Comparative analysis of nephrolithiasis in otherwise healthy versus medically complex gastrostomy fed children

Paul J. Smith, Seerath Basravi, Bruce J. Schlomer, Nicol C. Bush, Benjamin J. Brown, Aaron Gingrich, Linda A. Baker

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: The purpose was to compare nephrolithiasis in healthy versus medically complex gastrostomy fed children. Materials and methods: Children with nephrolithiasis with and without gastrostomy were identified by database searches from 1999 to 2009. Gastrostomy fed stone formers (GSF) were compared to an age-matched cohort of non-gastrostomy-fed stone formers (NGSF) for demographic and clinical data. Results: 16 neurologically impaired GSF (10M:6F), mean age 10.4 years (range 1.7-17.5 years), were compared to 32 matched neurologically intact NGSF. Compared to NGSF, GSF had significantly higher urine pH (6.93 vs 6.23, p = 0.001) and larger stones (14.5 vs 6.9 mm, p = 0.02) more commonly composed of calcium phosphate (7/11, 64% vs 3/28, 11%, p = 0.002). 15/16 (94%) of GSF were immobile while 0% of NGSF were immobile. GSF had lower l-spine bone density Z-scores (-3.02 vs -1, p = 0.002) but an equal rate of hypercalciuria (2/7, 29% vs 7/24, 29%, p = NS). Contributing lithogenic factors in 8/16 (50%) GSF included urinary tract infection (UTI) (5), lithogenic medications (2), and xanthinuria (1). Conclusions: Stone disease in GSF is multifactorial, and half of our study group had an identifiable risk factor for nephrolithiasis. A recurring pattern of alkaline urine and calcium phosphate stone formation was evident. GSF did not have higher rates of hypercalciuria despite chronic immobilization and markedly lower bone density. An awareness of the potential risk factors identified is mandatory for this vulnerable population.

Original languageEnglish (US)
Pages (from-to)244-247
Number of pages4
JournalJournal of Pediatric Urology
Volume7
Issue number3
DOIs
StatePublished - Jun 2011

Fingerprint

Nephrolithiasis
Gastrostomy
Hypercalciuria
Bone Density
Urine
Vulnerable Populations
Urinary Tract Infections
Immobilization
Spine
Demography
Databases

Keywords

  • Gastrostomy tube
  • Nephrolithiasis
  • Pediatric

ASJC Scopus subject areas

  • Urology
  • Pediatrics, Perinatology, and Child Health

Cite this

Comparative analysis of nephrolithiasis in otherwise healthy versus medically complex gastrostomy fed children. / Smith, Paul J.; Basravi, Seerath; Schlomer, Bruce J.; Bush, Nicol C.; Brown, Benjamin J.; Gingrich, Aaron; Baker, Linda A.

In: Journal of Pediatric Urology, Vol. 7, No. 3, 06.2011, p. 244-247.

Research output: Contribution to journalArticle

Smith, Paul J. ; Basravi, Seerath ; Schlomer, Bruce J. ; Bush, Nicol C. ; Brown, Benjamin J. ; Gingrich, Aaron ; Baker, Linda A. / Comparative analysis of nephrolithiasis in otherwise healthy versus medically complex gastrostomy fed children. In: Journal of Pediatric Urology. 2011 ; Vol. 7, No. 3. pp. 244-247.
@article{1b7cbcf726af4c5994e836682f557c22,
title = "Comparative analysis of nephrolithiasis in otherwise healthy versus medically complex gastrostomy fed children",
abstract = "Purpose: The purpose was to compare nephrolithiasis in healthy versus medically complex gastrostomy fed children. Materials and methods: Children with nephrolithiasis with and without gastrostomy were identified by database searches from 1999 to 2009. Gastrostomy fed stone formers (GSF) were compared to an age-matched cohort of non-gastrostomy-fed stone formers (NGSF) for demographic and clinical data. Results: 16 neurologically impaired GSF (10M:6F), mean age 10.4 years (range 1.7-17.5 years), were compared to 32 matched neurologically intact NGSF. Compared to NGSF, GSF had significantly higher urine pH (6.93 vs 6.23, p = 0.001) and larger stones (14.5 vs 6.9 mm, p = 0.02) more commonly composed of calcium phosphate (7/11, 64{\%} vs 3/28, 11{\%}, p = 0.002). 15/16 (94{\%}) of GSF were immobile while 0{\%} of NGSF were immobile. GSF had lower l-spine bone density Z-scores (-3.02 vs -1, p = 0.002) but an equal rate of hypercalciuria (2/7, 29{\%} vs 7/24, 29{\%}, p = NS). Contributing lithogenic factors in 8/16 (50{\%}) GSF included urinary tract infection (UTI) (5), lithogenic medications (2), and xanthinuria (1). Conclusions: Stone disease in GSF is multifactorial, and half of our study group had an identifiable risk factor for nephrolithiasis. A recurring pattern of alkaline urine and calcium phosphate stone formation was evident. GSF did not have higher rates of hypercalciuria despite chronic immobilization and markedly lower bone density. An awareness of the potential risk factors identified is mandatory for this vulnerable population.",
keywords = "Gastrostomy tube, Nephrolithiasis, Pediatric",
author = "Smith, {Paul J.} and Seerath Basravi and Schlomer, {Bruce J.} and Bush, {Nicol C.} and Brown, {Benjamin J.} and Aaron Gingrich and Baker, {Linda A.}",
year = "2011",
month = "6",
doi = "10.1016/j.jpurol.2011.02.018",
language = "English (US)",
volume = "7",
pages = "244--247",
journal = "Journal of Pediatric Urology",
issn = "1477-5131",
publisher = "Elsevier BV",
number = "3",

