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The effect of prophylactic treatment with Shohl's solution in children with cystinuria

Abstract Objective To investigate the effect of prophylactic treatment with Shohl's solution on the rates of stone recurrence in paediatric patients with cystinuria. Patients and methods Between June 2007 and October 2011, 185 patients aged 16 years and younger whose stones had been completely...

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Published in:	Journal of pediatric urology 2013-12, Vol.9 (6), p.1218-1222
Main Authors:	Izol, Volkan, Aridogan, Ibrahim Atilla, Karsli, Onur, Deger, Mutlu, Satar, Nihat
Format:	Article
Language:	English
Subjects:	Adolescent Child Child, Preschool Children Citric Acid - therapeutic use Cystinuria Cystinuria - drug therapy Cystinuria - epidemiology Female Follow-Up Studies Humans Hydrogen-Ion Concentration Infant Male Nephrostomy, Percutaneous Pediatrics Potassium Citrate - therapeutic use Recurrence Risk Factors Secondary Prevention Shohl's solution Solutions - therapeutic use Urolithiasis Urolithiasis - drug therapy Urolithiasis - epidemiology Urolithiasis - prevention & control Urology
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creator	Izol, Volkan Aridogan, Ibrahim Atilla Karsli, Onur Deger, Mutlu Satar, Nihat
description	Abstract Objective To investigate the effect of prophylactic treatment with Shohl's solution on the rates of stone recurrence in paediatric patients with cystinuria. Patients and methods Between June 2007 and October 2011, 185 patients aged 16 years and younger whose stones had been completely removed by percutaneous nephrolithotomy (PCNL) were assessed for metabolic risk factors. Seventeen (9%) patients with positive cyanide-nitroprusside tests (CNT) and cystine stones enrolled in this study, and a Shohl's solution was used for alkalinisation. The patients were followed up for a mean period of two years for stone recurrence. Results Of the patients, 10 (59%) were male, and 7 (41%) were female ( p = 0.13). Twelve patients (70.5%) continued to receive medical prophylaxis regularly, whereas 5 (29.5%) patients did not. The mean pre-treatment and post-treatment urinary pH values were 5.8 ± 0.5 (5–7) and 7.5 ± 0.4 (6.5–8), respectively ( p
doi_str_mv	10.1016/j.jpurol.2013.05.017
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Patients and methods Between June 2007 and October 2011, 185 patients aged 16 years and younger whose stones had been completely removed by percutaneous nephrolithotomy (PCNL) were assessed for metabolic risk factors. Seventeen (9%) patients with positive cyanide-nitroprusside tests (CNT) and cystine stones enrolled in this study, and a Shohl's solution was used for alkalinisation. The patients were followed up for a mean period of two years for stone recurrence. Results Of the patients, 10 (59%) were male, and 7 (41%) were female ( p = 0.13). Twelve patients (70.5%) continued to receive medical prophylaxis regularly, whereas 5 (29.5%) patients did not. The mean pre-treatment and post-treatment urinary pH values were 5.8 ± 0.5 (5–7) and 7.5 ± 0.4 (6.5–8), respectively ( p < 0.001). The pre-treatment and post-treatment specific gravities of the urine were 1021.5 ± 5.4 (1010–1030) and 1006 ± 2.3 (1004–1015), respectively ( p < 0.001). The rates of recurrence were 16.6% among those who continued prophylaxis and 100% among those who did not receive prophylaxis ( p = 0.001). The most common combination of metabolic anomalies was cystinuria and hypocitraturia ( p < 0.001). Conclusions This study demonstrated that detailed clinical and laboratory evaluations should be performed for all children with cystine stone disease, and, appropriate prophylactic treatment should be recommended to prevent the reformation of stones.