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The effect of prophylactic treatment with Shohl's solution in children with cystinuria

Volkan Izol1, Ibrahim Atilla Aridogan, Onur Karsli

  • 1Department of Urology, Faculty of Medicine, University of Çukurova, Balcali, 01330 Adana, Turkey.

Journal of Pediatric Urology
|June 29, 2013
PubMed

Insights

Prophylactic treatment with Shohl's solution significantly reduced cystine stone recurrence in children. Patients adhering to treatment had a 16.6% recurrence rate, while non-adherent patients experienced 100% recurrence.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Medical Chemistry

Background:

  • Cystinuria is a rare genetic disorder characterized by cystine stones.
  • Recurrent stone formation poses significant challenges in pediatric patients.
  • Effective prophylactic strategies are crucial for managing cystine stone disease.

Purpose of the Study:

  • To evaluate the efficacy of Shohl's solution in preventing cystine stone recurrence in children.
  • To assess the impact of adherence to prophylactic treatment on stone recurrence rates.
  • To identify associated metabolic risk factors in pediatric cystinuria patients.

Main Methods:

  • A cohort of 17 pediatric patients with cystine stones, post-percutaneous nephrolithotomy (PCNL), received Shohl's solution for alkalinization.
  • Patients were monitored for a mean of two years for stone recurrence.
  • Urinary pH and specific gravity were measured pre- and post-treatment.

Main Results:

  • Adherence to Shohl's solution prophylaxis was associated with a significantly lower recurrence rate (16.6%) compared to non-adherence (100%).
  • Treatment with Shohl's solution effectively increased urinary pH and decreased urine specific gravity.
  • Cystinuria combined with hypocitraturia was the most frequent metabolic anomaly observed.

Conclusions:

  • Comprehensive clinical and laboratory evaluation is essential for children with cystine stone disease.
  • Appropriate prophylactic treatment, including alkalinization with Shohl's solution, is vital for preventing stone recurrence.
  • Patient adherence to medical prophylaxis is a critical factor in managing pediatric cystinuria.
Abstract

Keywords:
ChildrenCystinuriaRecurrenceShohl's solutionUrolithiasis

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