For a study, researchers sought to determine the risk variables for a subsequent stone event (SSE) in pediatric patients for a study. Between 2012 and 2017, a retrospective review was conducted at 2 tertiary-care children’s hospitals in the state for children under the age of 17 with a diagnosis of nephrolithiasis and at least 1 complete follow-up. Children with known monogenic stone disease and those with less than a year of follow-up were eliminated. SSEs were defined as: later surgical intervention, new stone on imaging, reported stone passage, or ED examination for renal colic after first diagnosis and treatment for nephrolithiasis. Univariate and multivariate analyses using Cox proportional hazard models assessed clinical and demographic characteristics between patients with and without SSEs. Log-Rank and Wilcoxon comparisons were used to produce survival curves for significant SSE correlations. About 200 individuals were studied, with a median clinical follow-up of 2.9 years. The median age was 11.5 years (IQR: 6.0–15.5), and there were 109 (54.5%) men and 91 (45.5%) females, with 94 (47%) of them having relevant comorbidity. In 82 patients, an SSE was discovered (41.0%). On univariate analysis, age more than 12 (HR 2.21, 95% CI 1.42–3.45), confirmed stone event before registration encounter (i.e. personal history of nephrolithiasis) (HR 1.82, 95% CI 1.14–2.89), and family history of nephrolithiasis (HR 1.62, 95% CI 1.05–2.51) were associated with SSE, while age more than 12 (HR 2.09, 95% CI 1.33–3.27) and personal history of nephrolithiasis (HR 1.63, 1.02–2.6) retained importance on multivariable analysis. According to survival analysis, the aggregation of risk factors increases the likelihood of recurrence. All 3 variables remained significant after a sensitivity analysis that accounted for missing family history data. Independent risk factors for SSE in children included adolescent age and a personal history of nephrolithiasis. Understanding these risk variables and the form of SSE in children might help to improve counseling for further metabolic testing and targeted clinical follow-up.
Source:www.sciencedirect.com/science/article/abs/pii/S1477513121005684
