ESPN 53rd Annual Meeting

ESPN 2021


 
COMPARING DIFFERENT MORPHO-COMPOSITIONAL GROUPS OF KIDNEY STONES IN A PEDIATRIC RENAL LITHIASIS REGISTRY
JAVIER LUMBRERAS 1 MARIA DOLORES RODRIGO 1 RAFAEL MARIA PRIETO 2 ANTONIA COSTA-BAUZA 2 PILAR SANCHíS 2 NATALIA ESPINOSA 3 IRATXE TAPIA 3 JUAN DAVID GONZáLEZ 4 MARíA ISABEL LUIS-YANES 5 INéS VERGARA 6 HéCTOR RíOS 7 MONTSERRAT ANTóN-GAMERO 8 MAR ESPINO 9 Jorge Luján 10 FELIX GRASES 2

1- PEDIATRIC NEPHROLOGY UNIT. UNIVERSITY HOSPITAL SON ESPASES-BALEARIC ISLANDS HEALTH RESEARCH INSTITUTE (IDISBA). PALMA DE MALLORCA - SPAIN
2- LABORATORY OF RENAL LITHIASIS RESEARCH, UNIVERSITARY INSTITUTE OF HEALTH SCIENCES RESEARCH (IUNICS),UNIVERSITY OF BALEARIC ISLANDS-BALEARIC ISLANDS HEALTH RESEARCH INSTITUTE(IDISBA). PALMA DE MALLORCA - SPAIN
3- PEDIATRIC NEPHROLOGY UNIT. UNIVERSITY HOSPITAL SON ESPASES. PALMA DE MALLORCA - SPAIN
4- PEDIATRIC NEPHROLOGY UNIT. UNIVERSITY HOSPITAL SANTA LUCIA. CARTAGENA - SPAIN
5- PEDIATRIC NEPHROLOGY UNIT. UNIVERSITY HOSPITAL NUESTRA SEñORA DE CANDELARIA. SANTA CRUZ DE TENERIFE - SPAIN
6- PEDIATRIC NEPHROLOGY UNIT. COMPLEJO HOSPITALARIO UNIVERSITARIO A CORUñA. LA CORUñA - SPAIN
7- PEDIATRIC NEPHROLOGY DEPARTMENT. UNIVERSITY HOSPITAL VALL DHEBRON. BARCELONA - SPAIN
8- PEDIATRIC NEPHROLOGY UNIT. UNIVERSITY HOSPITAL REINA SOFíA. CóRDOBA - SPAIN
9- PEDIATRIC NEPHROLOGY UNIT. UNIVERSITY HOSPITAL 12 DE OCTUBRE. MADRID - SPAIN
10- Pediatric Nephrology Unit. Hospital Sanitas La Moraleja. Madrid - Spain
 
Abstract:

Objectives

Different morpho-compositional types of kidney stones represent different etiologies. By understanding these, we can achieve a correct therapeutic approach. We expose clinical and analytical particularities among several groups of stones in children.

Material and methods

A national renal lithiasis registry is active in our country since January 2015. A specialized laboratory analyses stones. Physicians provide clinical and analytical data. For this study, similar stone types were grouped in 5 categories, according to main component: calcium oxalate monohydrate (COM, n=8), calcium oxalate dihydrate (COD, n=34), hydroxyapatite (HAP, n=11), magnesium ammonium phosphate (MAP, n=16) and Others (n=14). Clinical and analytical variables were compared.


Results

83 stones from 69 patients were included. Male prevalence ranged from 64% in HAP to 93% in MAP. Mean age at diagnosis varied from COD (10.3 years old) to MAP and HAP (3.1). Highest prevalence of relatives with stones appeared in COM (100%), lowest in MAP (36%). Urinary tract abnormalities ranged between 40-44% in HAP and MAP respectively, and 12-14% in the rest. Past urinary infection appeared from 69% in MAP to 13% in COM. HAP had much more frequently multiple stones at diagnosis (73%) with the lowest spontaneous passage (55%). Lowest urine volumes were observed in COM (0.7 [0.6-1.1] mL/kg/h), highest urine pH in HAP (7,0 [7,0 – 8,5]). Hypercalciuria prevalence was similar among all groups (38-50%) except COM (17%). Hypocitraturia was more common in COM (50%), COD (36%) and HAP (29%). Calcium/citrate ratio>0.33 mg/mg was more frequent in COD (60%) and HAP (57%).

Conclusions

COM showed more frequently low urine volumes, hypocitraturia and stones in relatives. MAP and HAP were associated to urinary tract abnormalities, COD and HAP with high calcium/citrate ratio. HAP had higher urine pH.