PT  - JOURNAL ARTICLE
AU  - Sophia Ma
AU  - Amir Taher
AU  - Benjamin Zhu
AU  - Anne Maria Durkan
TI  - Post-renal transplant urolithiasis in children: an increasingly diagnosed complication: a retrospective cohort study
AID  - 10.1136/archdischild-2019-317203
DP  - 2020 Jan 01
TA  - Archives of Disease in Childhood
PG  - 69--73
VI  - 105
IP  - 1
4099  - http://adc.bmj.com/content/105/1/69.short
4100  - http://adc.bmj.com/content/105/1/69.full
SO  - Arch Dis Child2020 Jan 01; 105
AB  - Objective Urolithiasis in renal transplant (RTx) recipients is a potential cause of allograft loss if obstruction is untreated. It is not clear if paediatric transplant recipients are following the global trend for increased prevalence of urolithiasis over time.Design/Setting/Patients A retrospective chart review was undertaken to evaluate the frequency, risk factors and characteristics of post-RTx urolithiasis over two decades (1995–2016), in a tertiary Australian paediatric hospital.Results Stones were diagnosed in 8 of 142 (5.6%) recipients, 6 of whom were transplanted in the latter decade. All patients were male, with a median age 4.9 years and median weight 11.8 kg. Presentation was with haematuria (n=4), pain (n=2), dysuria (n=2), stone passage (n=1) and asymptomatic (n=1). Time to presentation was bimodal; three stones were identified in the initial 3 months post RTx and the remainder after 31–53 months. Two stones were in association with retained suture material and two patients had recurrent urinary tract infections. The average stone size was 8.4 mm. Five stones were analysed; all contained calcium oxalate, three were mixed, including one with uric acid. Five (83.3%) children had hypercalciuria but none had hypercalcaemia. Cystolithotripsy was the the most common treatment (n=5), in combination with citrate supplementation. No graft was lost due to stones.Conclusions Calculi occur with increasing frequency after renal transplantation. Clinicians need a high index of suspicion as symptoms may be atypical in this population. The cause for the increased frequency of stones in transplant recipients is not clear but is in keeping with the increase seen in the general paediatric population.