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Natural history of patients with infantile nephrolithiasis: what are the predictors of surgical intervention?

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Abstract

Background

We evaluated the risk factors for the requirement of surgical intervention in infants with nephrolithiasis.

Methods

The medical records of 122 (156 kidney units (KU)) infants were reviewed. The clinical features, stone characteristics, changes in stone status, and treatment protocols were noted. The stone status of the KU was categorized into 3 groups according to the change in size between the first and last ultrasound: resolution, unchanged, and growth.

Results

The median age was 8 months (r: 2–12). The median length of follow-up was 16 months (r: 10–36). Resolution was detected in 94 KUs (60%). Stone growth was detected in 39 KUs (25%), and stone size was unchanged in 23 KUs (15%). Surgical intervention was required in 26 patients (17%). A history of intensive care unit (ICU) follow-up and a stone size > 5 mm at time of diagnosis were defined as independent risk factors for stone growth (p = 0.005, < 0.001, respectively). The surgical intervention rate was higher in stones > 5 mm and stones with pelvic localization (p = 0.018, 0.021, respectively). Stone resolution was higher in patients with stone size ≤ 5 mm (p = 0.018).

Conclusion

A stone size > 5 mm at the time of diagnosis and a history of ICU follow-up are independent risk factors for stone growth. Pelvic localization of stones and stones > 5 mm are associated with an increased risk of surgical intervention.

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Author notes

  1. Seha Kamil Saygılı and Elif Altınay Kırlı contributed equally to this work.

Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, Istanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, 34098, Istanbul, Turkey

    Seha Kamil Saygılı, Emre Taşdemir, Nur Canpolat, Salim Çalışkan & Lale Sever

  2. Department of Urology, Istanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, 34098, Istanbul, Turkey

    Elif Altınay Kırlı, Zübeyr Talat & Bülent Önal

Authors
  1. Seha Kamil Saygılı
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  2. Elif Altınay Kırlı
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  6. Lale Sever
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  8. Bülent Önal
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Contributions

Conception and design of the study: Lale Sever and Salim Çalışkan

Acquisition of data: Elif Altınay Kırlı, Seha Kamil Saygılı, and Emre Taşdemir

Drafting the article: Elif Altınay Kırlı and Seha Saygılı Bülent Önal

Revision the article: Nur Canpolat and Zübeyr Talat

Final approval of the article before the submission: Bülent Önal

Contributed to the study conception and design: all authors

Corresponding author

Correspondence to Bülent Önal.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study was performed in line with the principles of the Declaration of Helsinki. Approval for this study was granted by the ethics Committee of Istanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine (Institutional approval number: 1872-822).

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All authors accepted the last version of the manuscript and consented for the publication.

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Saygılı, S.K., Kırlı, E.A., Taşdemir, E. et al. Natural history of patients with infantile nephrolithiasis: what are the predictors of surgical intervention?. Pediatr Nephrol 36, 939–944 (2021). https://doi.org/10.1007/s00467-020-04781-3

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  • DOI: https://doi.org/10.1007/s00467-020-04781-3

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