Pediatric Urolithiasis—Does Body Mass Index Influence Stone Presentation and Treatment?

Abstract

No AccessJournal of UrologyStone1 Oct 2010Pediatric Urolithiasis—Does Body Mass Index Influence Stone Presentation and Treatment? Kathleen Kieran, Dana W. Giel, Brent J. Morris, Jim Y. Wan, Chrisla D. Tidwell, Andrew Giem, Gerald R. Jerkins, and Mark A. Williams Kathleen KieranKathleen Kieran , Dana W. GielDana W. Giel , Brent J. MorrisBrent J. Morris , Jim Y. WanJim Y. Wan , Chrisla D. TidwellChrisla D. Tidwell , Andrew GiemAndrew Giem , Gerald R. JerkinsGerald R. Jerkins , and Mark A. WilliamsMark A. Williams View All Author Informationhttps://doi.org/10.1016/j.juro.2010.03.111AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Pediatric obesity is a major public health concern in the United States. We investigated the association of body mass index with presentation and outcome in children with urolithiasis. Materials and Methods: We identified all patients 2 to 18 years old at our institution with a radiographically confirmed first renal or ureteral stone between January 2003 and June 2008. Data abstracted included demographics, stone characteristics, treatment and metabolic evaluation. Patients were stratified into 3 body mass index categories, including lower (10th percentile or less for age), normal (10th to 85th percentile) and upper (85th percentile or greater) percentile body weight. Results: Of the children 62 boys (55.4%) and 50 girls (44.6%) were evaluable. Mean age at diagnosis was 11.8 years. Body mass index stratification showed lower percentile body weight in 11 patients (9.8%), normal percentile body weight in 55 (49.1%) and upper percentile body weight in 46 (41.1%). Mean stone diameter was 5.0 mm. Of the stones 31 (27.7%) were in the kidney or ureteropelvic junction and 81 (72.3%) were in the ureter. Surgery was done in 87 patients (78.9%) and stone clearance was accomplished by 1 (69.0%) or 2 (31.0%) procedures in all. Lower percentile body weight patients presented earlier than normal and upper percentile body weight patients (9.0 vs 12.2 and 12.0 years, respectively, p = 0.04). Neither stone size nor the number of procedures required for stone clearance differed significantly by body mass index. Conclusions: Upper percentile body weight was not associated with earlier stone development, larger stones or the need for multiple surgical procedures. In lower percentile body weight patients symptomatic renal stones developed significantly earlier than in normal or upper percentile body weight patients. Stone size and the surgical intervention rate were similar regardless of body mass index. Further research may identify potential factors predisposing children with lower percentile body weight to early stone development. 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Google Scholar Division of Pediatric Urology, Department of Urology, University of Tennessee Memphis-LeBonheur Children's Medical Center, Memphis, Tennessee© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byAlfandary H, Haskin O, Davidovits M, Pleniceanu O, Leiba A and Dagan A (2018) Increasing Prevalence of Nephrolithiasis in Association with Increased Body Mass Index in Children: A Population Based StudyJournal of Urology, VOL. 199, NO. 4, (1044-1049), Online publication date: 1-Apr-2018.Penido M, Srivastava T and Alon U (2018) Pediatric Primary Urolithiasis: 12-Year Experience at a Midwestern Children's HospitalJournal of Urology, VOL. 189, NO. 4, (1493-1497), Online publication date: 1-Apr-2013.Kokorowski P, Routh J, Hubert K, Graham D and Nelson C (2012) Association of Urolithiasis with Systemic Conditions Among Pediatric Patients at Children's HospitalsJournal of Urology, VOL. 188, NO. 4S, (1618-1622), Online publication date: 1-Oct-2012.Dwyer M, Krambeck A, Bergstralh E, Milliner D, Lieske J and Rule A (2018) Temporal Trends in Incidence of Kidney Stones Among Children: A 25-Year Population Based StudyJournal of Urology, VOL. 188, NO. 1, (247-252), Online publication date: 1-Jul-2012.Kim S, Luan X, Canning D, Landis J and Keren R (2011) Association Between Body Mass Index and Urolithiasis in ChildrenJournal of Urology, VOL. 186, NO. 4S, (1734-1739), Online publication date: 1-Oct-2011. Volume 184Issue 4SOctober 2010Page: 1810-1815 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.KeywordsthinnessobesityureterurolithiasiskidneyMetricsAuthor Information Kathleen Kieran More articles by this author Dana W. Giel More articles by this author Brent J. Morris More articles by this author Jim Y. Wan More articles by this author Chrisla D. Tidwell More articles by this author Andrew Giem More articles by this author Gerald R. Jerkins More articles by this author Mark A. Williams More articles by this author Expand All Advertisement PDF downloadLoading ...