</description><identifier>ISSN: 1477-5131</identifier><identifier>EISSN: 1873-4898</identifier><identifier>DOI: 10.1016/j.jpurol.2013.05.017</identifier><identifier>PMID: 23806278</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Child ; Child, Preschool ; Children ; Citric Acid - therapeutic use ; Cystinuria ; Cystinuria - drug therapy ; Cystinuria - epidemiology ; Female ; Follow-Up Studies ; Humans ; Hydrogen-Ion Concentration ; Infant ; Male ; Nephrostomy, Percutaneous ; Pediatrics ; Potassium Citrate - therapeutic use ; Recurrence ; Risk Factors ; Secondary Prevention ; Shohl's solution ; Solutions - therapeutic use ; Urolithiasis ; Urolithiasis - drug therapy ; Urolithiasis - epidemiology ; Urolithiasis - prevention & control ; Urology</subject><ispartof>Journal of pediatric urology, 2013-12, Vol.9 (6), p.1218-1222</ispartof><rights>Journal of Pediatric Urology Company</rights><rights>2013 Journal of Pediatric Urology Company</rights><rights>Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-ef1fb5446148b220ceaba53379467f707b1c863a5f27ab4c4703779accd50a723</citedby><cites>FETCH-LOGICAL-c417t-ef1fb5446148b220ceaba53379467f707b1c863a5f27ab4c4703779accd50a723</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23806278$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Izol, Volkan</creatorcontrib><creatorcontrib>Aridogan, Ibrahim Atilla</creatorcontrib><creatorcontrib>Karsli, Onur</creatorcontrib><creatorcontrib>Deger, Mutlu</creatorcontrib><creatorcontrib>Satar, Nihat</creatorcontrib><title>The effect of prophylactic treatment with Shohl's solution in children with cystinuria</title><title>Journal of pediatric urology</title><addtitle>J Pediatr Urol</addtitle><description>Abstract Objective To investigate the effect of prophylactic treatment with Shohl's solution on the rates of stone recurrence in paediatric patients with cystinuria. Patients and methods Between June 2007 and October 2011, 185 patients aged 16 years and younger whose stones had been completely removed by percutaneous nephrolithotomy (PCNL) were assessed for metabolic risk factors. Seventeen (9%) patients with positive cyanide-nitroprusside tests (CNT) and cystine stones enrolled in this study, and a Shohl's solution was used for alkalinisation. The patients were followed up for a mean period of two years for stone recurrence. Results Of the patients, 10 (59%) were male, and 7 (41%) were female ( p = 0.13). Twelve patients (70.5%) continued to receive medical prophylaxis regularly, whereas 5 (29.5%) patients did not. The mean pre-treatment and post-treatment urinary pH values were 5.8 ± 0.5 (5–7) and 7.5 ± 0.4 (6.5–8), respectively ( p < 0.001). The pre-treatment and post-treatment specific gravities of the urine were 1021.5 ± 5.4 (1010–1030) and 1006 ± 2.3 (1004–1015), respectively ( p < 0.001). The rates of recurrence were 16.6% among those who continued prophylaxis and 100% among those who did not receive prophylaxis ( p = 0.001). The most common combination of metabolic anomalies was cystinuria and hypocitraturia ( p < 0.001). Conclusions This study demonstrated that detailed clinical and laboratory evaluations should be performed for all children with cystine stone disease, and, appropriate prophylactic treatment should be recommended to prevent the reformation of stones.</description><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Citric Acid - therapeutic use</subject><subject>Cystinuria</subject><subject>Cystinuria - drug therapy</subject><subject>Cystinuria - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>Infant</subject><subject>Male</subject><subject>Nephrostomy, Percutaneous</subject><subject>Pediatrics</subject><subject>Potassium Citrate - therapeutic use</subject><subject>Recurrence</subject><subject>Risk Factors</subject><subject>Secondary Prevention</subject><subject>Shohl's solution</subject><subject>Solutions - therapeutic use</subject><subject>Urolithiasis</subject><subject>Urolithiasis - drug therapy</subject><subject>Urolithiasis - epidemiology</subject><subject>Urolithiasis - prevention & control</subject><subject>Urology</subject><issn>1477-5131</issn><issn>1873-4898</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNqFkbuO1TAQQCMEYpeFP0AoHTQJ40fipEFCK17SShS70FqOM1YcfO2L7Sy6f4-vslDQUM0UZ15nquolgZYA6d-u7XrcYnAtBcJa6Fog4lF1SQbBGj6Mw-OScyGajjByUT1LaQVgAuj4tLqgbICeiuGy-n63YI3GoM51MPUxhuNyckpnq-scUeUD-lz_snmpb5ewuNepTsFt2QZfW1_rxbo5ot8JfUrZ-i1a9bx6YpRL-OIhXlXfPn64u_7c3Hz99OX6_U2jORG5QUPM1HHeEz5MlIJGNamOMTHyXhgBYiJ66JnqDBVq4pqLcoIYldZzB0pQdlW92fuWxX9umLI82KTROeUxbEkS3tNihI5QUL6jOoaUIhp5jPag4kkSkGejcpW7UXk2KqGTxWgpe_UwYZsOOP8t-qOwAO92AMud9xajTNqi1zjbWKzKOdj_Tfi3gXbWW63cDzxhWsMWfXEoiUxUgrw9f_X8VMIASAeU_QaJm56q</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Izol, Volkan</creator><creator>Aridogan, Ibrahim