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How important urolithiasis is under 2 years of age?
Aysun Çaltik Yilmaz1, Necla Ünal2, Aslı Çelebi Tayfur3
1Department of Pediatric Nephrology, Baskent University, Ankara, Turkey. aysundr@hotmail.com.
Insights
Infantile urolithiasis (UL) is rising, with metabolic and UTI causes common. Many infant stones resolve spontaneously, but monitoring and preventing dehydration are key for high-risk groups.
Area of Science:
- Pediatric Nephrology
- Urology
- Metabolic Disorders
Background:
- Urolithiasis (UL) incidence is increasing in infants.
- Early diagnosis and understanding etiologic variables are crucial for management.
- Family history and dehydration are potential risk factors in pediatric stone disease.
Purpose of the Study:
- To analyze etiologic variables in infantile urolithiasis.
- To evaluate the outcomes of stone disease in children under two.
- To identify risk factors and effective management strategies for pediatric urolithiasis.
Main Methods:
- Retrospective analysis of 60 patients diagnosed with urolithiasis before age two.
- Comprehensive evaluation for etiologic factors.
- Minimum follow-up period of 6 months.
Main Results:
- Metabolic causes (31.6%) and UTI-related causes (20%) were the most frequent etiologies.
- A significant proportion of patients (68.3%) had a family history of stone disease.
- Spontaneous stone disappearance occurred in 64% of cases during follow-up.
Conclusions:
- Infantile urolithiasis requires thorough investigation for underlying causes.
- Close monitoring and preventative measures, such as managing dehydration, are essential.
- Early identification of high-risk infants can guide proactive interventions.
Abstract:
Urolithiasis (UL) is a common health problem in the world and the observed incidence of this disease is increasing in the infantile period. The study included cases of UL diagnosed before the age of two who had a comprehensive analysis for possible etiologic variables and were followed for a minimum of 6 months. Of the 60 patients included in the study, 37 were male, and the male/female ratio was 1.6. The average age at diagnosis is 8.5 ± 4.5 months. Of the cases diagnosed 41 (68.3%) were before than 1 year of age. The average time for follow-up is 28.9 ± 22.6 months. There was a family history of stone disease in 41 (68.3%) cases. Twenty-four (40%) patients were treated for dehydration at least once before stone disease was identified. The number of patients presenting with symptoms is 43 (71.7%). Restlessness was noted as the main symptom. In 17 (28.3%) patients, stone disease was found incidentally. Metabolic causes (n: 19, 31.6%) were determined to be the most common underlying cause, followed by UTI-related causes (n: 12, 20%). During the follow-up, 57 (64%) of the stones spontaneously disappeared. The size of 16 (18%) stones reduced, while the size of eleven remained same (13%). Following their absence, nine (15%) of the stones reappeared. The essential strategy is to identify high-risk groups, to closely monitor them, and to take preventative interventions against modifiable conditions such as dehydration if possible.
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