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Incidence and causes of urolithiasis in children between 0-2 years
Erkin Serdaroğlu1, Mahfuz Aydoğan1, Kadriye Özdemir2
1Department of Pediatric Nephrology, Dr Behcet Uz Child Disease And Surgery Education And Research Hospital, Izmir, Turkey.
Insights
Infantile urolithiasis presents unique causes and clinical patterns. Renal ultrasonography is crucial for detecting kidney stones in infants with nonspecific symptoms.
Area of Science:
- Pediatric Nephrology
- Urology
- Pediatric Urology
Background:
- Urolithiasis (UL) is a significant concern in pediatric nephrology, with infants under one year comprising a notable percentage of cases.
- Understanding the specific etiological factors, clinical presentations, and short-term outcomes of urolithiasis in early childhood is essential.
Purpose of the Study:
- To investigate the etiologic causes of urolithiasis in children aged 0-2 years.
- To describe the clinical features and presenting symptoms associated with infantile urolithiasis.
- To evaluate the short-term prognosis and recurrence rates of urolithiasis in this age group.
Main Methods:
- A cohort of 200 children aged 0-2 years diagnosed with urolithiasis was evaluated.
- Comprehensive etiological assessments were performed for all participants.
- Patients were followed for at least one year with regular 3-month intervals to monitor outcomes.
Main Results:
- A family history of urolithiasis was reported in 49.5% of patients.
- Common reasons for admission included urinary tract infections (50.5%), incidental findings (20%), and stone passage (10.5%).
- Associated urinary anomalies, particularly vesicoureteral reflux (VUR), were present in 25.5% of cases. New stone formation occurred in 22.5% within the first year.
Conclusions:
- Infantile urolithiasis represents a distinct clinical entity within pediatric urinary stone disease, differing in etiology and clinical course.
- Nonspecific symptoms in infants warrant consideration for renal ultrasonography to diagnose nephrolithiasis.
- Early detection and management are critical for improving outcomes in pediatric urolithiasis.
Background:
Urolithiasis (UL) is a common problem in pediatric nephrology practice. About 9-23% of all pediatric UL cases consist of patients under 1 years old. The aim of the present study was to determine etiologic causes, clinical features and short term prognosis of urolithiasis in the first two years of life.
Methods:
Two-hundred children between 0-2 years of age (mean age 10.3±6.1 months) with urolithiasis were included to the study. All children were completely evaluated for urolithiasis etiology. Patients were followed for at least 1 year with 3-month follow-up intervals.
Results:
The mean follow-up duration was 36.2 months. Family history was positive for urolithiasis in 99 (49.5%) patients. The cause of admission were urinary tract infection and related symptoms in 101 (50.5%), incidentally during imaging for other causes in 40 (20%), stone passage in 21 (10.5%), hematuria in 18 (9%), voiding difficulty in 14 (7%) and antenatal detected urinary anomaly in 6 (3%) patients. Accompanying urinary anomalies (anatomical defects) in 51 (25.5%) patients were detected primarily including vesiculoureteral reflux (VUR) in 32 (62.9%) of them. Development of new stones was determined in 45 (22.5%) patients in the first year, in 15 (22%) patients in the second year and in 8 (36.3%) patients in the third year.
Conclusions:
In result, among pediatric urinary stone diseases, infantile UL appears to be a seperate clinical entity in terms of both the etiological characteristics and the clinical course of the disease. Furthermore, when an infant is presented with nonspecific symptoms for kidney stone, a renal ultrasonography could be performed for detecting nephrolithiasis.
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