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Published on: August 5, 2010
Risk factors for development of urinary tract infection in children with nephrolithiasis
Nuran Cetin1, Aylin Gencler1, Aslı Kavaz Tufan1
1Department of Pediatric Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
Insights
Urinary tract infections (UTIs) are linked to kidney stones in children. Larger stone size, younger age at diagnosis, and metabolic factors increase UTI risk and recurrence in pediatric nephrolithiasis.
Area of Science:
- Pediatric Nephrology
- Urology
- Infectious Diseases
Background:
- Nephrolithiasis (kidney stones) is a known risk factor for urinary tract infections (UTIs).
- Understanding risk factors for UTIs in children with nephrolithiasis is crucial for effective management and prevention.
Purpose of the Study:
- To investigate the risk factors associated with urinary tract infections (UTIs) in children diagnosed with nephrolithiasis.
- To identify factors contributing to both the occurrence and recurrence of UTIs in this pediatric population.
Main Methods:
- A retrospective follow-up study evaluated data from 599 children with nephrolithiasis.
- Patients with prior UTIs or congenital urinary tract anomalies were excluded.
- Patients were categorized into groups with and without UTIs.
Main Results:
- Urinary tract infections (UTIs) occurred in 30.2% of the patients.
- Stone size (odds ratio [OR]: 1.355, P = 0.007) and age at diagnosis under 2 years (OR: 1.212, P = 0.041) were significant risk factors for UTI.
- Metabolic risk factors (OR: 2.272, P = 0.021) and hypercalciuria (OR: 1.854, P = 0.017) were associated with UTI recurrence.
Conclusions:
- Age at diagnosis, metabolic risk factors, and stone size are significant predictors of UTIs in children with nephrolithiasis.
- Children with idiopathic hypercalciuria, metabolic risk factors, and diagnosed under 2 years face a higher risk of recurrent UTIs.
Aim:
Nephrolithiasis is one of the causes of urinary tract infection (UTI). In this study, we investigated risk factors for UTI in children with nephrolithiasis.
Methods:
The data from the patients with nephrolithiasis were evaluated in this retrospective follow-up study. Patients with a history of UTI before admission and congenital anomaly of kidney or urinary tract were excluded. The patients were divided into two groups: patients with UTI (recurrent UTI and single UTI) and patients without UTI.
Results:
A total of 599 patients were included in this study. UTI occurred in 181 (30.2%) patients. There was a positive association between the size of stone and UTI (odds ratio (OR): 1.355, P = 0.007). Receiver operating characteristic curve analysis showed that the cut-off value of the size of stone for UTI was 5.3 mm, with a sensitivity of 74.9% and a specificity of 66.1% (area under the curve: 0.572 ± 0.028, P = 0.013). The presence of a metabolic risk factor and age at diagnosis under 2 years were significantly associated with both UTI and recurrence of UTI (OR: 2.272, P = 0.021, OR: 1.809, P = 0.028, respectively, for metabolic risk factor; OR: 1.212, P = 0.041, OR: 1.122, P = 0.046, respectively, for age at diagnosis under 2 years). Hypercalciuria was significantly associated with the recurrence of UTI (OR: 1.854, P = 0.017).
Conclusions:
The age at diagnosis, the presence of a metabolic risk factor and size of stone are significant risk factors for UTI in children with nephrolithiasis. The patients with idiopathic hypercalciuria, metabolic risk factor and age at diagnosis under 2 years have increased risk of recurrence of UTI.
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