Initial collection of an inadequate 24-hour urine sample in children does not predict subsequent inadequate collections

Chan, Katherine H.; Moser, Elizabeth A. S.; Whittam, Benjamin; Misseri, Rosalia; Cain, Mark P.; Krambeck, Amy E.; Schwaderer, Andrew L.

doi:10.1016/j.jpurol.2018.10.019

Cited by 9 publications

(8 citation statements)

References 15 publications

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“…But to conduct such tests in children is diffi cult, as problems with 24-hour urine collection are more common in younger individuals. [24] Worth noting is that approximately one fi fth of the children in our study were in either the thin or undernourished categories. This may be due to the fact that several causes of lithiasis during childhood have an impact on nutritional status.…”

Section: Original Researchmentioning

confidence: 69%

Urinary Metabolic Disorders Associated with Urolithiasis in Cuban Pediatric Patients

2021

MEDICC Review

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INTRODUCTION Pediatric urinary lithiasis (urolithiasis) is an important health issue linked to urinary metabolic disorders. In the United States alone, annual costs associated with urolithiasis are $229 million for hospital admissions and $146 million for emergency care.OBJECTIVE Identify urinary metabolic disorders in Cuban pediatric patients with urolithiasis and better understand the relationship of age, demographic and anthropometric variables to urinary metabolic disorders strongly associated with urolithiasis. METHODSWe carried out a descriptive, cross-sectional study. The study universe was comprised of Cuban patients aged 2 to 19 years with urinary lithiasis who underwent renal metabolic studies at the Dr Abelardo Buch López Nephrology Institute in Havana, Cuba, from 2008 through 2019. All data were obtained from reports of the aforementioned metabolic studies. We collected the following variables: age, sex, nutritional status, urinary volume, plasma and urinary creatine concentrations; and calcium, uric acid, oxalate and citrate urinary excretions collected during a 24-hour period. We included results of urinary cystine tests and urine mini-cultures. We obtained frequency distributions for categorical and qualitative variables and calculated means and standard deviations for quantitative variables. We also evaluated homogeneity of metabolic disorders between children and adolescents. RESULTSWe studied 1592 pediatric patients, of whom 67.7% (1078/1592) were adolescents. The main metabolic disorders included hypercalciuria (39.1%; 622/1592), decreased urinary fl ow (22.4%; 357/1592) and hypocitraturia (18.2%; 289/1592). Hypercalciuria, hypocitraturia and hyperoxaluria were more common in children, while decreased urinary fl ow and hyperuricosuria were more common in adolescents. Hyperuricosuria was more frequent in male patients (6.3%; 40/639 vs. 1.8%; 8/439) and had the greatest impact on lithogenesis. Hypercalciuria was more frequent in undernourished children (62.5%; 30/48) than in overweight children (21.7%; 10/46), or those with obesity (33.3%; 15/45). CONCLUSIONSThe main metabolic disorders among Cuban pediatric patients with urinary lithiasis are: hypercalciuria, decreased urinary fl ow and hypocitraturia. Hypercalciuria, hypocitraturia and hyperoxaluria are more common in children, and decreased urinary fl ow and hyperuricosuria are more common in adolescents. Identifying urinary metabolic disorders facilitates formulation of treatment plans tailored to decreasing the likelihood of urolithiasis.

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Section: Original Researchmentioning

confidence: 69%

Urinary Metabolic Disorders Associated with Urolithiasis in Cuban Pediatric Patients

2021

MEDICC Review

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“…Comparative statistics were performed between those children with normal and abnormal 24-h urine studies using an unpaired two-tailed ttest for continuous variables and a chi-square test for categorical variables. A priori hypothesized factors influencing 24-h urine findings were as follows: age (<12 years; ≥12 years); sex (male/ female); race (white/all others); ethnicity (Hispanic or Latino/all others); comorbidity (present/absent); recurrent stone disease (present/absent); family history of stone disease (present/absent); obesity (18). As only sex was significant on univariate analysis, no multivariate regressions were performed.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Abnormal Initial 24-Hour Urine Studies in Pediatric Nephrolithiasis: Can We Better Select Patients for Evaluation?

Moyer¹,

Ellison²,

Medairos³

et al. 2022

Front. Urol.

