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An association between kidney stone composition and urinary metabolic disturbances in children

Jan K Kirejczyk1, Tadeusz Porowski2, Renata Filonowicz2

  • 1Department of Pediatric Surgery, Medical University of Bialystok, Poland.

Journal of Pediatric Urology
|August 20, 2013
PubMed

Insights

Pediatric kidney stones are primarily calcium oxalate. High urinary calcium, oxalate, magnesium, and low urine pH significantly influence calcium oxalate stone formation in children.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Biochemistry

Background:

  • Kidney stones (renal lithiasis) are a growing concern in pediatric populations.
  • Understanding the composition of pediatric kidney stones is crucial for effective treatment and prevention strategies.
  • Metabolic urinary risk factors are implicated in stone formation, but their specific roles in children require further elucidation.

Purpose of the Study:

  • To determine the composition of kidney stones in pediatric patients.
  • To investigate the correlation between specific stone components and urinary pH and metabolic risk factors.

Main Methods:

  • Analysis of excreted or extracted kidney stones from 135 pediatric patients.
  • Comprehensive 24-hour urine assessment including volume, pH, and excretion levels of calcium, oxalate, uric acid, cystine, phosphate, magnesium, and citrate.
  • Correlation analysis between stone composition and urinary metabolic parameters.

Main Results:

  • Calcium oxalate was the predominant stone component (73%), followed by struvite (13%) and calcium phosphate (9%).
  • Higher calciuria, oxaluria, magnesuria, and lower urine pH were strongly associated with increased calcium oxalate content in stones.
  • Struvite and calcium phosphate stone compositions showed weaker and often inverse correlations with the studied urinary risk factors.

Conclusions:

  • Urinary calcium, oxalate, magnesium levels, and low urine pH are key determinants of calcium oxalate pediatric kidney stones.
  • The influence of urinary risk factors on calcium phosphate stone formation in children remains unclear.
  • Urinary citrate excretion did not demonstrate a significant correlation with kidney stone composition in this pediatric cohort.
Abstract

Keywords:
ChildrenMetabolic examinationStone compositionUrolithiasis

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