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Pediatric KIDney Stone (PKIDS) Care Improvement Network

Completed
Conditions
Kidney Stone
Nephrolithiasis
Interventions
Procedure: Percutaneous Nephrolithotomy
Procedure: Ureteroscopy
Procedure: Shock Wave Lithotripsy
Registration Number
NCT04285658
Lead Sponsor
Children's Hospital of Philadelphia
Brief Summary

The goals of this study are to improve the ability of pediatric patients and their caregivers to select surgical treatment options for kidney stones and to enable urologists to use techniques that result in the best outcomes for these surgeries.

Detailed Description

The rapid increase in the incidence of kidney stones among youth has resulted in a large population of patients who require surgery to removes stones but for whom little evidence exists to guide clinical care. Proper selection of surgical treatment options, which is directed by patient-specific factors and individual treatment goals, is the greatest determinant of successful outcomes.

This is a prospective cohort study. Investigators seek to compare stone clearance, re-treatment, and unplanned healthcare encounters for ureteroscopy, shockwave lithotripsy, and percutaneous nephrolithotomy.

Additionally, Investigators also seek to compare patients' experiences after ureteroscopy, shockwave lithotripsy, and percutaneous nephrolithotomy.

Setting/Participants:

This study will be conducted by the Pediatric KIDney Stone (PKIDS) Care Improvement Network, which includes 23 pediatric healthcare systems (25 sites) in the United States.

Patient participants include patients aged 8 to 21 years who undergo a surgical intervention for kidney stones as part of their clinical care. The surgical interventions include ureteroscopy, shockwave lithotripsy, and percutaneous nephrolithotomy, all of which would be performed as part of routine clinical care.

Study Interventions and Measures:

Stone clearance will be assessed with ultrasound (obtained as part of clinical care) 6 weeks after surgery, which is the standard of care at all PKIDS sites. Re-treatment and unplanned healthcare encounters will be assessed within the first 3 months after surgery. Patients' experiences will be measured through questionnaires administered pre-operatively and within 3 months after surgery.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1290
Inclusion Criteria
  1. Males or females, 8-21 years of age, undergoing planned URS, SWL, or PCNL for the removal of at least one kidney and/or ureteral stone.
  2. Parental/guardian or participant (if ≥ 18 years old) permission (informed consent), and if appropriate, child assent

2a. Individuals who are not able to provide consent/assent (whether ≥18 or < 18 years) and/or not willing or able to complete questionnaires are eligible for participation for the stone clearance assessment and Electronic Health Record (EHR) surveillance if the legal guardian consents for study participation.

2b. Individuals for whom native-language questionnaires are not available can also participate in stone clearance assessment and EHR surveillance.

Exclusion Criteria
  1. Patients for whom conducting informed consent and baseline study procedures would confer additional risk (e.g. obstructing ureteral stone with fever requiring emergency surgery) and delay necessary immediate clinical care.
  2. Parent/guardians or patients, who, in the opinion of the Investigator, may be non-compliant with study schedules or procedures

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Percutaneous NephrolithotomyPercutaneous Nephrolithotomy-
UreteroscopyUreteroscopy-
Shock Wave LithotripsyShock Wave Lithotripsy-
Primary Outcome Measures
NameTimeMethod
Stone clearance6 weeks post-op +/- 2 weeks

Presence or absence of kidney stones will be assessed via post-operative clinically-indicated renal bladder ultrasound.

Secondary Outcome Measures
NameTimeMethod
Patient-Reported OutcomesImmediate impact (within 7 days) and delayed impact (up to 90 days) after surgery

Patients' experiences before and after URS, SWL, and PCNL will be measured. Investigators will assess the immediate and delayed impact of surgery on patient-reported outcomes (PROs) selected by PKIDS patient partners. The patient reported outcomes (PROs) include the Patient-Reported Outcomes Measurement Information System (PROMIS), other questionnaires commonly used in studying the impact of kidney stone disease on health states, and urinary tract symptoms.

Patients' ExperiencesUp to 90 days after surgery

Investigators will also determine unplanned hospitalizations, emergency department (ED) visits, and repeat surgeries for the 3 months following each procedure to examine impact on patients' experiences.

Trial Locations

Locations (31)

UCLA Mattel Children's Hospital

🇺🇸

Los Angeles, California, United States

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

Nationwide Children's Hospital

🇺🇸

Columbus, Ohio, United States

Children's Medical Center of Dallas

🇺🇸

Dallas, Texas, United States

Seattle Children's Hospital

🇺🇸

Seattle, Washington, United States

Nemours A. I. duPont Hospital for Children

🇺🇸

Wilmington, Delaware, United States

Children's National Health System

🇺🇸

Washington, District of Columbia, United States

St. Louis Children's Hospital

🇺🇸

Saint Louis, Missouri, United States

Children's Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Primary Children's Hospital

🇺🇸

Salt Lake City, Utah, United States

Texas Children's Hospital

🇺🇸

Houston, Texas, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Children's Hospital of Richmond at VCU

🇺🇸

Richmond, Virginia, United States

Monroe Carell Jr. Children's Hospital at Vanderbilt

🇺🇸

Nashville, Tennessee, United States

The Hospital for Sick Children

🇨🇦

Toronto, Ontario, Canada

Riley Hospital for Children

🇺🇸

Indianapolis, Indiana, United States

University of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, United States

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

University of Kentucky

🇺🇸

Lexington, Kentucky, United States

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

Children's of Alabama

🇺🇸

Birmingham, Alabama, United States

Children's Hospital Los Angeles

🇺🇸

Los Angeles, California, United States

Children's Hospital Colorado

🇺🇸

Aurora, Colorado, United States

University of Florida Health Shands Children's Hospital

🇺🇸

Gainesville, Florida, United States

Nemours Children's Specialty Care

🇺🇸

Jacksonville, Florida, United States

AdventHealth Orlando

🇺🇸

Orlando, Florida, United States

Nemours Children's Hospital

🇺🇸

Orlando, Florida, United States

Cohen Children's Medical Center

🇺🇸

New York, New York, United States

Ann & Robert H. Lurie Children's Hospital of Chicago

🇺🇸

Chicago, Illinois, United States

Children's Hospital of Atlanta

🇺🇸

Atlanta, Georgia, United States

Children's Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

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