Related Experiment Video
Updated: May 24, 2026
Estimation of Urinary Nanocrystals in Humans using Calcium Fluorophore Labeling and Nanoparticle Tracking Analysis
Published on: February 9, 2021
Urine risk factors in children with calcium kidney stones and their siblings
Kristin J Bergsland1, Fredric L Coe, Mark D White
1Nephrology Section, Department of Medicine, University of Chicago, Chicago, Illinois 60637, USA. kbergsland@uchicago.edu
Insights
Pediatric calcium nephrolithiasis is rising, with hypercalciuria identified as the main risk factor. Managing high calcium excretion is crucial for preventing recurrent kidney stones in children.
Area of Science:
- Pediatric Nephrology
- Urology
- Mineral Metabolism
Background:
- Calcium nephrolithiasis in children is increasingly common and often recurrent.
- The etiology of pediatric kidney stones is less understood than in adults, potentially limiting treatment effectiveness.
- Understanding metabolic abnormalities is key to optimizing treatment for pediatric stone formers.
Purpose of the Study:
- To compare urine chemistry and crystallization properties in children with and without a history of calcium stones.
- To identify key risk factors for calcium nephrolithiasis in the pediatric population.
- To differentiate pediatric stone formation mechanisms from those observed in adults.
Main Methods:
- Analysis of 24-hour urine collections from 129 pediatric stone formers, 105 non-stone-forming siblings, and 183 healthy controls (ages 6-17).
- Measurement of urine chemical composition and crystallization properties.
- Comparison of metabolic parameters between stone-forming children and control groups.
Main Results:
- Hypercalciuria was the principal risk factor for calcium stone formation in children.
- Stone formers exhibited significantly higher calcium excretion and increased supersaturation for calcium oxalate and calcium phosphate.
- A reduced gap between the upper limit of metastability and supersaturation for calcium phosphate indicated higher crystallization risk.
- Unlike adults, pediatric stone formers did not show common abnormalities like hyperoxaluria, hypocitraturia, abnormal urine pH, or low urine volume.
Conclusions:
- Hypercalciuria and altered calcium phosphate crystallization dynamics are critical determinants of kidney stone risk in children.
- Effective management of hypercalciuria is essential for addressing calcium nephrolithiasis in pediatric patients.
- Pediatric calcium stone formation appears to have distinct underlying mechanisms compared to adult stone disease.
Abstract:
Calcium nephrolithiasis in children is increasing in prevalence and tends to be recurrent. Although children have a lower incidence of nephrolithiasis than adults, its etiology in children is less well understood; hence, treatments targeted for adults may not be optimal in children. To better understand metabolic abnormalities in stone-forming children, we compared chemical measurements and the crystallization properties of 24-h urine collections from 129 stone formers matched to 105 non-stone-forming siblings and 183 normal, healthy children with no family history of stones, all aged 6 to 17 years. The principal risk factor for calcium stone formation was hypercalciuria. Stone formers have strikingly higher calcium excretion along with high supersaturation for calcium oxalate and calcium phosphate, and a reduced distance between the upper limit of metastability and supersaturation for calcium phosphate, indicating increased risk of calcium phosphate crystallization. Other differences in urine chemistry that exist between adult stone formers and normal individuals such as hyperoxaluria, hypocitraturia, abnormal urine pH, and low urine volume were not found in these children. Hence, hypercalciuria and a reduction in the gap between calcium phosphate upper limit of metastability and supersaturation are crucial determinants of stone risk. This highlights the importance of managing hypercalciuria in children with calcium stones.
Related Concept Videos
01:28Urinary Tract Calculi I: Introduction
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
01:30Urinary Tract Calculi III: Medical Management
01:28Urinary Tract Calculi V: Nursing Management
01:20Disorders of the Urinary System
Urinary tract infections (UTIs) are one of the most common urinary system disorders. They are caused by bacteria that enter the urethra and can spread to the bladder resulting in cystitis. Pyelonephritis is the result of a UTI that has ascended to the level of the...