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Metabolic factors associated with urinary calculi in children
Mitra Naseri1, Abdol Reza Varasteh, Seied Ali Alamdaran
1Department of Pediatrics, Dr Sheikh Children Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. naserim@mums.ac.ir
Insights
Metabolic abnormalities are common in children with urinary calculi, with calcium and uric acid issues being most frequent. Anatomical issues like vesicoureteral reflux also contribute to stone formation.
Area of Science:
- Pediatric Nephrology
- Urology
- Metabolic Disorders
Background:
- Urinary calculi (kidney stones) in children present diagnostic challenges.
- Identifying underlying metabolic and anatomical causes is crucial for effective management.
Purpose of the Study:
- To investigate the prevalence of metabolic and anatomical abnormalities in pediatric patients diagnosed with urinary calculi.
- To determine the most common metabolic and urological factors contributing to stone formation in this age group.
Main Methods:
- A cohort of 142 pediatric calculus formers underwent comprehensive metabolic evaluation.
- Evaluations included serum biochemistry and detailed urinary analysis for calcium, uric acid, oxalate, citrate, and magnesium.
- Renal ultrasonography was performed to assess for anatomical abnormalities.
Main Results:
- Metabolic abnormalities were identified in 42.7% of patients, with hypercalciuria (17.6%) and hyperuricosuria (16.1%) being most prevalent.
- Anatomical abnormalities were present in 8.4% of cases, with vesicoureteral reflux noted as a significant factor.
- Idiopathic stone formation accounted for 46.2% of cases, while infectious calculi were found in 2.1%.
Conclusions:
- Metabolic abnormalities are a frequent finding in children with urinary calculi.
- Abnormalities in calcium and uric acid metabolism are particularly common.
- Urological abnormalities, such as vesicoureteral reflux leading to urinary stasis, play a role in pediatric stone formation.
Introduction:
We aimed to identify metabolic and anatomical abnormalities present in children with urinary calculi.
Materials And Methods:
Metabolic evaluation was done in 142 pediatric calculus formers. Evaluation included serum biochemistry; measurement of daily excretion of urinary calcium, uric acid, oxalate, citrate, and magnesium (in older children); and measurement of calcium, uric acid, oxalate, and creatinine in random urine samples in nontoilet-trained patients. Urinary tests for cystinuria were also performed. All of the patients underwent renal ultrasonography.
Results:
Sixty-one patients (42.7%) had metabolic abnormalities. Anatomical abnormalities were found in 12 patients (8.4%). Three children (2.1%) had infectious calculi, and 3(2.1%) had a combination of metabolic and anatomic abnormalities. In 66 children (46.2 %) we did not find any reasons for calculus formation (idiopathic). Urinalysis revealed hypercalciuria in 25 (17.6%), hyperuricosuria in 23 (16.1%), hyperoxaluria in 17 (11.9%), cystinuria in 9 (6.3%), hypocitraturia in 3 (2.1%), and low urinary magnesium level in 1 (0.7%) patients. Sixteen patients (11.2%) had mixed metabolic abnormalities.
Conclusions:
Metabolic abnormalities are common in pediatric patients with urinary calculi. In our study, calcium and uric acid abnormalities were the most common, and vesicoureteral reflux seemed to be the most common urological abnormality which led to urinary stasis and calculus formation.
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