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.

Urolithiasis
|October 16, 2015
PubMed

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.

Related Concept Videos

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
689
Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
325
Urinary Tract Calculi I: Introduction01:28

Urinary Tract Calculi I: Introduction

Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
863
Urinary Tract Calculi IV: Nutrition Therapy and Prevention01:27

Urinary Tract Calculi IV: Nutrition Therapy and Prevention

Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
643
Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
422
Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
827