Summary
Introduction
Urolithiasis is a condition that is most commonly found in adults, but is becoming
increasingly prevalent in children. Little is known about the relationship between
blood pressure (BP) and urolithiasis in children.
Objectives
The aim was to evaluate the relationship between urolithiasis and BP, and to determine
the association of BP with 24-h urine parameters in children.
Methods
We retrospectively analyzed BP and 24-h urine data from children <18 years with and
without urolithiasis from 2004 to 2015 at a single tertiary center. Children with
a diagnosis of non-glomerular hematuria without history of urolithiasis were chosen
as the control group. Non-stone formers were excluded if they presented with any abnormal
24-h urine data or kidney disease. Casual BP, BP index (BPi), and 24-h urine parameters
were compared between groups using t-tests. Multiple regression analyses adjusting for age, sex and body mass index (BMI)
z-score evaluated the association of BP with urolithiasis and urine electrolytes.
Results
The urolithiasis group (N = 71) was significantly older, taller and heavier than the non-stone former group
(N = 53) (Table). Systolic BP and diastolic BP in stone formers were significantly greater
than in non-stone formers, respectively (p = 0.019). Additionally, systolic BPi was significantly higher in the urolithiasis
group (p = 0.03) but there was no significant difference in diastolic BPi (p = 0.45). Urolithiasis was a significant predictor of systolic BPi in the adjusted
model (β = 0.04, 95% CI 0.001–0.07). In stone formers, systolic BP and systolic BPi
were directly associated with 24-h urine sodium, oxalate/1.73 m2, and uric acid (all p < 0.05). Urine calcium was not associated with any BP parameter.
Discussion
The findings are consistent with previous studies in adults that examined the correlation
between blood pressure and kidney stones. The results of this study also showed that
blood pressure was positively associated with urine sodium, oxalate, and uric acid.
Interestingly, contrary to adult literature, our hypothesis which postulated that
blood pressure would be associated with an increase in urine calcium was not supported
by our findings. The small sample size is a study limitation and the use of healthy
controls as a comparison would have been ideal.
Conclusions
TableStone formers vs. non-stone formers.
| Characteristics | Stone formers (N = 71) | Non-stone formers (N = 53) | p |
|---|---|---|---|
| Male | 34 (47.9) | 34 (64.2) | 0.07 |
| Age (years) | 11.2 ± 4.1 | 9.2 ± 3.5 | 0.005 |
| Body mass index z-score | 0.57 ± 2.68 | 0.68 ± 1.19 | 0.78 |
| Systolic blood pressure (mmHg) | 109.4 ± 14.7 | 103.0 ± 12.7 | 0.01 |
| Diastolic blood pressure (mmHg) | 65.0 ± 8.3 | 61.4 ± 8.6 | 0.02 |
| Systolic blood pressure index | 0.89 ± 0.10 | 0.86 ± 0.10 | 0.03 |
| Diastolic blood pressure index | 0.81 ± 0.10 | 0.78 ± 0.35 | 0.45 |
Note. Values are mean ± SD or N (%).
Keywords
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Article info
Publication history
Published online: September 18, 2016
Accepted:
July 1,
2016
Received:
March 8,
2016
Identification
Copyright
© 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