}

TY - JOUR

T1 - Comparative analysis of nephrolithiasis in otherwise healthy versus medically complex gastrostomy fed children

AU - Smith, Paul J.

AU - Basravi, Seerath

AU - Schlomer, Bruce J.

AU - Bush, Nicol C.

AU - Brown, Benjamin J.

AU - Gingrich, Aaron

AU - Baker, Linda A.

PY - 2011/6

Y1 - 2011/6

N2 - Purpose: The purpose was to compare nephrolithiasis in healthy versus medically complex gastrostomy fed children. Materials and methods: Children with nephrolithiasis with and without gastrostomy were identified by database searches from 1999 to 2009. Gastrostomy fed stone formers (GSF) were compared to an age-matched cohort of non-gastrostomy-fed stone formers (NGSF) for demographic and clinical data. Results: 16 neurologically impaired GSF (10M:6F), mean age 10.4 years (range 1.7-17.5 years), were compared to 32 matched neurologically intact NGSF. Compared to NGSF, GSF had significantly higher urine pH (6.93 vs 6.23, p = 0.001) and larger stones (14.5 vs 6.9 mm, p = 0.02) more commonly composed of calcium phosphate (7/11, 64% vs 3/28, 11%, p = 0.002). 15/16 (94%) of GSF were immobile while 0% of NGSF were immobile. GSF had lower l-spine bone density Z-scores (-3.02 vs -1, p = 0.002) but an equal rate of hypercalciuria (2/7, 29% vs 7/24, 29%, p = NS). Contributing lithogenic factors in 8/16 (50%) GSF included urinary tract infection (UTI) (5), lithogenic medications (2), and xanthinuria (1). Conclusions: Stone disease in GSF is multifactorial, and half of our study group had an identifiable risk factor for nephrolithiasis. A recurring pattern of alkaline urine and calcium phosphate stone formation was evident. GSF did not have higher rates of hypercalciuria despite chronic immobilization and markedly lower bone density. An awareness of the potential risk factors identified is mandatory for this vulnerable population.

AB - Purpose: The purpose was to compare nephrolithiasis in healthy versus medically complex gastrostomy fed children. Materials and methods: Children with nephrolithiasis with and without gastrostomy were identified by database searches from 1999 to 2009. Gastrostomy fed stone formers (GSF) were compared to an age-matched cohort of non-gastrostomy-fed stone formers (NGSF) for demographic and clinical data. Results: 16 neurologically impaired GSF (10M:6F), mean age 10.4 years (range 1.7-17.5 years), were compared to 32 matched neurologically intact NGSF. Compared to NGSF, GSF had significantly higher urine pH (6.93 vs 6.23, p = 0.001) and larger stones (14.5 vs 6.9 mm, p = 0.02) more commonly composed of calcium phosphate (7/11, 64% vs 3/28, 11%, p = 0.002). 15/16 (94%) of GSF were immobile while 0% of NGSF were immobile. GSF had lower l-spine bone density Z-scores (-3.02 vs -1, p = 0.002) but an equal rate of hypercalciuria (2/7, 29% vs 7/24, 29%, p = NS). Contributing lithogenic factors in 8/16 (50%) GSF included urinary tract infection (UTI) (5), lithogenic medications (2), and xanthinuria (1). Conclusions: Stone disease in GSF is multifactorial, and half of our study group had an identifiable risk factor for nephrolithiasis. A recurring pattern of alkaline urine and calcium phosphate stone formation was evident. GSF did not have higher rates of hypercalciuria despite chronic immobilization and markedly lower bone density. An awareness of the potential risk factors identified is mandatory for this vulnerable population.

KW - Gastrostomy tube

KW - Nephrolithiasis

KW - Pediatric

UR - http://www.scopus.com/inward/record.url?scp=79958262113&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79958262113&partnerID=8YFLogxK

U2 - 10.1016/j.jpurol.2011.02.018

DO - 10.1016/j.jpurol.2011.02.018

M3 - Article

C2 - 21527227

AN - SCOPUS:79958262113

VL - 7

SP - 244

EP - 247

JO - Journal of Pediatric Urology

JF - Journal of Pediatric Urology

SN - 1477-5131

IS - 3

ER -