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 .

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Diseases presenting "nine in the lower pole and four and one in the pelvic and ureteric areas" symptom

primary hyperoxaluria type 1

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