ESPN 51th Annual Meeting

ESPN 2018


 
Risk factors for recurrent kidney stones in children
CHARLOTTE DE RUYSSCHER 1 LYNN PIEN 1 JOHAN VANDE WALLE 1 THOMAS TAILLY 2 ERIK VAN LAECKE 2 AGNIESZKA PRYTULA 1

1- (1) GHENT UNIVERSITY HOSPITAL, DEPARTMENT OF PAEDIATRIC NEPHROLOGY AND RHEUMATOLOGY
2- (2) GHENT UNIVERSITY HOSPITAL, DEPARTMENT OF PAEDIATRIC UROLOGY
 
Introduction:

Despite a growing incidence of nephrolithiasis in children and its high recurrence rates, there is a paucity of data on the factors contributing to the recurrence of kidney stones. The purpose of this study is to identify risk factors associated with recurrent kidney stones in children followed at a Belgian tertiary centre.

Material and methods:

Medical records of children who were treated and followed for urinary stone disease were retrospectively reviewed. Children with the first episode of nephrolithiasis between 1998 and 2016, followed at the Ghent University Hospital and at least one year follow-up were included. We analysed whether patient characteristics, past medical history, presenting symptoms, the results of laboratory investigations and the applied management strategy were associated with a risk of kidney stone recurrence. The risk of stone recurrence was evaluated by univariate and multivariate analysis.

Results:

97 children were eventually included in the analysis. 33 (34%) of them presented with at least one episode of stone recurrence. Body mass index (BMI) above the 85th percentile and asymptomatic stones at the initial presentation were associated with a lower risk of recurrent stones (p=0.020 and p=0.017). In contrast, immobility resulted in a 10 times higher risk (p=0.002, 95% CI 1.968-50.005) and the need for surgical treatment was associated with a 3.2 times higher risk (p=0.017, 95% CI 1.297-8.084) of developing recurrent stones.

Conclusions:

There was a higher risk of recurrent stones in immobile patients and those who required surgical intervention at initial presentation in contrast to patients with a high BMI or asymptomatic presentation, which appears to be a protective factor against the development of recurrent stones. These data can be used to identify children who require an intense follow-up after the 1st episode of nephrolithiasis.