ESPN 53rd Annual Meeting

ESPN 2021


 
COMPOSITION OF URINARY STONES IN CHILDREN: CLINICAL AND METABOLIC DETERMINANTS IN A FRENCH TERTIARY CARE CENTER
CAMILLE RAUTURIER 1 CHRISTELLE MACHON 1 DELPHINE DEMEDE 1 LAURENCE DUBOURG 1 JUSTINE BACCHETTA 1 AURELIA BERTHOLET-THOMAS 1

1- HFME
 
Abstract:

 

Objectives : The aim was to describe the composition of stones of pediatric patients in a tertiary center, to illustrate current epidemiological trends in pediatric urolithiasis.

Methods : Clinical and metabolic data from all pediatric patients with at least one stone that was analyzed by Fourier Transformed Infrared Spectroscopy (FTIR) in the Hospices Civils de Lyon s Civils de Lyon between 2013 and 2017 were retrospectively collected.

Results : A total of 111 patients (sex ratio 1.4:1) were included; their median [IQR] age was 7.5 [3.1-10.5] years. The main component of stones was calcium oxalate [weddellite for 34 (31%) stones, whewellite 23 (21%)], calcium phosphate [carbapatite 32 (29%), brushite 6 (5%), amorphous calcium phosphate 3 (3%)], struvite 5 (5%), cystine 4 (4%), uric acid 2 (2%), and ammonium acid urate 2 (2%). A total of 20 (18%) stones were pure and 24 (22%) were infectious. Carbapatite stones were the most frequent in patients < 2 years and calcium oxalate stones in patients > 2 years old. Metabolic abnormalities (most frequently hypercalciuria) were found in 50% of tested patients and in 54% of patients with infectious stones. Congenital anomalies of the kidney and/or urinary tract (CAKUT) or neurogenic bladder was present in 9/24 (38%) patients with infectious stones and 12/16 (76%) patients with bladder stones.

Conclusion: This study confirms that calcium oxalate stones are the most frequent among pediatric patients, which could reflect the nutritional habits of predisposed patients. In contrast, infectious stones are less frequent and occur mostly in association with anatomic or metabolic favoring factors.