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Abstract: FR-PO650

Clinical and Metabolic Findings in Children with Nephrolithiasis: A Single-Center Experience

Session Information

  • Pediatric Nephrology - II
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Mercado, Amelia Elizabeth, Texas Children's Pediatrics, Houston, Texas, United States
  • Scioscia, Jacob P., Texas Children's Pediatrics, Houston, Texas, United States
  • Tal, Leyat, Texas Children's Pediatrics, Houston, Texas, United States
  • Janzen, Nicolette, Texas Children's Pediatrics, Houston, Texas, United States
  • Michael, Mini, Texas Children's Pediatrics, Houston, Texas, United States
Background

Prevalence of nephrolithiasis in children has increased in recent decades and is associated with high risk of recurrence. Over 50% of children with nephrolithiasis may have a metabolic, genetic, or anatomic cause, making the epidemiology of the disease notable. The epidemiology of stones, including etiology, may better inform future treatment and prevention in at-risk populations. This study aims to describe clinical and metabolic findings in children with nephrolithiasis followed at a multidisciplinary stone clinic within a tertiary children’s hospital.

Methods

This is a retrospective study that included all children (n=330) with nephrolithiasis followed in the stone clinic from 5/2013-5/2023. Demographic, clinical, and metabolic variables were recorded from the patient’s first encounter in the clinic. Descriptive statistics were utilized.

Results

A total of 82 patients were reviewed at the time of reporting. Majority of patients were male (59%, n=48). Roughly 37% (n=30) of patients were Hispanic and 48% (n=39) were non-Hispanic White. The median age of presentation with first kidney stone was 11 years (range: 6 months–18 years). Almost half of patients had a family history of stone disease (48%, n=39), with the most common relative being the patient’s mother (33%, n=13). For patients who underwent a 24-hour urine collection (73%, n=60), 78% had metabolic abnormalities (n=47). The most common metabolic abnormalities were hypocitraturia (77%, n=36) and hypercalciuria (40%, n=19). A fifth of patients with hypocitraturia (22%, n=8) had bilateral nephrolithiasis. Almost a third of patients had hydronephrosis (30%, n=25) and required surgical stone removal (36%, n=9). Majority of patients had spontaneous passage of a stone (56%, n=46). For patients that completed stone analysis (38%, n=31), 71% (n=22) contained calcium, with the most common composition being calcium phosphate (73%, n=16). Being wheelchair bound (15%, n=12), having cerebral palsy (13%, n=11), or taking Zonisamide (10%, n=8) were frequent risk factors for stone formation.

Conclusion

Almost half of patients had a family history of stone disease, suggesting a genetic aspect to nephrolithiasis and importance of genetic testing in this subset of patients. Metabolic abnormalities were frequent among children with stone disease, with hypocitraturia being the most common.