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Chang H et al, 2017: Melamine Poisoning Pediatric Urolithiasis Treatment in Gansu, China 5-Year Follow-up Analysis.

Chang H, Wu G, Yue Z, Ma J, Qin Z.
Department of Urology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China; Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou, Gansu Province, China; Department of Clinical Laboratory Center, The Second Clinical Medical College of Lanzhou University, Lanzhou, Gansu Province, China.

Abstract

OBJECTIVE: To investigate the clinical characteristics of urolithiasis, retrospectively, in children who ingested melamine-poisoned formula as infants, and report a 5-year follow-up analysis.
MATERIALS AND METHODS: Clinical data on 207 patients (mean ± standard deviation, 13.6 ± 8.0 months) with melamine-induced urolithiasis were retrospectively analyzed. Patients were subdivided into 2 groups according to treatment. A 5-year follow-up study was conducted with 95.7% (198 of 207) of the children. Ultrasonography, renal function evaluation, and urinalysis were analyzed.
RESULTS: A total of 149 (72.0%) patients accepted conservative treatment. Fifty-eight (28.0%) patients accepted surgical intervention after conservative treatment proved ineffective. Of the 48 patients in whom retrograde ureteral catheterization was performed, 33 discharged the stone successfully, 4 had residual stones, 2 were switched to percutaneous nephrolithotripsy, and 9 underwent ureteroscopic lithotripsy. Six patients underwent extracorporeal shock wave lithotripsy, and other 4 patients underwent ureteral lithectomy. The age of onset, clinical presentations, size and location of stones, renal function, and mean time of hospitalization in patients with surgical intervention were significantly different from those of patients who accepted conservative treatment only (P < .001). The main component of the 12 melamine-contained stone samples was urate. The results of 5-year follow-up (mean ± standard deviation, 72.7 ± 4.1 months) study in 198 children did not show any significant difference of stone residue, renal function, and urinalysis between 2 groups.
CONCLUSION: If the stones were treated appropriately in patients with melamine-induced urolithiasis, there is no medium-term risk for stone formation. Still, a longer time follow-up study is required to determine if there is any long-term poisonous effect on these patients.

Urology. 2017 Jul 10. pii: S0090-4295(17)30717-3. doi: 10.1016/j.urology.2017.06.043. [Epub ahead of print]

 

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Kommentare 1

Hans-Göran Tiselius am Dienstag, 23. Januar 2018 09:06

It was of great interest to read about the 5-year course of stone-disease in children who were poisoned by melamine. In the authors region there were 619 children who developed stones and overall more than 294 000 children were afflicted. This report is a follow-up of 207 (out of 619) children.
The result is probably of greatest interest from a metabolic point of view with the observation that there were no stone recurrences during the follow-up period. Of 58 patients requiring surgical intervention only 6 had been treated with SWL. Four of these children were stone free whereas two had residuals

It was of great interest to read about the 5-year course of stone-disease in children who were poisoned by melamine. In the authors region there were 619 children who developed stones and overall more than 294 000 children were afflicted. This report is a follow-up of 207 (out of 619) children. The result is probably of greatest interest from a metabolic point of view with the observation that there were no stone recurrences during the follow-up period. Of 58 patients requiring surgical intervention only 6 had been treated with SWL. Four of these children were stone free whereas two had residuals
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