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Risk factors for nephrolithiasis in children
Banu Acar1, F Inci Arikan, Serhat Emeksiz
1Department of Pediatrics, Ankara Research and Training Hospital, Ankara, Turkey. banuacar@gmail.com
Insights
Pediatric nephrolithiasis is linked to hypercalciuria and hypocitraturia. Metabolic screening is crucial for children with kidney stones, especially those with a family history of the condition.
Area of Science:
- Pediatric Nephrology
- Urology
- Metabolic Disorders
Background:
- Nephrolithiasis, or kidney stones, can occur in children, necessitating an understanding of its underlying causes and clinical outcomes.
- Identifying risk factors for childhood kidney stones is essential for effective prevention and management strategies.
Purpose of the Study:
- To evaluate the clinical outcomes of children diagnosed with urinary calculi.
- To identify and analyze risk factors associated with nephrolithiasis in the pediatric population.
Main Methods:
- A retrospective analysis of 62 pediatric nephrolithiasis patients (48% girls, 52% boys) treated between January 2002 and August 2006.
- Data collection included patient demographics, clinical presentation, and metabolic screening results.
Main Results:
- Hypercalciuria was identified in 40% of patients, often presenting with abdominal/flank pain (60%), hematuria (28%), or dysuria (12%).
- Hypocitraturia was the second most significant risk factor. Urinary calcium excretion positively correlated with stone size (r=0.482, P=0.043).
- Recurrent urinary tract infections (UTIs) showed a positive correlation with hypercalciuria (r=0.528, P=0.017) and a negative correlation with urinary citrate excretion (r=-0.503, P=0.024). Hyperuricaciduria and hyperoxaluria did not significantly impact stone size or UTI occurrence.
Conclusions:
- Metabolic screening is recommended for all children diagnosed with nephrolithiasis.
- Children with a family history of kidney stones or consanguinity require careful monitoring for metabolic abnormalities.
Objective:
The aim of this study is to evaluate the clinical outcome in children with urinary calculi, to detect risk factors for nephrolithiasis in childhood.
Material And Methods:
This retrospective study comprised 62 pediatric nephrolithiasis patients who have come for routine follow-up visits between the dates of January 2002-August 2006 (48% girls and 52% boys).
Results:
The mean age of the patients was 8.8 +/- 4.5 years (1-16 years). Hypercalciuria was found in 25 (40%) patients. The mean urinary calcium excretion for hypercalciuric patients was 5.7 +/- 1.2 mg/kg (4.8 mg/kg per day). In our hypercalciuric patients 15 (60%) children had abdominal or flank pain, seven (28%) patients macroscopic hematuria and three (12%) dysuria. Hypocitraturia is the second important risk factor for nephrolithiasis. Urinary calcium excretion showed a positive correlation with the stone size (r = 0.482, P = 0.043). A positive correlation was found between recurrent urinary tract infection (UTI) and hypercalciuria (r = 0.528, P = 0.017). Urinary citrate excretion showed a negative correlation with recurrent UTI (r = -0.503, P = 0.024). Hyperuricaciduria, hyperoxaluria were found to have no effect on the stone size and UTI of the patients. Stones were disintegrated with ESWL in two patients, endoscopic interventions were used in one patient and two underwent an open surgical procedure.
Conclusion:
All children with nephrolithiasis should have a metabolic screen. Children with a positive family history and consanguinity should be followed carefully with respect to metabolic abnormalities.
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