Risk factors for formation of steinstrasse after extracorporeal shock wave lithotripsy for pediatric renal calculi: a multivariate analysis model
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- 作者：Ahmed El-Assmy ; Ahmed R. El-Nahas…
- 关键词：Shock wave lithotripsy ; Steinstrasse ; Renal calculi ; Pediatric ; Risk factors
- 刊名：International Urology and Nephrology
- 出版年：2015
- 出版时间：April 2015
- 年：2015
- 卷：47
- 期：4
- 页码：573-577
- 全文大小：171 KB
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- 刊物主题：Medicine & Public Health
Nephrology
Urology and Andrology - 出版者：Springer Netherlands
- ISSN：1573-2584
文摘
Objectives To define various stone, renal and therapy factors that could affect steinstrasse (SS) formation after extracorporeal shock wave lithotripsy (SWL) for pediatric kidney stones. Thus, SS could be anticipated and prophylactically avoided Methods From January 1999 through December 2012, 317 children underwent SWL with Dornier Lithotripter S for the treatment of renal stones. Univariate and multivariate statistical analyses of patients, stones and therapy characteristics in relation to the incidence of SS were performed to detect the factors that had a significant impact on SS formation. Results The overall incidence of SS was 8.5?%. The steinstrasse was in the pelvic ureter in 74.1?% of the cases, lumbar ureter in 18.5?% and iliac ureter in 7.4?%. Steinstrasse incidence significantly correlated with stone size, site and age of child. Steinstrasse was more common with increasing stone length and stones located in renal pelvis or upper calyx with the age below 4?years. A statistical model was constructed to estimate the risk of steinstrasse formation accurately. The equation for logistic regression is Z?=??.758?+?B for age?+?B for size stone X length in mm?+?B for stone site. Conclusions The stone size, site and age are the most important risk factors responsible for SS formation in children. Our regression analysis model can help with prospective identification of children who will be at risk of SS formation. Those children at high risk of SS formation should be closely monitored or treated by endoscopic maneuvers from the start.