Kidney Stone Recurrence among Children and Adolescents

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.

Outcomes of ureteroscopy (URS) for stone disease in the paediatric population: results of over 100 URS procedures from a UK tertiary centre

“…While paediatric urolithiasis remains rare, its incidence is rising [1,2]. Furthermore, for those individuals affected by stone disease, recurrence can occur in up to 50% of cases [3,4]. Therefore, the need to establish and develop effective and safe surgical treatments is paramount.…”

Antibiotics and Kidney Stones: Perturbation of the Gut-Kidney Axis

“…1,3 Nephrolithiasis is a disorder of mineral metabolism that is associated with increased risk for chronic kidney disease, 4,5 fracture, 6 and hypertension. 5,7 Individuals with nephrolithiasis also have a high risk for recurrent painful kidney stone events, 8,9 some of which require surgery and are associated with increased risk for kidney failure and death. 10 Due the rapid shift in the epidemiology of nephrolithiasis, investigators have focused on identifying novel determinants of kidney stone disease, including antibiotics and their impact on the intestinal and urinary microbiome composition.…”

Dietary Habits among Patients with Kidney Stones: A Retrospective Study

“…This study in the same stream with [30] who reported that there is a significant relation between high intake of meat, poultry, fish and kidney stone formation Compared to low intake. Moreover a study done by [31] found that increase animal protein intake are associated with increase excretion of calcium, oxalate, uric acid and decrease excretion of citrate result in risk of stone disease. The current study findings also showed that there was statistical significance difference between kidney stone and higher Cereals and grains intake (χ 2 =8.420, p= .004*).…”