Kidney Stones as an Underrecognized Clinical Sign in Pediatric Cushing Disease

J Pediatr. 2016 Mar:170:273-7.e1. doi: 10.1016/j.jpeds.2015.11.045. Epub 2015 Dec 15.

Abstract

Objective: To investigate the prevalence of kidney stones in a population of children with Cushing disease (CD) and to compare it with the prevalence of kidney stones in healthy children.

Study design: Clinical and biochemical data from 139 pediatric patients with CD (68 females, 71 males) were analyzed retrospectively. Computed tomography scans were reviewed for kidney stones.

Results: Among 139 patients, 27 with CD (19.4%) had either radiographic evidence and/or a history of kidney stones. Those with kidney stones had higher urine free cortisol (P = .008) and transsphenoidal surgery at an older age (P = .007). The average urinary calcium/creatinine ratio was elevated in patients with CD (0.22 ± 0.11). The prevalence of kidney stones was higher in children with CD than in normal children (19.42% vs 1.0%; P < .001).

Conclusion: Our results illustrate that kidney stones are an underestimated complication of pediatric CD, especially when compared with the prevalence of nephrolithiasis in the general pediatric population. Long-term consequences for kidney function are not known and need to be studied.

MeSH terms

  • Adolescent
  • Child
  • Female
  • Humans
  • Kidney Calculi / diagnostic imaging
  • Kidney Calculi / epidemiology
  • Kidney Calculi / etiology*
  • Male
  • Pituitary ACTH Hypersecretion / complications
  • Pituitary ACTH Hypersecretion / diagnosis*
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed