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Pediatric urolithiasis
Jessica A Mandeville1, Caleb P Nelson
1Children's Hospital Boston, Boston, Massachusetts 02468, USA.
Insights
Pediatric urolithiasis, or kidney stones in children, is increasing. New diagnostic tools and surgical techniques like robotic-assisted laparoscopy are improving care for these complex cases.
Area of Science:
- Pediatric Nephrology
- Urology
- Medical Research
Background:
- Pediatric urolithiasis incidence data are limited, yet reports suggest a rising trend in childhood kidney stones.
- Environmental factors, such as contaminated infant formula, have been linked to pediatric urolithiasis.
- Establishing normal metabolic parameters in children remains challenging due to demographic variations.
Purpose of the Study:
- To review recent literature on pediatric urolithiasis.
- To present updated findings on epidemiology, diagnosis, and management.
- To highlight emerging trends and challenges in the field.
Main Methods:
- Literature review of recent studies on pediatric urolithiasis.
- Analysis of epidemiological data and diagnostic advancements.
- Evaluation of current medical and surgical treatment strategies.
Main Results:
- Anecdotal evidence and single-center reports indicate an increase in pediatric kidney stone cases.
- The Bonn Risk Index shows promise for assessing urolithiasis risk in children.
- Recurrent urolithiasis in children is often associated with metabolic abnormalities.
- Robotic-assisted laparoscopy represents a significant advancement in surgical management.
- Deflux implants can mimic ureteral stones on CT scans, requiring clinical awareness.
Conclusions:
- Pediatric urolithiasis is a growing concern in pediatric urology.
- Ongoing research aims to refine diagnostic and therapeutic approaches for children with kidney stones.
Purpose Of Review:
We review the recent literature on pediatric urolithiasis and present up-to-date findings on epidemiology, diagnosis, and medical and surgical management.
Recent Findings:
There are surprisingly few reliable data on pediatric urolithiasis incidence, but widespread anecdotal and single-center reports suggest that more children with stones are being seen. The contamination of Chinese infant formula with melamine caused urolithiasis and other renal problems in hundreds of thousands of infants in the region, underlining the role of environmental factors in urolithiasis. Efforts continue to determine normal metabolic parameters in children, but have been hampered by variations among regions, races, and ethnicities. The Bonn Risk Index may prove to be a useful tool for assessing risk of urolithiasis in children. Children with recurrent urolithiasis are more likely to have detectable metabolic abnormalities. Surgical approaches to urolithiasis in children continue to evolve, with robotic-assisted laparoscopy being perhaps the most significant new technique. Finally, clinicians and radiologists must be aware of the potential for dextranomer/hyaluronic acid (Deflux) implants to mimic distal ureteral stones on computed tomography (CT) scan.
Summary:
Pediatric urolithiasis is an expanding field, due in part to the apparent increase in cases. Research continues, seeking to refine the appropriate diagnostic and therapeutic approaches in these unfortunate children.
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