Atilla</creator><creator>Karsli, Onur</creator><creator>Deger, Mutlu</creator><creator>Satar, Nihat</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>The effect of prophylactic treatment with Shohl's solution in children with cystinuria</title><author>Izol, Volkan ; Aridogan, Ibrahim Atilla ; Karsli, Onur ; Deger, Mutlu ; Satar, Nihat</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-ef1fb5446148b220ceaba53379467f707b1c863a5f27ab4c4703779accd50a723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Citric Acid - therapeutic use</topic><topic>Cystinuria</topic><topic>Cystinuria - drug therapy</topic><topic>Cystinuria - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>Infant</topic><topic>Male</topic><topic>Nephrostomy, Percutaneous</topic><topic>Pediatrics</topic><topic>Potassium Citrate - therapeutic use</topic><topic>Recurrence</topic><topic>Risk Factors</topic><topic>Secondary Prevention</topic><topic>Shohl's solution</topic><topic>Solutions - therapeutic use</topic><topic>Urolithiasis</topic><topic>Urolithiasis - drug therapy</topic><topic>Urolithiasis - epidemiology</topic><topic>Urolithiasis - prevention & control</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Izol, Volkan</creatorcontrib><creatorcontrib>Aridogan, Ibrahim Atilla</creatorcontrib><creatorcontrib>Karsli, Onur</creatorcontrib><creatorcontrib>Deger, Mutlu</creatorcontrib><creatorcontrib>Satar, Nihat</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Izol, Volkan</au><au>Aridogan, Ibrahim Atilla</au><au>Karsli, Onur</au><au>Deger, Mutlu</au><au>Satar, Nihat</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of prophylactic treatment with Shohl's solution in children with cystinuria</atitle><jtitle>Journal of pediatric urology</jtitle><addtitle>J Pediatr Urol</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>9</volume><issue>6</issue><spage>1218</spage><epage>1222</epage><pages>1218-1222</pages><issn>1477-5131</issn><eissn>1873-4898</eissn><abstract>Abstract Objective To investigate the effect of prophylactic treatment with Shohl's solution on the rates of stone recurrence in paediatric patients with cystinuria. Patients and methods Between June 2007 and October 2011, 185 patients aged 16 years and younger whose stones had been completely removed by percutaneous nephrolithotomy (PCNL) were assessed for metabolic risk factors. Seventeen (9%) patients with positive cyanide-nitroprusside tests (CNT) and cystine stones enrolled in this study, and a Shohl's solution was used for alkalinisation. The patients were followed up for a mean period of two years for stone recurrence. Results Of the patients, 10 (59%) were male, and 7 (41%) were female ( p = 0.13). Twelve patients (70.5%) continued to receive medical prophylaxis regularly, whereas 5 (29.5%) patients did not. The mean pre-treatment and post-treatment urinary pH values were 5.8 ± 0.5 (5–7) and 7.5 ± 0.4 (6.5–8), respectively ( p < 0.001). The pre-treatment and post-treatment specific gravities of the urine were 1021.5 ± 5.4 (1010–1030) and 1006 ± 2.3 (1004–1015), respectively ( p < 0.001). The rates of recurrence were 16.6% among those who continued prophylaxis and 100% among those who did not receive prophylaxis ( p = 0.001). The most common combination of metabolic anomalies was cystinuria and hypocitraturia ( p < 0.001). Conclusions This study demonstrated that detailed clinical and laboratory evaluations should be performed for all children with cystine stone disease, and, appropriate prophylactic treatment should be recommended to prevent the reformation of stones.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>23806278</pmid><doi>10.1016/j.jpurol.2013.05.017</doi><tpages>5</tpages></addata></record>
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subjects	Adolescent Child Child, Preschool Children Citric Acid - therapeutic use Cystinuria Cystinuria - drug therapy Cystinuria - epidemiology Female Follow-Up Studies Humans Hydrogen-Ion Concentration Infant Male Nephrostomy, Percutaneous Pediatrics Potassium Citrate - therapeutic use Recurrence Risk Factors Secondary Prevention Shohl's solution Solutions - therapeutic use Urolithiasis Urolithiasis - drug therapy Urolithiasis - epidemiology Urolithiasis - prevention & control Urology
title	The effect of prophylactic treatment with Shohl's solution in children with cystinuria
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