Urinary metabolic evaluations in solitary and recurrent stone forming children.
Urinary metabolic evaluations in solitary and recurrent stone forming children.
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孤立性和复发性结石儿童的尿液代谢评估。
DOI：
10.1016/j.juro.2008.01.151
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
J. Asplin
中科院分区：
文献类型：
--
作者：
W. DeFoor;E. Minevich;E. Jackson;P. Reddy;C. Clark;C. Sheldon;J. Asplin
目的我们之前曾报道，与正常对照组相比，结石形成儿童的尿代谢异常率较高。我们的机构在儿童首次结石发作后开始进行 24 小时尿液评估，以测量结石风险指数。本研究的目的是确定哪些儿童复发性结石形成的风险最大。材料和方法进行回顾性队列研究以评估尿石症儿童的尿液代谢特征。对所有患者进行 24 小时尿液收集并在其他地方进行评估。根据肌酐和体重调整尿液化学评估，例如钙和柠檬酸盐。测量草酸钙过饱和度。根据病历审查，将患者分为孤立性或复发性结石形成者。采用双尾 t 检验进行均值之间的单变量分析。结果对来自 88 个孤立性结石形成者的 148 个样本和来自 51 个复发性结石形成者的 84 个样本进行了评估。两组之间的年龄和性别匹配良好。复发性结石患者的肌酐和柠檬酸盐定时尿钙水平显着升高。复发性结石儿童草酸钙过饱和水平较高，但未达到统计学意义。结论孤立性和复发性钙结石儿童24小时尿钙水平存在显着差异。 24 小时样本尿钙指数升高的患者可能会受益于更积极的初始饮食和药物治疗，以防止结石复发。
PurposeWe have previously reported a high rate of urinary metabolic abnormalities in stone forming children compared to normal controls. At our institution a 24-hour urine evaluation is initiated after the first stone episode in children, to measure stone risk indices. The purpose of this study was to determine which children are at the greatest risk for recurrent stone formation.Materials and MethodsA retrospective cohort study was performed to assess urinary metabolic profiles in children with urolithiasis. In all patients 24-hour urine collections were performed and evaluated elsewhere. Urine chemistry assessments such as calcium and citrate were adjusted for creatinine and weight. Calcium oxalate supersaturation was measured. Patients were stratified as solitary or recurrent stone formers based on review of the medical record. Univariate analysis between means was performed with a 2-tailed t test.ResultsA total of 148 samples from 88 solitary stone formers and 84 samples from 51 recurrent stone formers were evaluated. Age and gender were well matched between the 2 groups. Timed urinary calcium levels referenced to creatinine and citrate were significantly higher in patients with recurrent stones. Supersaturation levels of calcium oxalate were higher in recurrent stone formers but did not reach statistical significance.ConclusionsThere are significant differences in 24-hour urinary calcium levels between solitary and recurrent calcium stone forming children. A patient with increased urinary calcium indices on a 24-hour specimen may benefit from more aggressive initial dietary and pharmacological treatment to prevent stone recurrence.
影响因子：
19.6
作者：
Parks,JH;Coe,FL
通讯作者：
Coe,FL