title: Ureteropelvic junction obstruction with concurrent renal pelvic calculi in the pediatric patient: a long-term followup.
abstract: OBJECTIVE
  We determined the long-term prognosis of the pediatric patient presenting with simultaneous ureteropelvic junction obstruction and a renal calculus.
  
  
  METHODS
  We retrospectively reviewed all individuals younger than 17 years who presented to our institutions with simultaneous ureteropelvic junction obstruction and an ipsilateral renal calculus.
  
  
  RESULTS
  Simultaneous ureteropelvic junction obstruction with nonstruvite calculi was present in 22 patients, while 6 had struvite calculi. Median age at diagnosis was 11 years (range 5 to 16). During a median followup of 9 years (range 2 to 38) renal calculi recurred in 19 patients (68%), including 10 (36%) with 1 and 9 (32%) with 2 or more recurrences. Median time to first stone recurrence was 11 years (range 2 to 38). Of the 22 patients with nonstruvite calculi 15 (68%) had recurrence. An identifiable metabolic etiology for renal lithiasis was found in 13 of these patients (87%). In contrast, only 2 of the 7 patients (29%) with nonstruvite calculi and no recurrent stones had an identifiable abnormality. This finding suggests that the presence of an identifiable metabolic abnormality significantly predisposes to recurrent nonstruvite renal lithiasis (p < 0.01).
  
  
  CONCLUSIONS
  Of the pediatric patients presenting with simultaneous ureteropelvic junction obstruction and a renal calculus 68% will have recurrent renal lithiasis. It remains to be determined whether active treatment of coexisting metabolic abnormalities could prevent or reduce the incidence of recurrent stone disease.
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Husmann
authors.forename: D S
authors.initials: DS
authors.lastname: Milliner
authors.forename: J W
authors.initials: JW
authors.lastname: Segura
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000737:chemistry / Q000150:complications*; D007682:Kidney Pelvis; D017616:Magnesium Compounds; D010710:Phosphates; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D000069877:Struvite; D013997:Time Factors; D014517:Ureteral Obstruction / Q000150:complications*
chemical_list: D017616:Magnesium Compounds; D010710:Phosphates; D000069877:Struvite