Follow-up results of children with melamine induced urolithiasis: a prospective observational cohort study
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Follow-up results of children with melamine induced urolithiasis: a prospective observational cohort study Jian Gao, Hong Xu, Xin-Yu Kuang, Wen-Yan Huang, Nai-Qing Zhao, Jia Rao, Qiang-Ying Qian, Xian-Ying Cheng, Zhi-Min Feng, Jing Xu, Xin Zhang, Xiang Wang Shanghai, China
Original article
Background: Melamine-contaminated milk powder was the cause of the 2008 outbreak of urolithiasis in young children and infants in China, but the prognosis of these children remains unknown. We hypothesized that urolithiasis induced by melamine-contaminated milk powder may be associated with secondary renal injury. Methods: A total of 8335 children (≤6 years old) with a history of consuming melamine-contaminated milk powder were screened. Urine analysis and urinary system ultrasonography were performed. For children with urolithiasis, the basic information and the results of examination were recorded, and effective therapy was given. They were followed up for 6 months after the original diagnosis, and urinary microprotein profiles were measured. Results: Of the 8335 children, 105 (1.26%) were diagnosed with melamine-contaminated milk powderassociated urolithiasis. The size of the stone was correlated with the duration of exposure to melamine. Six months later, 69.8% (67) of the children with urolithiasis passed stones (follow-up rate: 91.4%). Of the 67 children, 28 passed stones within 2 months. The higher possibility of passing a stone was correlated with the smaller diameter of the stone (P12 to ≤36 18 (39.1) 28 (60.9) 0.287 (0.051-1.618) 0.157 >36 to ≤72 4 (44.4) 5 (55.6) 1 Concentration of consumed melamine 0.312 High 21 (36.2) 37 (63.8) 2.840 (0.639-12.635) 0.170 Middle 4 (30.8) 9 (69.2) 1.135 (0.163-7.911) 0.898 Low 4 (16.0) 21 (84.0) 1 Duration of exposure (mon) 0.216 0 to ≤6 7 (20.6) 27 (79.4) 0.829 (0.174-3.955) 0.814 >6 to ≤12 11 (27.5) 29 (72.5) 0.281 (0.060-1.317) 0.107 >12 11 (50.0) 11 (50.0) 1 Diameter of calculi (mm) 10 8 (80.0) 2 (20.0) 29.982 (3.834-234.485) 0.001 >5 to ≤10 11 (50.0) 11 (50.0) 9.181 (2.514-33.506) 0.001 ≤5 10 (15.6) 54 (84.4) 1 P‡ Urinalysis (n=85)† Proteinuria 21 (26.6) 58 (73.4) 0.009 5 (83.3) 1 (16.7) +§ Microscopic 18 (25.0) 54 (75.0) 0.018 hematuria + 8 (61.5) 5 (38.5) Leukocyturia 20 (28.2) 51 (71.8) 0.344 + 6 (42.9) 8 (57.1) *: The enter method was used; †: Of 96 follow-up patients, 85 underwent urinalysis; ‡: The urinalysis results between patients with passed and persistent stones were compared. Fisher's exact test and the Chi-square test (microscopic hematuria) were used to calculate P values; §: Patients with proteinuria comprised those who had microscopic hematuria but urinary tract infection.
World J Pediatr, Vol 7 No 3 . August 15, 2011 . www.wjpch.com
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Original article
Table 2. Multivariate analysis using ordinal regression for comparison of data about children with urolithiasis at initial presentation and different calculi diameters Diameter of calculi (mm)*, n (%) Characteristics Odds ratio (95% CI) P Estimate† ≤5 >5 to ≤10 >10 Gender Male 45 (66.2) 17 (25.0) 6 (8.8) -0.3
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