Mp43-08 Utilization of Medical Expulsive Therapy in Children: an Assessment of Nationwide Practice Patterns and Outcomes
Year: 2016
Type: article
Study design: Observational Study
Abstract: METHODS: A multi-institutional retrospective study was performed to assess urinary metabolic profiles in children aged 2-18 years old with any urolithiasis.The patients were stratified based upon review of medical record.Twenty-four hour urine collections were performed and evaluated, along with analysis of stone fragments when available.Urine chemistries were adjusted for creatinine and weight.Differences in mean urine collections between the two groups were assessed using two-tailed t-tests.Chi-square tests were used to test the association between gender, stone type and recurrence status.Multivariate analyses were performed using general linear models, allowing us to account for age, BMI, stone analysis and site.P values <0.05 were considered statistically significant.RESULTS: A total of 231 samples from 109 patients with a solitary stone episode and 122 with recurrent stone episodes were examined.Patients with recurrent stone disease were older than patients with a single stone (MeanÆSD: 13.3Æ3.5 years vs. 11.7Æ3.9years, p¼.0020).Females were more likely to have recurrent stones than males (63% vs 42%, p¼0.0014).Stone analysis and patient BMI were not associated with recurrence (p¼0.1790 and p¼0.7218, respectively).Abnormal values for citrate were associated with recurrent stone disease in multivariate analysis (p 0.0084), while abnormal values for calcium were associated with recurrence in univariate (p¼0.0223) and multivariate analysis (p¼0.0085).Centers located in the Southeast of the United States had higher rates of recurrence compared to the West (Tennessee 62.4%, Virginia 44.4%, Oregon 30.9%, p¼0.0002).CONCLUSIONS: Abnormal urinary calcium and citrate levels are associated with recurrent stone disease in children.Children living in "The Stone Belt" seem to be at higher risk for recurrence.Metabolic evaluation of patients with stones may help stratify patients that are likely to form recurrent stones and are amenable to increased surveillance, and dietary or pharmacologic intervention.
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4254492651