Melamine-tainted milk product-associated urinary stones in children.

Abstract

BACKGROUND:

An outbreak of urinary stones related to consumption of melamine-tainted milk products (MTMP) occurred in China in 2008. The aim of the present study was to evaluate such children to identify their clinical features and risk factors.

METHODS:

Renal ultrasound was performed for 7328 children who presented to a Sichuan teaching hospital between 13 September and 15 October 2008 due to concern of such stones. Clinical data, family information, feeding history and urinary stones were analyzed.

RESULTS:

Of the 7328 children, 189 (2.58%) had ultrasound findings of urinary stones, and 51 were admitted. Age (mean ± SD) was 27.4 ± 25.5 months, and 101 were male and 88, female. The odds ratio (OR) for urinary stones for infants and young children (1-3 years) as compared to older children (>3 years), was 2.42 (95% confidence interval [CI], 1.64-3.56; P < 0.0001) and 1.95 (95%CI, 1.31-2.89; P < 0.0011), respectively. Independent risk factors associated with urinary stones included consumption of MTMP with melamine at > 5500 mg/kg (OR, 13.3; 95%CI, 6.8-26.1, P < 0.0001) as compared to that with melamine at < 200 mg/kg, and younger father (P = 0.0006). On logistic regression, the only risk factor associated with inpatient care was lower family income per person (OR, 4.4; 95%CI, 1.2-15.9, P = 0.02). Repeat ultrasound for 51 children at mean follow up of 15.3 ± 8.9 days found that 33 passed out all stones, which was associated with a larger number of smaller stones (P = 0.003). Urinary stones contained melamine and uric acid, but no cyanuric acid.

CONCLUSIONS:

MTMP-associated urinary stones were more frequent in young children and more severe in children from poorer families.

• Authors: Zheng Wang, Hong Luo, Wenwei Tu, Hui Yang, Wilfred Hing-Sang Wong, Wing-Tak Wong, Ka-Fu Yung, Nan Zhou, Jingti Zhang, Xiaoqing Li, Zerong Wang, Wenjun Guo, Dezhi Mu, Fanghong Li, Meng Mao, Yu-Lung Lau
• Journal: Pediatrics international : official journal of the Japan Pediatric Society (Pediatr Int) Vol. 53 Issue 4 Pg. 489-96 (Aug 2011) ISSN: 1442-200X [Electronic] Australia
• PMID: 21040195 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

Chemical References

• Resins, Synthetic
• Triazines
• melamine

Topics

• Animals
• Child, Preschool
• China (epidemiology)
• Female
• Food Contamination
• Humans
• Infant
• Infant Formula (chemistry)
• Logistic Models
• Male
• Milk (chemistry)
• Odds Ratio
• Resins, Synthetic (poisoning)
• Risk Factors
• Triazines (poisoning)
• Ultrasonography
• Urinary Calculi (chemically induced, diagnostic imaging, epidemiology)