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[Evaluation of treatment and preventive care for recurrent urolithiasis in children]
B Gołabek1, M Słowik, M Grabowska
1Klinika Pediatrii IMD, Instytut Matki i Dziecka w Warszawie.
Insights
Recurrent urolithiasis in children is often linked to metabolic causes like idiopathic hypercalciuria. Etiology-specific prevention strategies significantly reduce recurrence rates in pediatric kidney stones.
Area of Science:
- Pediatric Nephrology
- Urology
- Metabolic Disorders
Context:
- Urolithiasis affects children, with recurrent cases posing significant challenges.
- A retrospective study analyzed 425 children treated for urolithiasis between 1976-1997.
- Recurrent urolithiasis was identified in 11.7% of the pediatric cohort.
Purpose:
- To investigate the etiology and recurrence patterns of urolithiasis in children.
- To evaluate the effectiveness of etiology-specific prevention strategies for recurrent kidney stones.
- To identify common metabolic and non-metabolic causes of pediatric urolithiasis.
Summary:
- Metabolic causes accounted for 68% of recurrent urolithiasis cases.
- Idiopathic hypercalciuria was the most frequent metabolic cause (24 cases).
- Other identified etiologies included infection, idiopathic urolithiasis, and renal spongiosis.
- Prevention strategies were successful in 45 out of 50 recurrent cases, with recurrences noted in cystinuria and incomplete renal tubular acidosis.
Impact:
- Highlights the critical role of identifying underlying etiology in managing pediatric urolithiasis.
- Demonstrates the efficacy of tailored preventive measures in reducing stone recurrence.
- Provides long-term outcome data for recurrent pediatric kidney stone disease.
Abstract:
Among 425 children with urolithiasis treated in the Paediatric Clinical Department of the National Research Institute of Mother and Child in Warsaw between 1976-1997, 50 of them i.e. 11.7% (26 boys and 24 girls) had recurrent urolithiasis. Patients' age was from 10 months to 16 years and 5 months. The number of recurrences of uroliothiasis before treatment in the Institute was from 1 to 8. Most of the children had numerous surgical operations, some of them excreted stones spontaneously. The etiology was determined in all cases. A metabolic cause of urolithiasis was found in 34 cases, i.e. 68% of the analysed group. They were as follows: idiopathic hypercalcuria--24 cases, uric acid urolithiasis--5 cases, cystynuria--4 cases, and incomplete distal renal tubular acidosis--1 case. Other reasons for urolithiasis were: infection--7 cases, idiopathic urolithiasis--8 cases, ren spongiosum--1 case. Prevention of recurrences depending on the etiology was successful. In 45 cases no recurrences were found. Recurrent urolithiasis was observed in 4 cases of cystynuria and in one case of incomplete tubular acidosis. The observation period was from 3-19 years.
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