Pediatric urolithiasis - Does body mass index influence stone presentation and treatment?

Kathleen Kieran, Dana Giel, Brent J. Morris, Jim Wan, Chrisla D. Tidwell, Andrew Giem, Gerald R. Jerkins, Mark A. Williams

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Purpose: Pediatric obesity is a major public health concern in the United States. We investigated the association of body mass index with presentation and outcome in children with urolithiasis. Materials and Methods: We identified all patients 2 to 18 years old at our institution with a radiographically confirmed first renal or ureteral stone between January 2003 and June 2008. Data abstracted included demographics, stone characteristics, treatment and metabolic evaluation. Patients were stratified into 3 body mass index categories, including lower (10th percentile or less for age), normal (10th to 85th percentile) and upper (85th percentile or greater) percentile body weight. Results: Of the children 62 boys (55.4%) and 50 girls (44.6%) were evaluable. Mean age at diagnosis was 11.8 years. Body mass index stratification showed lower percentile body weight in 11 patients (9.8%), normal percentile body weight in 55 (49.1%) and upper percentile body weight in 46 (41.1%). Mean stone diameter was 5.0 mm. Of the stones 31 (27.7%) were in the kidney or ureteropelvic junction and 81 (72.3%) were in the ureter. Surgery was done in 87 patients (78.9%) and stone clearance was accomplished by 1 (69.0%) or 2 (31.0%) procedures in all. Lower percentile body weight patients presented earlier than normal and upper percentile body weight patients (9.0 vs 12.2 and 12.0 years, respectively, p = 0.04). Neither stone size nor the number of procedures required for stone clearance differed significantly by body mass index. Conclusions: Upper percentile body weight was not associated with earlier stone development, larger stones or the need for multiple surgical procedures. In lower percentile body weight patients symptomatic renal stones developed significantly earlier than in normal or upper percentile body weight patients. Stone size and the surgical intervention rate were similar regardless of body mass index. Further research may identify potential factors predisposing children with lower percentile body weight to early stone development.

Original languageEnglish (US)
Pages (from-to)1810-1815
Number of pages6
JournalJournal of Urology
Volume184
Issue number4 SUPPL.
DOIs
StatePublished - Oct 1 2010

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Urolithiasis
Body Mass Index
Body Weight
Pediatrics
Therapeutics
Kidney
Ideal Body Weight
Pediatric Obesity
Ureter
Causality
Public Health
Demography

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Pediatric urolithiasis - Does body mass index influence stone presentation and treatment? / Kieran, Kathleen; Giel, Dana; Morris, Brent J.; Wan, Jim; Tidwell, Chrisla D.; Giem, Andrew; Jerkins, Gerald R.; Williams, Mark A.

In: Journal of Urology, Vol. 184, No. 4 SUPPL., 01.10.2010, p. 1810-1815.

Research output: Contribution to journalArticle

Kieran, K, Giel, D, Morris, BJ, Wan, J, Tidwell, CD, Giem, A, Jerkins, GR & Williams, MA 2010, 'Pediatric urolithiasis - Does body mass index influence stone presentation and treatment?', Journal of Urology, vol. 184, no. 4 SUPPL., pp. 1810-1815. https://doi.org/10.1016/j.juro.2010.03.111
Kieran, Kathleen ; Giel, Dana ; Morris, Brent J. ; Wan, Jim ; Tidwell, Chrisla D. ; Giem, Andrew ; Jerkins, Gerald R. ; Williams, Mark A. / Pediatric urolithiasis - Does body mass index influence stone presentation and treatment?. In: Journal of Urology. 2010 ; Vol. 184, No. 4 SUPPL. pp. 1810-1815.
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abstract = "Purpose: Pediatric obesity is a major public health concern in the United States. We investigated the association of body mass index with presentation and outcome in children with urolithiasis. Materials and Methods: We identified all patients 2 to 18 years old at our institution with a radiographically confirmed first renal or ureteral stone between January 2003 and June 2008. Data abstracted included demographics, stone characteristics, treatment and metabolic evaluation. Patients were stratified into 3 body mass index categories, including lower (10th percentile or less for age), normal (10th to 85th percentile) and upper (85th percentile or greater) percentile body weight. Results: Of the children 62 boys (55.4{\%}) and 50 girls (44.6{\%}) were evaluable. Mean age at diagnosis was 11.8 years. Body mass index stratification showed lower percentile body weight in 11 patients (9.8{\%}), normal percentile body weight in 55 (49.1{\%}) and upper percentile body weight in 46 (41.1{\%}). Mean stone diameter was 5.0 mm. Of the stones 31 (27.7{\%}) were in the kidney or ureteropelvic junction and 81 (72.3{\%}) were in the ureter. Surgery was done in 87 patients (78.9{\%}) and stone clearance was accomplished by 1 (69.0{\%}) or 2 (31.0{\%}) procedures in all. Lower percentile body weight patients presented earlier than normal and upper percentile body weight patients (9.0 vs 12.2 and 12.0 years, respectively, p = 0.04). Neither stone size nor the number of procedures required for stone clearance differed significantly by body mass index. Conclusions: Upper percentile body weight was not associated with earlier stone development, larger stones or the need for multiple surgical procedures. In lower percentile body weight patients symptomatic renal stones developed significantly earlier than in normal or upper percentile body weight patients. Stone size and the surgical intervention rate were similar regardless of body mass index. Further research may identify potential factors predisposing children with lower percentile body weight to early stone development.",
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AB - Purpose: Pediatric obesity is a major public health concern in the United States. We investigated the association of body mass index with presentation and outcome in children with urolithiasis. Materials and Methods: We identified all patients 2 to 18 years old at our institution with a radiographically confirmed first renal or ureteral stone between January 2003 and June 2008. Data abstracted included demographics, stone characteristics, treatment and metabolic evaluation. Patients were stratified into 3 body mass index categories, including lower (10th percentile or less for age), normal (10th to 85th percentile) and upper (85th percentile or greater) percentile body weight. Results: Of the children 62 boys (55.4%) and 50 girls (44.6%) were evaluable. Mean age at diagnosis was 11.8 years. Body mass index stratification showed lower percentile body weight in 11 patients (9.8%), normal percentile body weight in 55 (49.1%) and upper percentile body weight in 46 (41.1%). Mean stone diameter was 5.0 mm. Of the stones 31 (27.7%) were in the kidney or ureteropelvic junction and 81 (72.3%) were in the ureter. Surgery was done in 87 patients (78.9%) and stone clearance was accomplished by 1 (69.0%) or 2 (31.0%) procedures in all. Lower percentile body weight patients presented earlier than normal and upper percentile body weight patients (9.0 vs 12.2 and 12.0 years, respectively, p = 0.04). Neither stone size nor the number of procedures required for stone clearance differed significantly by body mass index. Conclusions: Upper percentile body weight was not associated with earlier stone development, larger stones or the need for multiple surgical procedures. In lower percentile body weight patients symptomatic renal stones developed significantly earlier than in normal or upper percentile body weight patients. Stone size and the surgical intervention rate were similar regardless of body mass index. Further research may identify potential factors predisposing children with lower percentile body weight to early stone development.

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