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E29 Stones type in children with urolithiasis aged 0-3 years and occurence of urinary tract infections and urinary tract malformations
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THURSDAY 10 SEPTEMBER 2015 / EUROPEAN UROLOGY SUPPLEMENTS 14 (2015) 29–78
14.00–15.30 Sala 6 (2nd floor) Poster session 3: Basic research, genetics and epidemiology
E29 Stones type in children with urolithiasis aged 0-3 years and occurence of urinary tract infections and urinary tract malformations
E28 How to interpret selected macromolecules level in a morning urine sample of children with idiopathic hypercalciuria?
Bak-Wachnicka A., Jobs K., Jung A. Wojskowy Instytut Medyczny, Dept. of Pediatric Nephrology, Warsaw, Poland
Jobs K. Wojskowy Instytut Medyczny, Dept. of Pediatric Nephrology, Warsaw, Poland Introduction and objectives: Urolithiasis in Europe occurs in 0,5% of adults and in about 2% of children. Nowadays occurrence of disease in children is growing, especially in youngest children. Idiopathic hypercalciuria is the most common basis of urolithiasis. To form a stone increased urine level of crystallization promoters and decreased level of inhibitors is needed. In healthy people’s urine we can find many kinds of macromolecules. To the part of them we can attribute function of calcium stones inhibitors. Paradoxically most of them can be both: Inhibitors and promoters. Correct level and structure of macromolecules can be a defense of stones formation. In our previously reported work we found statistically significant lower excretion of osteopontin and statistically significant higher excretion of bikunin in hypercalciuric group. There was also trend to higher excretion of calgranulin. The aim of the study was estimation of children’s age and gender and warm or cold season of the year in time of examinations impact on four selected proteins (osteopontin, uromodulin, bikunin and calgranulin) level, in children with idiopathic hypercalciuria and in healthy control group. In hypercalciuric group level of studied proteins and stage of the disease (remission or active stage) were compared as well. Materials and methods: 90 children aged 2-18 years. 57 children (27 girls, 30 boys) -hypercalciuric patients: 32 (16 girls and 16 boys) with active stage of the disease (with stones present in their urinary tract in time of examinations), and 25 children (11 girls and 14 boys) without stones actually (remission of the disease). Control group -33 children (19 girls, 14 boys) age matched, diagnosed because of headache, faint or suspicion of allergy without abnormalities in performed examinations. Osteopontin, bikunin, uromodulin and calgranulin urine levels examinations were performed with ELISA method. Results: There was no impact of gender on studied proteins excretion (in hypercalciuric group: Osteopontin p 0,69, calgranulin p 0,20, uromodulin p 0,07, bikunin p 0,78; in control group: osteopontin p 0,57, calgranulin p 0,43, uromodulin p 0,89, bikunin p 0,59). There was no impact of children’s age (hypercalciuric pts: osteopontin p 0,67, calgranulin p 0,72, uromodulin p 0,46, bikunin p 0,63; control group: Osteopontin p 0,77, calgranulin p 0,70, uromodulin p 0,83, bikunin p 0,51) and season of the year on studied proteins (hypercalciuric pts: osteopontin p 0,42, calgranulin p 0,99, uromodulin p 0,26, bikunin p 0,09; control group: Osteopontin p 0,92, calgranulin p 0,30, uromodulin p 0,64, bikunin p 0,63). There was no impact of the stage of the disease (active vs remission) on excretion of studied proteins (osteopontin p 0,26, calgranulin p 0,30, uromodulin p 0,64, bikunin p 0,89). Conclusions: Lack of impact of age, gender, warm or cold season of the year and, in hypercalciuric group, no difference between active stage of disease or remission on excretion of examined macromolecules makes further investigations and interpretation of results much easier.
