of 148 samples from 88 solitary stone formers and 84 samples from 51 recurrent stone formers were evaluated. Age and gender were well matched between the 2 groups. Timed urinary calcium levels referenced to creatinine and citrate were significantly higher in patients with recurrent stones. Supersaturation levels of calcium oxalate were higher in recurrent stone formers but did not reach statistical significance.

CONCLUSIONS

There are significant differences in 24-hour urinary calcium levels between solitary and recurrent calcium stone forming children. A patient with increased urinary calcium indices on a 24-hour specimen may benefit from more aggressive initial dietary and pharmacological treatment to prevent stone recurrence.

Authors+Show Affiliations

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA. bob.defoor@cchmc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18433777

Citation

DeFoor, William, et al. "Urinary Metabolic Evaluations in Solitary and Recurrent Stone Forming Children." The Journal of Urology, vol. 179, no. 6, 2008, pp. 2369-72.
DeFoor W, Minevich E, Jackson E, et al. Urinary metabolic evaluations in solitary and recurrent stone forming children. J Urol. 2008;179(6):2369-72.
DeFoor, W., Minevich, E., Jackson, E., Reddy, P., Clark, C., Sheldon, C., & Asplin, J. (2008). Urinary metabolic evaluations in solitary and recurrent stone forming children. The Journal of Urology, 179(6), pp. 2369-72. doi:10.1016/j.juro.2008.01.151.
DeFoor W, et al. Urinary Metabolic Evaluations in Solitary and Recurrent Stone Forming Children. J Urol. 2008;179(6):2369-72. PubMed PMID: 18433777.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urinary metabolic evaluations in solitary and recurrent stone forming children. AU - DeFoor,William, AU - Minevich,Eugene, AU - Jackson,Elizabeth, AU - Reddy,Pramod, AU - Clark,Curtis, AU - Sheldon,Curtis, AU - Asplin,John, Y1 - 2008/04/23/ PY - 2007/09/21/received PY - 2008/4/25/pubmed PY - 2008/6/3/medline PY - 2008/4/25/entrez SP - 2369 EP - 72 JF - The Journal of urology JO - J. Urol. VL - 179 IS - 6 N2 - PURPOSE: We have previously reported a high rate of urinary metabolic abnormalities in stone forming children compared to normal controls. At our institution a 24-hour urine evaluation is initiated after the first stone episode in children, to measure stone risk indices. The purpose of this study was to determine which children are at the greatest risk for recurrent stone formation. MATERIALS AND METHODS: A retrospective cohort study was performed to assess urinary metabolic profiles in children with urolithiasis. In all patients 24-hour urine collections were performed and evaluated elsewhere. Urine chemistry assessments such as calcium and citrate were adjusted for creatinine and weight. Calcium oxalate supersaturation was measured. Patients were stratified as solitary or recurrent stone formers based on review of the medical record. Univariate analysis between means was performed with a 2-tailed t test. RESULTS: A total of 148 samples from 88 solitary stone formers and 84 samples from 51 recurrent stone formers were evaluated. Age and gender were well matched between the 2 groups. Timed urinary calcium levels referenced to creatinine and citrate were significantly higher in patients with recurrent stones. Supersaturation levels of calcium oxalate were higher in recurrent stone formers but did not reach statistical significance. CONCLUSIONS: There are significant differences in 24-hour urinary calcium levels between solitary and recurrent calcium stone forming children. A patient with increased urinary calcium indices on a 24-hour specimen may benefit from more aggressive initial dietary and pharmacological treatment to prevent stone recurrence. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/18433777/Urinary_metabolic_evaluations_in_solitary_and_recurrent_stone_forming_children_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2008.01.151?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -