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Author Spotlight: Developing a Bedside Protocol for Kidney and Genitourinary Ultrasonography
Published on: June 21, 2024
Clinical, demographic, and laboratory characteristics of children with nephrolithiasis
David J Sas1, Lauren J Becton2, Jeffrey Tutman3
1Division of Pediatric Nephrology and Hypertension, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. sas.david@mayo.edu.
Insights
Pediatric kidney stone (nephrolithiasis) analysis reveals common calcium-based stones and metabolic abnormalities like low urine volume and hypercalciuria. Obesity is unlikely to be a major risk factor in children.
Area of Science:
- Nephrology
- Pediatric Urology
Background:
- The incidence of pediatric kidney stones (nephrolithiasis) is rising.
- Limited understanding exists regarding the characteristics of pediatric stone formers.
Purpose of the Study:
- To describe demographic, clinical, laboratory, and management variables in pediatric nephrolithiasis patients.
- To identify trends and potential risk factors in this population.
Main Methods:
- Retrospective chart review of pediatric patients with imaging-confirmed nephrolithiasis.
- Analysis of 155 patient records, including 54 analyzed calculi.
- Comparison of body mass index (BMI) with a general pediatrics population.
Main Results:
- 98% of analyzed calculi were calcium-based.
- Common metabolic abnormalities included low urine volume, elevated calcium phosphate/oxalate supersaturation, and hypercalciuria.
- Pediatric stone formers did not exhibit higher BMI compared to the general population.
- Adolescent girls were more likely to present with their first stone, suggesting hormonal influences.
Conclusions:
- Calcium-based stones and specific metabolic derangements are prevalent in pediatric nephrolithiasis.
- Obesity is unlikely to be a primary driver of kidney stones in children.
- Hormonal factors may play a role in adolescent girls presenting with kidney stones.
Abstract:
While the incidence of pediatric kidney stones appears to be increasing, little is known about the demographic, clinical, laboratory, imaging, and management variables in this patient population. We sought to describe various characteristics of our stone-forming pediatric population. To that end, we retrospectively reviewed the charts of pediatric patients with nephrolithiasis confirmed by imaging. Data were collected on multiple variables from each patient and analyzed for trends. For body mass index (BMI) controls, data from the general pediatrics population similar to our nephrolithiasis population were used. Data on 155 pediatric nephrolithiasis patients were analyzed. Of the 54 calculi available for analysis, 98 % were calcium based. Low urine volume, elevated supersaturation of calcium phosphate, elevated supersaturation of calcium oxalate, and hypercalciuria were the most commonly identified abnormalities on analysis of 24-h urine collections. Our stone-forming population did not have a higher BMI than our general pediatrics population, making it unlikely that obesity is a risk factor for nephrolithiasis in children. More girls presented with their first stone during adolescence, suggesting a role for reproductive hormones contributing to stone risk, while boys tended to present more commonly at a younger age, though this did not reach statistical significance. These intriguing findings warrant further investigation.
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