Year: 2016
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyPediatrics: Testis, Varicocele & Stones1 Apr 2016MP43-05 VARIATION IN CONSECUTIVE 24-HOUR URINE STUDIES IN PEDIATRIC PATIENTS Jonathan Ellison, John Hollingsworth, Phyllis Yan, John Asplin, Maggie Bierlein, Mark Barraza, William Defoor, T Ernesto Figueroa, Elizabeth Jackson, Rama Jayanthi, Emilie Johnson, David Joseph, Craig Langman, Andrew Schwaderer, and Margarett Shnorhavorian Jonathan EllisonJonathan Ellison More articles by this author , John HollingsworthJohn Hollingsworth More articles by this author , Phyllis YanPhyllis Yan More articles by this author , John AsplinJohn Asplin More articles by this author , Maggie BierleinMaggie Bierlein More articles by this author , Mark BarrazaMark Barraza More articles by this author , William DefoorWilliam Defoor More articles by this author , T Ernesto FigueroaT Ernesto Figueroa More articles by this author , Elizabeth JacksonElizabeth Jackson More articles by this author , Rama JayanthiRama Jayanthi More articles by this author , Emilie JohnsonEmilie Johnson More articles by this author , David JosephDavid Joseph More articles by this author , Craig LangmanCraig Langman More articles by this author , Andrew SchwadererAndrew Schwaderer More articles by this author , and Margarett ShnorhavorianMargarett Shnorhavorian More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.214AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A 24-hour urine (24HU) evaluation is considered the gold-standard for metabolic evaluation in children with nephrolithiasis. The accuracy of a single 24HU sample, however, has been called into question. While variability in 24HU studies has been well characterized in the adults, such variability is less well defined in the pediatric population. As such, we sought to evaluate the variability of consecutive 24HU studies in children via a multi-institutional study. METHODS Six institutions contributed data on 24-hour urine studies in patients ≤ than 17 years of age. All studies were analyzed by an outside central laboratory. Inclusion criteria for consecutive samples included collection within 7 days of the index sample and less than 10% variation in 24-hour creatinine between samples. Percent difference in individual urinary parameters was assessed between consecutive samples. If individual parameters were in a trivial range in both samples, these parameters were excluded from final analysis in order to ensure clinically relevant differences in urinary parameters were measured. Trivial ranges were defined as calcium ≤ 1.5 mg/kg, oxalate ≤ 30 mg/1.73 m2 body surface area (BSA), citrate ≤ 200 mg/g creatinine, and uric acid ≤ 0.4 g/1.73 m2 BSA. RESULTS Of the 2,066 children providing at least one 24HU sample, 733 (35.5%) had two consecutive samples eligible for review. A greater proportion of children receiving 2 consecutive samples were older, aged 14-17 (38.6% vs 35.9%, p= 0.0448). Mean time between sample collections was 1.1 days. Percent differences for individual urine parameters between consecutive samples are shown in the Table. pH varied by 0.3, 0.6, and 1.0 in 50.7%, 21.0%, and 4.5% of patients, respectively. Oxalate varied by a greater degree in children ≤ 4 as compared to children aged 6-13 (p = 0.0041) and 14-17 ( p = 0.0474). Variation in other urinary parameters did not vary significantly by age. CONCLUSIONS Adolescents received consecutive 24-hour samples more frequently than younger children. Variation was quantified for all individual urinary parameters with greater than 30% difference noted between consecutive samples in more than a third of patients for both calcium and volume. Oxalate variability is greater in younger children. This information is useful when interpreting 24-hour urine studies. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e580 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Jonathan Ellison More articles by this author John Hollingsworth More articles by this author Phyllis Yan More articles by this author John Asplin More articles by this author Maggie Bierlein More articles by this author Mark Barraza More articles by this author William Defoor More articles by this author T Ernesto Figueroa More articles by this author Elizabeth Jackson More articles by this author Rama Jayanthi More articles by this author Emilie Johnson More articles by this author David Joseph More articles by this author Craig Langman More articles by this author Andrew Schwaderer More articles by this author Margarett Shnorhavorian More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2319972127