Introduction and objectives: Recently, growing incidence of urolithiasis in children, including very young ones, is observed. They are caused, among other factors, by climate changes and epidemic of obesity. However in youngest children their significance seems to be not so important. The knowledge about etiology of urolithiasis in very young patients is limited. About 75% of them present metabolic abnormalities leading to stone formation. It is possible that urinary tract infections (UTI) and malformations of urinary tract causing urine retention are reason of stone forming and that youngest children with urolithiasis are more prone to form staghorn calculi if there are urinary tract infections and/or malformations. The aim of the study was estimation of frequency of urinary tract malformations and urinary tract infections and estimation of stones type in children with urolithiasis diagnosed at the age of 0-3 years (y). Materials and methods: Retrospective analysis of medical records of 122 children from 514 patients (pts) with urolithiasis treated in our Nephrology department between 2008 and 2014 (288 F- 56%, 226 M- 44%). Results: Among 514 patients there were 122 children between 0-3 y (23,7% of all pts)- 59 F (48%), 63 M (52%). In 53 pts (43% of the youngest group) urolithiasis was diagnosed in the first year of life (24 F-45%, 29 M- 55%). Among children 0-3 y urinary tract malformations were diagnosed in 18 pts (15%): 5 F, 13 M, urinary tract infections were diagnosed in 29 pts (24%): 17 F, 12 M. In 14 pts (11,5%): 9 F, 5 M there were both UTI and malformations. Among children with UTI there were 6 with staghorn calculi (21%), in subgroup with malformations- 4 with this type of stones (22%), among pts with both UTI and malformations- 3 patients with staghorn calculi (22%). In subgroup of children aged 0-1 y malformations were diagnosed in 10 pts (19%): 2 F, 8 M, UTI were diagnosed in 14 pts (26,5%): 7 F, 7 M, both malformations and UTI in 5 pts (9,5%): 2 F, 3 M. Conclusions: As much as a quarter of examined pts with urolithiasis were children from the youngest group and among them almost in 50% the disease was diagnosed in the first year if life. Urinary tract malformations and urinary tract infections were not dominant cause of urolithiasis in the youngest group of patients. It confirms the fact that even in youngest children metabolic abnormalities are main reason of stone formation. However in observed children of all subgroups staghorn stones were seen in more than 20%. We concluded that they are subjects of that kind of stones particularly often. E30 Nephrolithiasis in children: Urinary factors of its lower prevalence compared to adults Prieto R.M.1, Rodriguez A.1, Costa-Bauza A.1, Saez-Torres C.1, Rodrigo M.D.2, Frontera G.3, Mir-Perello C.2, Gomez C.4, Grases F.1 1 University Of The Balearic Islands, University Institute of Health Science Research, Palma of Majorca, Spain, 2Son Espases Hospital, Pediatric Department, Palma of Majorca, Spain, 3Son Espases Hospital, Research Unit, Palma of Majorca, Spain, 4Son Espases Hospital, Laboratory Department, Palma of Majorca, Spain Introduction and objectives: The prevalence of calcium oxalate nephrolithiasis is increasing in children and tends to be recurrent. However, renal stones are still infrequent during the pediatric period and are often associated with an underlying metabolic
THURSDAY 10 SEPTEMBER 2015 / EUROPEAN UROLOGY SUPPLEMENTS 14 (2015) 29–78
14.00–15.30 Sala 6 (2nd floor) Poster session 3: Basic research, genetics and epidemiology
E29 Stones type in children with urolithiasis aged 0-3 years and occurence of urinary tract infections and urinary tract malformations
E28 How to interpret selected macromolecules level in a morning urine sample of children with idiopathic hypercalciuria?
Bak-Wachnicka A., Jobs K., Jung A. Wojskowy Instytut Medyczny, Dept. of Pediatric Nephrology, Warsaw, Poland
Jobs K. Wojskowy Instytut Medyczny, Dept. of Pediatric Nephrology, Warsaw, Poland Introduction and objectives: Urolithiasis in Europe occurs in 0,5% of adults and in about 2% of children. Nowadays occurrence of disease in children is growing, especially in youngest children. Idiopathic hypercalciuria is the most common basis of urolithiasis. To form a stone increased urine level of crystallization promoters and decreased level of inhibitors is needed. In healthy people’s urine we can find many kinds of macromolecules. To the part of them we can attribute function of calcium stones inhibitors. Paradoxically most of them can be both: Inhibitors and promoters. Correct level and structure of macromolecules can be a defense of stones formation. In our previously reported work we found statistically significant lower excretion of osteopontin and statistically significant higher excretion of bikunin in hypercalciuric group. There was also trend to higher excretion of calgranulin. The aim of the study was estimation of children’s age and gender and warm or cold season of the year in time of examinations impact on four selected proteins (osteopontin, uromodulin, bikunin and calgranulin) level, in children with idiopathic hypercalciuria and in healthy control group. In hypercalciuric group level of studied proteins and stage of the disease (remission or active stage) were compared as well. Materials and methods: 90 children aged 2-18 years. 