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Clinical course of pediatric urolithiasis: follow-up data in a long-term basis
Hakan Koyuncu1, Faruk Yencilek, Sakip Erturhan
1Department of Urology, Yeditepe University Medical School, Devlet yolu Ankara Cad. 102/104, 34752, Kozyataği, Istanbul, Turkey. hakan.koyuncu@yeditepe.edu.tr
Insights
Pediatric urinary stone disease recurs frequently, especially in younger children and those with metabolic abnormalities. Close follow-up and metabolic evaluation are crucial for managing recurrent kidney stones in children.
Area of Science:
- Pediatric Nephrology
- Urology
- Metabolic Disorders
Background:
- Urinary stone disease is a significant health concern in children.
- Understanding the natural history of pediatric urolithiasis is essential for effective management.
Purpose of the Study:
- To evaluate the spontaneous passage and recurrence rates of urinary stones in pediatric patients.
- To analyze stone recurrence based on age groups and the presence of metabolic abnormalities.
Main Methods:
- A cohort of 142 children with primary urinary stone disease was followed.
- Patients were divided into two age groups (0-5 years and 6-15 years).
- Follow-up included assessment of spontaneous stone passage, recurrence, and regrowth rates.
Main Results:
- Stone recurrence was observed in 44% of children aged 0-5 years and 31% in those aged 6-15 years.
- Children with identifiable metabolic abnormalities had significantly higher recurrence rates (nearly 50%) compared to those without (14%).
- Metabolic abnormalities were associated with increased stone recurrence despite conservative management.
Conclusions:
- High recurrence and regrowth rates necessitate close monitoring of pediatric patients with urinary stones.
- Identifying and managing metabolic risk factors is fundamental for preventing recurrent stone events and calculus growth in children.
Objective:
To evaluate the natural course of the stone disease in pediatric patients from different perspectives among which the spontaneous passage and stone recurrence rates evaluated during the follow-up.
Materials And Methods:
A total of 142 children referring with primary urinary stone disease were evaluated and followed. All children in the study were divided into two groups with respect to the age (Group 1: 0-5 years and Group 2: 6-15 years). Children were followed with respect to spontaneous passage rates, recurrence-regrowth rates, physical as well as the renal growth rates.
Results:
Stone recurrence has been noted in 44% of patients in group 1, this value was 31% in group 2. Children with at least one identifiable metabolic abnormality tended to have higher recurrence rates than the others despite conservative measures. The average stone recurrence rate in children without any metabolic abnormality was 14% and nearly 50% in children with an identifiable metabolic abnormality.
Conclusions:
We may emphasize that due to the high recurrence and re-growth rates, all children with urinary stone disease should be followed closely with regular visits. The evaluation of metabolic risk factors in children with renal stone disease is the basis of medical treatment aimed at preventing recurrent stone events and the growth of pre-existing calculi.
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