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A systematic review on urolithiasis in children with neurological disorders
Atinc Tozsin1, Hakan Akdere1, Selcuk Guven2
1Department of Urology, Trakya University School of Medicine, Edirne, Turkey.
Insights
Children with neurological disorders face increased risk of kidney stones due to immobility and infections. Management involves monitoring bone density, urine analysis, and encouraging physical activity to prevent nephrolithiasis.
Area of Science:
- Pediatric Nephrology
- Neurology
- Urology
Background:
- Improved medical care increases life expectancy for children with neurological disorders.
- This leads to a rise in secondary health issues, notably nephrolithiasis (kidney stones).
- Understanding risk factors and management is crucial for this vulnerable population.
Purpose of the Study:
- To review risk factors, management strategies, and treatment outcomes for stone disease in pediatric patients with neurological disorders.
- To specifically analyze the roles of immobilization, urinary tract infections (UTIs), and metabolic abnormalities in nephrolithiasis occurrence.
Main Methods:
- A systematic literature search was performed on PubMed and Ovid Medline.
- 11 relevant articles were included after screening 771 initial records.
- Studies reviewed were primarily small-scale, single-center investigations.
Main Results:
- Nephrolithiasis incidence ranged from 5-54% across the included studies.
- Key identified risk factors included immobilization, UTIs, and hypercalciuria.
- Treatment modalities comprised medical expulsive therapy (MET), ESWL, RIRS, and PCNL.
Conclusions:
- Essential management steps include bone mineral density monitoring and 24-h urine analysis for metabolic assessment.
- Encouraging physical activity, as tolerated, is vital.
- Addressing these factors can help mitigate the risk and impact of nephrolithiasis in children with neurological disorders.
Purpose:
Advancements in medical treatments and increased access to healthcare have significantly extended the life expectancy of children with neurological disorders. However, this has also led to a higher incidence of secondary health issues, such as nephrolithiasis. This review aims to analyze the risk factors, management, and treatment outcomes for stone disease in children with neurological disorders and focus on specific risk factors such as immobilization, urinary tract infections, and metabolic abnormalities to identify key points in the occurrence of nephrolithiasis.
Methods:
A comprehensive literature search was conducted across two primary databases, PubMed and Ovid Medline, to identify studies on urolithiasis in children with neurological disorders. A total of 771 articles were initially identified. After removing four duplicate articles, 729 were excluded following title and abstract screening due to irrelevance. Thirty-eight articles were selected for full-text review, and after further exclusions, 11 articles were included in this review.
Results:
The studies mainly consisted of small-scale, single-center investigations. Nephrolithiasis were reported in 5-54% of patients across the studies. The most commonly identified risk factors were immobilization, urinary tract infections (UTIs), and hypercalciuria. Treatment options for urinary stones included medical expulsive therapy (MET), extracorporeal shock wave lithotripsy (ESWL), endoscopic surgery (RIRS), and percutaneous nephrolithotomy (PCNL).
Conclusion:
Key steps in managing these patients include monitoring bone mineral density, conducting a 24-h urine analysis to assess metabolic components (despite challenges in obtaining this), and encouraging physical activity as much as the patient's condition permits.
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