Gina M Cambareri1, Dana W Giel2, Aaron P Bayne3, Sean Corbett4, Elleson Schurtz2, Larisa Kovacevic5, Troy Sukhu4, Michael Yap6, George Chiang7. 1. Department of Urology, University of California San Diego, San Diego, CA. Electronic address: ginacambareri@gmail.com. 2. Division of Pediatric Urology, University of Tennessee Health Science Center/Le Bonheur Children's Hospital, Memphis, TN. 3. Department of Urology, Oregon Health Sciences University, Portland, OR. 4. Department of Urology, University of Virginia, Charlottesville, VA. 5. Department of Urology, Children's Hospital of Michigan, Detroit, MI. 6. Department of Urology, University of California San Diego, San Diego, CA. 7. University of California San Diego Department of Urology, Rady Children's Specialists of San Diego, San Diego, CA.
Abstract
OBJECTIVE: To determine if 24-hour urinary parameters in children with nephrolithiasis across 4 institutions were influenced by body mass index (BMI). MATERIALS AND METHODS: The 24-hour urinary parameters obtained from children with nephrolithiasis between 2000 and 2013 were stratified by BMI percentile ≥85th and <85th (overweight and obese patients vs healthy weight, respectively). A total of 206 children were included in the study. Exclusion criteria included patients with a history of spina bifida, neurogenic bladder, and cerebral palsy, and patients on medical treatment before the first 24-hour urine collection. RESULTS: Overweight and obese patients consisted of 35.4% of the cohort (n = 73). Metabolic abnormalities were present in 130 children (63.1%). The most common abnormality present in the <85th percentile was hypercalciuria (32.3%), and in the ≥85th percentile, hyperoxaluria (37.0%). Univariable and multivariable analyses revealed that overweight and obese children were more likely to have low urinary volume and elevated uric acid compared to normal-weight children. CONCLUSION: Although there is a link between stone formation and BMI in adults, no definitive conclusions have been proven in the pediatric literature. Our study indicates that stone-forming children who are overweight or obese have low urinary volume and elevated uric acid compared to normal-weight stone-forming children.
OBJECTIVE: To determine if 24-hour urinary parameters in children with nephrolithiasis across 4 institutions were influenced by body mass index (BMI). MATERIALS AND METHODS: The 24-hour urinary parameters obtained from children with nephrolithiasis between 2000 and 2013 were stratified by BMI percentile ≥85th and <85th (overweight and obesepatients vs healthy weight, respectively). A total of 206 children were included in the study. Exclusion criteria included patients with a history of spina bifida, neurogenic bladder, and cerebral palsy, and patients on medical treatment before the first 24-hour urine collection. RESULTS: Overweight and obesepatients consisted of 35.4% of the cohort (n = 73). Metabolic abnormalities were present in 130 children (63.1%). The most common abnormality present in the <85th percentile was hypercalciuria (32.3%), and in the ≥85th percentile, hyperoxaluria (37.0%). Univariable and multivariable analyses revealed that overweight and obesechildren were more likely to have low urinary volume and elevated uric acid compared to normal-weight children. CONCLUSION: Although there is a link between stone formation and BMI in adults, no definitive conclusions have been proven in the pediatric literature. Our study indicates that stone-forming children who are overweight or obese have low urinary volume and elevated uric acid compared to normal-weight stone-forming children.
Authors: Julia B Ward; Lydia Feinstein; Casey Pierce; John Lim; Kevin C Abbott; Tamara Bavendam; Ziya Kirkali; Brian R Matlaga Journal: Urology Date: 2019-04-18 Impact factor: 2.649