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BackgroundChildren, especially adolescents, constitute the most rapid growing demographic of nephrolithiasis. Due to the risks of recurrent stone disease, a 24-h urine analysis is recommended for the evaluation of children at risk of recurrent nephrolithiasis or those who are otherwise interested in further evaluation. However, data regarding patients most likely to have abnormal urine studies are sparse. We aim to identify predictors of abnormal 24-h urine studies in children presenting for evaluation of nephrolithiasis.MethodsA retrospective review of children ≤17 years of age with a diagnosis of nephrolithiasis at both primary children’s hospitals within our state from 2012 to 2017 was performed. Children with an adequate initial 24-h urine study (creatinine ≥9 mg/kg/24 h) not on a thiazide or potassium citrate during the study were included. Factors associated with any abnormality [calcium ≥4 mg/kg; oxalate ≥45 mg/1.73 m2; citrate ≤310 mg/1.73 m2 (girls) or ≤365 mg/1.73 m2 (boys)] were evaluated as well as magnesium, uric acid, volume, sodium, and phosphorus.ResultsA total of 111 children were included, 69 of whom (62%) had at least one abnormal result. Of factors hypothesized to be associated with an abnormal 24-h urine study, only sex was significant (p = 0.001). Boys had a greater proportion of hypercalciuria (55%) and hypocitraturia (73%) and a slightly lower proportion of hyperoxaluria (48%) than those in girls.ConclusionMale sex was the only factor associated with an abnormal 24-h urine study, largely driven by increased rates of hypercalciuria and hypocitraturia in boys.

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“…Una de las causas de la baja adherencia a las pautas de la recolección de orina de 24 horas, podría ser que la mayor demanda para este tipo de análisis son las personas mayores que pueden padecer con frecuencia y de forma simultánea varias enfermedades crónicas, junto con alteración de los órganos sensoriales o pérdida de funciones cognitivas o de movilidad. A causa de esta fragilidad necesitan de un apoyo familiar o de personas cercanas para que realicen sus actividades y, por lo observado en nuestro estudio, una gran parte de ellos tienen que valerse por sí mismos y eso dificulta la adecuada recolección de la muestra de orina; sin embargo, en estudios realizados en niños y personas que habitan en zonas desatendidas, las recolecciones inadecuadas de orina de 24 horas también son muy comunes (9,10) .…”

Section: Discussionunclassified

Errores preanalíticos en la recolección de orina de 24 horas

Orejón

2021

An Fac med

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Introducción. La recolección de orina en el lapso de 24 horas es necesaria para la medición de constituyentes bioquímicos que presentan una excreción urinaria variable; sin embargo, dicho proceso no está exento de errores preanalíticos. Objetivos. Evaluar el nivel de cumplimiento de las instrucciones para recoger la muestra, identificar la recolección de orinas incompletas y conocer los procesos preanalíticos que aplica un grupo de profesionales. Métodos. Estudio de diseño observacional, en el que se realizó encuestas anónimas y voluntarias a 257 pacientes ambulatorios y 59 profesionales tecnólogos médicos, además de estimar la excreción urinaria de creatinina a 416 muestras. Resultados. El estudio evidenció recolecciones incorrectas (39,7%), uso de recipientes inadecuados (58,14%), mala conservación de las muestras (98,8%), cambio en los hábitos de ingesta de líquidos (23,7%), escasa información y retroalimentación a los pacientes sobre la preparación de la prueba, el 76,92% de muestras presentaron pérdidas o excesos en el volumen recolectado y una alta variabilidad de los criterios que utilizan los profesionales para rechazar las muestras mal colectadas. Conclusión. Se observó un bajo cumplimiento de los pacientes a las indicaciones para la recolección de la muestra, una alta proporción de recolecciones incompletas y discordancia en los procesos preanalíticos para el análisis de orina de 24 horas.

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Initial collection of an inadequate 24-hour urine sample in children does not predict subsequent inadequate collections

Abstract: curate specimen collection using qualitative research methodology.

Cited by 9 publications

References 15 publications

Urinary Metabolic Disorders Associated with Urolithiasis in Cuban Pediatric Patients

Urinary Metabolic Disorders Associated with Urolithiasis in Cuban Pediatric Patients

Factors Associated With Abnormal Initial 24-Hour Urine Studies in Pediatric Nephrolithiasis: Can We Better Select Patients for Evaluation?

Errores preanalíticos en la recolección de orina de 24 horas

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