title: Dissolution therapy versus shock wave lithotripsy for radiolucent renal stones in children: a prospective study.
abstract: OBJECTIVE
  We prospectively evaluated the efficacy of dissolution therapy and standard shock wave lithotripsy as a noninvasive modality for radiolucent renal stones in children.
  
  
  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.
authors.affiliation: Pediatric Urology Department, Assiut University Hospital, Assiut University, Assiut, Egypt.
authors.forename: Ahmad A
authors.initials: AA
authors.lastname: Elderwy
authors.affiliation: Pediatric Urology Department, Assiut University Hospital, Assiut University, Assiut, Egypt.
authors.forename: Adel
authors.initials: A
authors.lastname: Kurkar
authors.affiliation: Pediatric Nephrology Department, Assiut University Hospital, Assiut University, Assiut, Egypt.
authors.forename: AlMontaser
authors.initials: A
authors.lastname: Hussein
authors.affiliation: Radiology Department, Assiut University Hospital, Assiut University, Assiut, Egypt.
authors.forename: Hazem
authors.initials: H
authors.lastname: Abozeid
authors.affiliation: Pediatric Urology Department, Assiut University Hospital, Assiut University, Assiut, Egypt.
authors.forename: Hisham M
authors.initials: HM
authors.lastname: Hammodda
authors.affiliation: Pediatric Urology Department, Assiut University Hospital, Assiut University, Assiut, Egypt.
authors.forename: Abdel-Fatah
authors.initials: AF
authors.lastname: Ibraheim
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D008096:Lithotripsy; D008297:Male; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: kidney; lithotripsy; nephrolithiasis; outcome assessment; potassium citrate