title: Evaluation of ureteral jet dynamics in pediatric kidney stone formers: A cross-sectional study.
abstract: BACKGROUND
  The risk of kidney stone formation increases with urinary stasis, which is associated with decreased peristaltism. The relationship between nonobstructive kidney stone formation and ureteral jet dynamics, which can be measured with Doppler ultrasonography (US) and provide information about ureteral peristaltism, has been demonstrated in adults.
  
  
  OBJECTIVE
  To investigate the relationship between ureteral jet dynamics, which provide information about ureteral peristaltism, and stone formation in children.
  
  
  METHODS
  Children admitted to Dokuz Eylul University Hospital with flank pain, and asymptomatic age-matched children for the control group, were prospectively enrolled and underwent Doppler US for diagnostic reasons and bilateral ureteral jet flow measurements. Children diagnosed with unilateral nonobstructive lower pole kidney stones formed Group 1, and the control group, without any evidence of stone disease, formed Group 2. Ureteral jet dynamics were compared between the affected renal units in Group 1, and healthy renal units in Group 1 and Group 2.
  
  
  RESULTS
  A total of 32 children were included for each group. The mean average jet flow-rate (JETave (cm/second)) in affected renal units in Group 1 was found to be significantly lower than in the healthy renal units in Group 1 and left and right healthy renal units in Group 2 (P < 0.05). The continuous JETpattern rate in affected renal units in Group 1 was found to be significantly higher compared with healthy renal units in Groups 1 and 2 (P = 0.012) (Table). The odds ratio for kidney stone formation was 5.6 for renal units with JETave <9.5 cm/s when compared with renal units with JETave ≥9.5 cm/s.
  
  
  CONCLUSIONS
  In a recent study, it was demonstrated in adults that low ureteral jet flow-rate and continuous JETpattern were significantly higher in affected renal units. The findings in children were also similar to adults: the mean JETave was significantly lower and determination rate of continuous flow pattern was significantly higher in affected renal units.
  
  
  CONCLUSIONS
  Children with low JETave and continuous JETpattern as a sign of decreased ureteral peristaltism are at an increased risk of kidney stone formation. However, it is vital that further studies are conducted to elaborate on this topic.
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Urology, Izmir, Turkey. Electronic address: serdarcelik84@hotmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Celik
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Urology, Izmir, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Bozkurt
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Radiology, Izmir, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Altay
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Pediatrics, Izmir, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Celebi Celik
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Radiology, Izmir, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Uz
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Pediatric Nephrology, Izmir, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Soylu
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Urology, Izmir, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Kefi
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Pediatric Nephrology, Izmir, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Kavukcu
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Radiology, Izmir, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Secil
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Urology, Izmir, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Demir
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D018608:Ultrasonography, Doppler; D014513:Ureter / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014563:Urodynamics
keywords: Children; Kidney stone; Stone formation; Ureteral jet dynamics; Ureteral peristaltism