Two recent studies published in the journal JAMA Network Open provide important insights about the clinical effectiveness of surgical interventions for children and adolescents with kidney or ureteral stones. The findings are based on the largest comparative effectiveness trial done in youth with kidney stones; Ann & Robert H. Lurie Children’s Hospital of Chicago played a critical part in this multi-center study.
Key Points
- Children are increasingly presenting with kidney stones, which become a life-long problem.
- Surgeries to treat kidney stones include shockwave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy.
- The Pediatric Kidney Stone Care Improvement Network was created with support from the Patient-Centered Outcomes Research Institute to compare the three surgical options for children 8–21 years old with kidney stones.
- The results of the first study showed that for small stones, shockwave lithotripsy had similar stone clearance compared to ureteroscopy, but shockwave lithotripsy was associated with better lived experiences in patients after surgery and during recovery.
- The results of the second study showed that for larger stones, percutaneous nephrolithotomy had better stone clearance and better lived experiences in patients after surgery and during recovery compared to ureteroscopy.
Next Steps
Both studies demonstrated an association between treatment and patient-reported outcomes. Future research in this area will focus on specific nuances with each surgical technique that improve outcomes, according to one of the study authors David Chu, MD, MSCE, Attending Pediatric Urologist at Lurie Children’s and Associate Professor of Urology at Northwestern University Feinberg School of Medicine.
Pediatric research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute.
