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Risk factors evaluation for urolithiasis among children.

Francisco Velásquez-Forero1, Mariela Esparza1, Alejandro Salas2

  • 1Laboratorio de Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.

Boletin Medico Del Hospital Infantil De Mexico
|February 9, 2018
PubMed
Summary

Pediatric urolithiasis is linked to multiple risk factors, primarily low citrate and magnesium levels in urine. Many children with kidney stones have more than one contributing factor.

Keywords:
Acidosis metabólica sistémicaFactores de riesgo para urolitiasisHipercalciuriaHipocitraturiaHipomagnesuriaHypercalciuriaHypocitraturiaHypomagnesuriaPediatric urolithiasisSystemic metabolic acidosisUrolithiasis risk factorsUrolitiasis pediátrica

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Area of Science:

  • Pediatric Nephrology
  • Urology
  • Metabolic Disorders

Background:

  • Pediatric urolithiasis affects 0.01-0.03% of children, with recurrence rates from 16-67%.
  • Risk factors include anatomical, metabolic, and environmental influences, often associated with metabolic abnormalities.
  • Identifying these factors is crucial for managing and preventing pediatric kidney stones.

Purpose of the Study:

  • To identify specific risk factors contributing to urolithiasis in a pediatric population.
  • To investigate the association between metabolic parameters and the occurrence of kidney stones in children.
  • To understand the multifactorial nature of pediatric urolithiasis.

Main Methods:

  • Analyzed 24-hour urine and blood samples from 162 children with urolithiasis and normal renal function.
  • Assessed metabolic parameters, urinary tract infections, and evaluated the effects of calcium restriction and load.
  • Employed statistical analysis to determine the significance of various risk factors.

Main Results:

  • Hypocitraturia (70%) and hypomagnesuria (42%) were the most prevalent risk factors.
  • Hypercalciuria (37%) was also significant, with other factors including alkaline urine (21%), metabolic acidosis (20%), and urinary infections (16%).
  • Nephrocalcinosis, oliguria, urinary tract anomalies, hyperuricosemia, hypermagnesemia, hypercalcemia, hyperoxaluria, and hypercystinuria were also observed.

Conclusions:

  • Low urinary citrate and magnesium levels are primary risk factors for pediatric urolithiasis.
  • Hypercalciuria is another significant contributing factor.
  • Children often present with multiple concurrent risk factors for kidney stone formation.