Kidney Stone Recurrence among Children and Adolescents.

TitleKidney Stone Recurrence among Children and Adolescents.
Publication TypeJournal Article
Year of Publication2016
AuthorsTasian GE, Kabarriti AE, Kalmus A, Furth SL
JournalJ Urol
Date Published2016 Aug 10
ISSN1527-3792
Abstract

PURPOSE: Kidney stone disease has become increasingly common during childhood and adolescence; however, the rate of symptomatic kidney stone recurrence for pediatric patients is uncertain.

MATERIALS AND METHODS: We performed a retrospective cohort study of patients aged 3-18 years without anatomic abnormalities or genetic causes of nephrolithiasis who presented with a first symptomatic kidney stone between 2008 and 2014. We determined recurrence rates of symptomatic nephrolithiasis, defined as a new kidney stone on ultrasound and/or CT associated with pain and/or vomiting. We also estimated associations between completing 24-hour urine analyses and symptomatic kidney stone recurrence using Kaplan-Meier curves and multivariable Cox regression models.

RESULTS: Among 285 children with a median age at nephrolithiasis diagnosis of 14.8 years (IQR 11.3-16.6) who were followed for 492 person-years, 68 patients (24%) developed 86 symptomatic recurrent stones over the follow-up period. The probability of symptomatic stone recurrence was 50% three years after the index kidney stone. The median time to stone recurrence was 3 and 5 years to the first and second stone recurrence, respectively. Adjusting for confounders, including adherence to follow-up, completing a 24-hour urine analysis after a kidney stone episode was associated with a 60% decreased risk of recurrence (hazard ratio 0.40; 95% CI, 0.18-0.91).

CONCLUSIONS: The risk of kidney stone recurrence is high during childhood, with approximately 50% presenting with a symptomatic recurrence within three years of the first stone. The role and utility of analyzing 24-hour urine chemistries in decreasing kidney stone recurrence should be explored in future prospective studies.

DOI10.1016/j.juro.2016.07.090
Alternate JournalJ. Urol.
PubMed ID27521691