High-risk factors for urinary calculus recurrence in Chinese preschool children: findings from a medium-term follow-up survey.

IF 1.7 3区 医学 Q4 ANDROLOGY
Translational andrology and urology Pub Date : 2025-06-30 Epub Date: 2025-06-26 DOI:10.21037/tau-2024-650
Hou-Yu Zhou, You-Quan Zhao, Xiao-Chuan Wang, Shao Zhang, Jun Li
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Abstract

Background: To date, most literature has focused on factors contributing to the initial occurrence of pediatric urinary stones. However, there is scant literature on the risk factors for recurrence following the initial episode. Effective treatment strategies for the initial episode and measures to reduce the risk of stone recurrence are crucial. This study aimed to investigate the impact of children's dietary habits on the recurrence of urinary stones in children.

Methods: A retrospective analysis was conducted on the clinical data of pediatric patients diagnosed with urinary stones by the Department of Urology at Beijing Friendship Hospital Affiliated with Capital Medical University from January 2014 to December 2023. Dietary habits were compared between patients who experienced recurrence and those who did not.

Results: We conducted a follow-up study from January 2014 to December 2023 on 310 children with urinary stones. During the follow-up period, which had a median duration of 50.93±1.79 months, 62 patients (20.0%) experienced recurrence, while 248 patients (80.0%) did not. Among the recurrent patients, 9 (14.5%) did not consume animal proteins, 21 (33.9%) had low water intake, and 34 (54.8%) had a high dietary oxalate intake. In comparison, among the non-recurrent patients, 34 (13.7%) did not consume animal proteins, 36 (14.5%) had low water intake, and 120 (48.4%) had a high dietary oxalate intake. Univariate analysis revealed that a high-protein diet [odds ratio (OR) =0.805, 95% confidence interval (CI): 0.707-0.917, P<0.001] was a protective factor against recurrence, while a high oxalate diet (OR =1.335, 95% CI: 1.146-1.554, P<0.001), low water intake (OR =1.138, 95% CI: 1.013-1.279, P=0.03), and younger age at onset (OR =1.062, 95% CI: 1.025-1.110, P=0.001) were identified as risk factors. In multivariate analysis, the high-protein diet remained a protective factor (OR =0.825, 95% CI: 0.725-0.940, P=0.004), while high dietary oxalate intake (OR =1.304, 95% CI: 1.122-1.515, P<0.001), low water intake (OR =1.141, 95% CI: 1.019-1.276, P=0.02), and younger age at onset (OR =1.076, 95% CI: 1.038-1.114, P<0.001) continued to be significant risk factors.

Conclusions: The study concluded that a high-protein diet serves as a protective factor, whereas a high oxalate diet, low water intake, and younger age at onset are significant risk factors for the recurrence of pediatric urinary stones. The cumulative five-year recurrence rate of pediatric urinary stones was 18.1%. Therefore, dietary modifications, including increased protein intake and reduced oxalate consumption, along with ensuring adequate hydration, are crucial in managing pediatric urinary stones and preventing early recurrence.

中国学龄前儿童尿路结石复发的高危因素:中期随访调查结果
背景:迄今为止,大多数文献都集中在导致儿童尿路结石最初发生的因素上。然而,关于首次发作后复发的危险因素的文献很少。有效的治疗策略和措施,以减少结石复发的风险是至关重要的。本研究旨在探讨儿童饮食习惯对儿童尿路结石复发的影响。方法:回顾性分析2014年1月至2023年12月在首都医科大学附属北京友谊医院泌尿外科诊断为泌尿系结石的儿童患者的临床资料。研究人员比较了复发患者和未复发患者的饮食习惯。结果:我们从2014年1月至2023年12月对310例尿路结石患儿进行了随访研究。随访中位时间为50.93±1.79个月,62例(20.0%)复发,248例(80.0%)未复发。复发患者中,9例(14.5%)不摄入动物蛋白,21例(33.9%)水摄入量低,34例(54.8%)草酸盐摄入量高。相比之下,在非复发患者中,34例(13.7%)不摄入动物蛋白,36例(14.5%)水摄入量低,120例(48.4%)饮食中草酸盐摄入量高。单因素分析显示,高蛋白饮食[比值比(OR) =0.805, 95%可信区间(CI): 0.707-0.917]结论:研究结论:高蛋白饮食是儿童尿路结石复发的保护因素,而高草酸饮食、低水摄入量和发病年龄较轻是儿童尿路结石复发的重要危险因素。小儿尿路结石5年累计复发率为18.1%。因此,饮食调整,包括增加蛋白质摄入量和减少草酸盐摄入量,以及确保充足的水合作用,对于治疗儿童尿路结石和预防早期复发至关重要。
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来源期刊
CiteScore
4.10
自引率
5.00%
发文量
80
期刊介绍: ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.
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