Clinical Follow-up Analysis Of Asymptomatic Children With Melamine-associated Nephrolithiasis And Non-melamine-associated Nephrolithiasis

Objects: To evaluate the long-term prognosis of asymptomatic childrenwith melamine-associated nephrolithiasis and non-melamine-associatednephrolithiasis.Methods: Between September2008and November2012,75asymptomatic children with renal stones, including melamine-associatedrenal calculi (MARC, n=37) and non-melamine-associated renal calculi(NMARC, n=38), were enrolled in our study. All the subjects acceptedurinary system ultrasound, urinalysis and urinary microprotein profilesexamination. A prospective cohort study was performed to access theprognosis of children with asymptomatic nephrolithiasis.Results:1During a mean of42months of follow-up, the spontaneous stonedischarge rate in MARC children (73.53%) was obviously higher than thatin NMARC patients (36.84%)(P<0.05).2Stone size was a major influencing factor for the stone discharge.3Urinalysis showed that a small part of patients had persistent hematuria (12.82%), and none of MARC children had proteinuria,proteinuria remission rate in MARC children was higher than those ofNMARC patients.4The presence of proteinuria among children with persistent stoneswas significantly increased compared with children who had passed stones(P<0.05).5For children with normal urinalysis, the detection rate of abnormalurinary microprotein excretion THP and ALB were30%,15%,respectively.Conclusions:1Most asymptomatic children with melamine-associated nephrolithiasiscould pass out spontaneously.2Persistent renal stone is probably an important risk factor of theoccurrence of proteinuria.3Early detection of kidney stones may be a means of reducing theoccurrence of chronic kidney disease (CKD).