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Symptomatic recurrence rate of upper urinary tract calculi in children after endourological procedures
Xiaochuan Wang1, Yu Zhang1, Fangzhou Zhao1
1Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, People's Republic of China.
Insights
The recurrence rate of pediatric kidney stones in Chinese children is lower than in Caucasian children. Higher body mass index and larger stone burden predict increased recurrence risk.
Area of Science:
- Pediatric Nephrology
- Urology
- Epidemiology
Background:
- Paediatric urolithiasis recurrence rates, particularly in Asian populations, are underreported.
- Understanding recurrence patterns is crucial for effective management.
Purpose of the Study:
- To determine the symptomatic recurrence rate of kidney stones in Chinese children.
- To identify predictive factors for stone recurrence in this demographic.
Main Methods:
- Retrospective review of 230 children with initial upper urinary tract calculi (June 2014 - September 2019).
- Kaplan-Meier plots and Cox proportional hazard regression analyses were used for follow-up.
- Recurrence defined as new symptomatic stones confirmed by imaging.
Main Results:
- A total of 230 children were analyzed; 14.8% experienced stone recurrence after a median follow-up of 39.5 months.
- Older age, higher body mass index (BMI), and greater stone burden (> 2 cm³ ) were associated with increased recurrence risk.
- Children with higher BMI had a 2.99-fold increased risk, and those with stone burden > 2 cm³ had a 4.84-fold increased risk of recurrence.
Conclusions:
- The symptomatic recurrence rate of paediatric kidney stones in Chinese children is lower than previously reported in Caucasian populations.
- Higher body mass index and larger initial stone burden are significant predictors of stone recurrence in paediatric urolithiasis.
Introduction:
The recurrence rate of paediatric urolithiasis was less reported, especially in Asians. Our aim was to verify the symptomatic recurrence rate of Chinese paediatric urolithiasis and to determine the predictive factors for stone recurrence.
Materials And Methods:
We performed a retrospective review of children who presented with first upper urinary tract calculi from June 2014 to September 2019. For the follow-up, we generated Kaplan-Meier plots with time to stone recurrence and Cox proportional hazard regression analyses were applied. The recurrence was defined as a new symptomatic stone on ultrasound and/or computerized tomography.
Results:
A total of 230 children with a median age of 5 yr (IQR 4-8) were included. Calcium oxalate was found in 72% of stones, and calcium apatite was found in 32% of stones. After a median follow-up of 39.5 months, 34 (14.8%) children had stone recurrence. Median time to stone recurrence was 31 months. Among them, 31 (91.2%) required surgical intervention. Older children (P < 0.01), higher BMI (HBM) (P < 0.01) and higher stone burden (P < 0.01) were shown to be associated with stone recurrence in the univariate analysis. The multivariate Cox regression analysis showed that children with stone burden > 2 cm3 had a higher risk of recurrence (HR 4.84, 95%CI 2.28-10.3). Children with HBM had an increased recurrence rate compared to normal BMI children (HR 2.99, 95%CI 1.36-6.56).
Conclusions:
The symptomatic recurrence rate of paediatric urolithiasis in Chinese is not as high as that reported in Caucasians. HBM and higher stone burden are associated with higher recurrence rates.
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