Dissolution therapy versus shock wave lithotripsy for radiolucent renal stones in children: a prospective study.
PURPOSE
We prospectively evaluated the efficacy of dissolution therapy and standard shock wave lithotripsy as a noninvasive modality for radiolucent renal stones in children.


MATERIALS AND METHODS
A total of 87 children with radiolucent renal calculi were included in study. Median age was 2.5 years (range 0.5 to 13). Computerized tomography was done to confirm a stone density of less than 500 HU. Median stone length was 12 mm (range 7 to 24). Patients were randomly divided into 2 groups. The medical group of 48 patients received potassium sodium hydrogen citrate at a dose of 1 mEq/kg per day for 1 to 3 months. The shock wave lithotripsy group of 39 patients were treated with a Lithotripter S (Dornier Medtech, Kennesaw, Georgia) while under general anesthesia. Complications in each group were recorded. Patients were considered stone free when imaging within 3 months showed no evidence of stones.


RESULTS
The stone-free rate was 72.9% for dissolution therapy vs 82.1% after a single session of shock wave lithotripsy (p = 0.314). One patient per group experienced a pyelonephritis episode during followup (p = 0.698). Three of the 13 patients in whom medical regimens failed were noncompliant and 5 ingested the medication sporadically.


CONCLUSIONS
Medical dissolution therapy is a well tolerated, effective treatment for radiolucent renal stones in children. It eliminates the need for shock wave lithotripsy in up to 73% of cases.
['Elderwy|Ahmad A|AA|', 'Kurkar|Adel|A|', 'Hussein|AlMontaser|A|', 'Abozeid|Hazem|H|', 'Hammodda|Hisham M|HM|', 'Ibraheim|Abdel-Fatah|AF|']
D000293:Adolescent D002648:Child D002675:Child, Preschool D005260:Female D006801:Humans D007223:Infant D007669:Kidney Calculi D008096:Lithotripsy D008297:Male D011446:Prospective Studies D014057:Tomography, X-Ray Computed D016896:Treatment Outcome
lithotripsy kidney nephrolithiasis outcome assessment potassium citrate