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Extracorporal shock wave lithotripsy in the management of stones in children with oxalosis--still the first choice?
[primary hyperoxaluria type 1]
Primary
hyperoxaluria
(
PH
)
is
a
recognised
cause
of
nephrolithiasis
.
The
aim
of
this
study
was
to
evaluate
the
success
of
extracorporal
shock
wave
lithotripsy
(
ESWL
)
in
treating
nephrolithiasis
in
children
with
PH
.
T
his
was
a
retrospective
review
of
patient
characteristics
,
treatments
and
outcomes
of
36
children
with
oxalate
stones
due
to
PH
.
A
total
of
52
stones
were
formed
in
28
patients
,
of
which
23
stones
were
treated
with
ESWL
.
Of
these
23
stones
,
ten
improved
and
13
did
not
;
nine
were
located
in
the
upper
pole
,
nine
in
the
lower
pole
and
four
and
one
in
the
pelvic
and
ureteric
areas
,
respectively
.
All
pelvic
and
ureteric
stones
improved
,
while
66
.
7
%
of
upper
pole
stones
and
89
.
9
%
of
lower
pole
stones
did
not
;
20
%
of
PH
type
1
stones
improved
compared
to
47
%
of
PH
type
2
stones
.
The
mean
pre-
and
post-e
GFR
in
stone-improvers
was
98
.
82
and
104
.
7
ml
/
min
/
1
.
73
m
(
2
)
,
respectively
;
in
the
non-improvers
,
these
values
were
100
.
75
and
95
.
68
ml
/
min
/
1
.
73
m
(
2
)
,
respectively
.
Mean
pre-
ESWL
stone
size
in
the
improved
and
non-improved
groups
was
7
.
3
mm
and
8
.
5
mm
respectively
.
Based
on
our
results
,
ESWL
is
not
the
ideal
method
of
stone
therapy
for
patients
with
PH
.
ESWL
was
more
effective
in
treating
pelvic
and
ureteric
stones
,
with
upper
pole
stone
response
being
better
than
lower
pole
response
.
PH
2
patients
were
more
than
twice
as
likely
to
respond
to
ESWL
treatment
.
Stone
size
and
prior
preventive
treatment
did
not
affect
outcome
.
eGFR
was
not
affected
by
ESWL
.
Diseases
Validation
Diseases presenting
"nephrolithiasis"
symptom
adrenal incidentaloma
cushing syndrome
cystinuria
familial hypocalciuric hypercalcemia
primary hyperoxaluria type 1
This symptom has already been validated