57 children (27 girls, 30 boys) -hypercalciuric patients: 32 (16 girls and 16 boys) with active stage of the disease (with stones present in their urinary tract in time of examinations), and 25 children (11 girls and 14 boys) without stones actually (remission of the disease). Control group -33 children (19 girls, 14 boys) age matched, diagnosed because of headache, faint or suspicion of allergy without abnormalities in performed examinations. Osteopontin, bikunin, uromodulin and calgranulin urine levels examinations were performed with ELISA method. Results: There was no impact of gender on studied proteins excretion (in hypercalciuric group: Osteopontin p 0,69, calgranulin p 0,20, uromodulin p 0,07, bikunin p 0,78; in control group: osteopontin p 0,57, calgranulin p 0,43, uromodulin p 0,89, bikunin p 0,59). There was no impact of children’s age (hypercalciuric pts: osteopontin p 0,67, calgranulin p 0,72, uromodulin p 0,46, bikunin p 0,63; control group: Osteopontin p 0,77, calgranulin p 0,70, uromodulin p 0,83, bikunin p 0,51) and season of the year on studied proteins (hypercalciuric pts: osteopontin p 0,42, calgranulin p 0,99, uromodulin p 0,26, bikunin p 0,09; control group: Osteopontin p 0,92, calgranulin p 0,30, uromodulin p 0,64, bikunin p 0,63). There was no impact of the stage of the disease (active vs remission) on excretion of studied proteins (osteopontin p 0,26, calgranulin p 0,30, uromodulin p 0,64, bikunin p 0,89). Conclusions: Lack of impact of age, gender, warm or cold season of the year and, in hypercalciuric group, no difference between active stage of disease or remission on excretion of examined macromolecules makes further investigations and interpretation of results much easier.
Introduction and objectives: Recently, growing incidence of urolithiasis in children, including very young ones, is observed. They are caused, among other factors, by climate changes and epidemic of obesity. However in youngest children their significance seems to be not so important. The knowledge about etiology of urolithiasis in very young patients is limited. About 75% of them present metabolic abnormalities leading to stone formation. It is possible that urinary tract infections (UTI) and malformations of urinary tract causing urine retention are reason of stone forming and that youngest children with urolithiasis are more prone to form staghorn calculi if there are urinary tract infections and/or malformations. The aim of the study was estimation of frequency of urinary tract malformations and urinary tract infections and estimation of stones type in children with urolithiasis diagnosed at the age of 0-3 years (y). Materials and methods: Retrospective analysis of medical records of 122 children from 514 patients (pts) with urolithiasis treated in our Nephrology department between 2008 and 2014 (288 F- 56%, 226 M- 44%). Results: Among 514 patients there were 122 children between 0-3 y (23,7% of all pts)- 59 F (48%), 63 M (52%). In 53 pts (43% of the youngest group) urolithiasis was diagnosed in the first year of life (24 F-45%, 29 M- 55%). Among children 0-3 y urinary tract malformations were diagnosed in 18 pts (15%): 5 F, 13 M, urinary tract infections were diagnosed in 29 pts (24%): 17 F, 12 M. In 14 pts (11,5%): 9 F, 5 M there were both UTI and malformations. Among children with UTI there were 6 with staghorn calculi (21%), in subgroup with malformations- 4 with this type of stones (22%), among pts with both UTI and malformations- 3 patients with staghorn calculi (22%). In subgroup of children aged 0-1 y malformations were diagnosed in 10 pts (19%): 2 F, 8 M, UTI were diagnosed in 14 pts (26,5%): 7 F, 7 M, both malformations and UTI in 5 pts (9,5%): 2 F, 3 M. Conclusions: As much as a quarter of examined pts with urolithiasis were children from the youngest group and among them almost in 50% the disease was diagnosed in the first year if life. Urinary tract malformations and urinary tract infections were not dominant cause of urolithiasis in the youngest group of patients. It confirms the fact that even in youngest children metabolic abnormalities are main reason of stone formation. However in observed children of all subgroups staghorn stones were seen in more than 20%. We concluded that they are subjects of that kind of stones particularly often. E30 Nephrolithiasis in children: Urinary factors of its lower prevalence compared to adults Prieto R.M.1, Rodriguez A.1, Costa-Bauza A.1, Saez-Torres C.1, Rodrigo M.D.2, Frontera G.3, Mir-Perello C.2, Gomez C.4, Grases F.1 1 University Of The Balearic Islands, University Institute of Health Science Research, Palma of Majorca, Spain, 2Son Espases Hospital, Pediatric Department, Palma of Majorca, Spain, 3Son Espases Hospital, Research Unit, Palma of Majorca, Spain, 4Son Espases Hospital, Laboratory Department, Palma of Majorca, Spain Introduction and objectives: The prevalence of calcium oxalate nephrolithiasis is increasing in children and tends to be recurrent. However, renal stones are still infrequent during the pediatric period and are often associated with an underlying metabolic