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Predisposing factors for infantile urinary calculus in south-west of Iran
Mohammad Hasan Alemzadeh-Ansari, Ehsan Valavi1, Ali Ahmadzadeh
1Department of Pediatric Nephrology, Abuzar Children's Hospital, Jundishapour University of Medical Sciences, Ahvaz, Iran. dr_ehsan_valavi@yahoo.com.
Insights
Infant kidney stones are increasingly common. Most infants with kidney stones have underlying metabolic issues like hypercalciuria and hypocitraturia, requiring metabolic evaluation for diagnosis and treatment.
Area of Science:
- Pediatric Nephrology
- Urology
- Metabolic Disorders
Background:
- Infant urinary calculi incidence is rising.
- Kidney stones in infants are uncommon but increasing.
- Study investigates clinical presentation, metabolic factors, and urinary tract abnormalities in infants with kidney stones.
Purpose of the Study:
- To investigate clinical presentation of kidney stones in infants.
- To identify metabolic risk factors associated with infant kidney stones.
- To evaluate urinary tract abnormalities in infants with kidney calculus.
Main Methods:
- Analyzed 152 infants with ultrasonography-proven urolithiasis (2009-2012).
- Collected 24-hour urine samples for calcium, citrate, oxalate, uric acid, and magnesium analysis.
- Assessed urinary tract structural abnormalities and performed nitroprusside test for cystinuria.
Main Results:
- Mean age at diagnosis was 5.46 months.
- Common findings included restlessness and urinary tract infections.
- Metabolic abnormalities (96.1%) and urinary tract abnormalities (15.1%) were prevalent.
- Hypercalciuria (79.6%) and hypocitraturia (40.9%) were the most common metabolic risks.
- Hyperoxaluria and hypomagnesuria (approx. 28%) associated with bilateral urolithiasis.
Conclusions:
- Urinary metabolic abnormalities are highly prevalent in infants with urolithiasis.
- Metabolic evaluation is crucial for accurate diagnosis and effective treatment of infant kidney stones.
Introduction:
Urinary calculi in infants are relatively infrequent, but their incidence has increased in the recent decades. The aim of this study was to investigate the clinical presentation, metabolic risk factors, and urinary tract abnormalities in infants suffering from kidney calculus.
Materials And Methods:
A total of 152 infants were admitted between 2009 and 2012 with ultrasonography-proven urolithiasis. A Foley catheter was fixed and 24-hour urine samples were analyzed for calcium, citrate, oxalate, uric acid, and magnesium. For detecting cystinuria, qualitative measurement of urinary cystine was done by nitroprusside test. Urinary tract structural abnormalities were also evaluated.
Results:
The mean age at the diagnosis of kidney calculus was 5.46 months (range, 15 days to 12 months). The most common clinical findings were restlessness and urinary tract infection. A family history of calculi was found in 67.1% of the patients and 68.4% were born to consanguineous marriages. Metabolic abnormalities and urinary tract abnormalities were found in 96.1% and 15.1% of children, respectively. Urinary tract abnormalities were more common in girls. The most common metabolic risk factors were hypercalciuria (79.6%) and hypocitraturia (40.9%). Hyperoxaluria and hypomagnesuria were found in about 28% of patients, both of which were associated with bilateral urolithiasis.
Conclusions:
These findings show that urinary metabolic abnormalities are very common in infants with urolithiasis. Appropriate evaluation of urinary metabolic parameters can lead us to proper diagnosis and treatment.
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