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Urinary tract calculi in children
Insights
Pediatric urinary tract calculi necessitate thorough investigation for underlying causes like urodynamic issues or infections. If no cause is found, recurrence is low, and conservative management is often suitable for children with kidney stones.
Area of Science:
- Pediatric Nephrology
- Urology
Background:
- Urinary tract calculi (kidney stones) are uncommon in children.
- Investigating the etiology of pediatric urinary stones is crucial for appropriate management.
Purpose of the Study:
- To review and investigate children diagnosed with urinary tract calculi.
- To identify etiological factors contributing to pediatric urinary stone formation.
Main Methods:
- Retrospective review of 109 children with urinary tract calculi.
- Inclusion of reinvestigation for some cases.
- Classification of etiological groups for upper urinary tract calculi.
Main Results:
- Lower urinary tract calculi were invariably linked to urodynamic abnormalities.
- Upper urinary tract calculi in 60% of cases were classifiable into four etiological groups: urodynamic abnormality, urinary tract infection, metabolic disorders, or idiopathic hypercalciuria.
- 32% of upper tract calculi cases had no identifiable underlying abnormality; 39% presented painlessly.
Conclusions:
- Pediatric urinary tract calculi require comprehensive evaluation for urodynamic, infective, and metabolic abnormalities.
- In the absence of identified abnormalities, recurrence rates are low, supporting conservative treatment.
Abstract:
One hundred and nine children with urinary tract calculi were reviewed and in some cases reinvestigated. Eighteen children had lower urinary tract calculi, which in all cases were associated with an underlying urodynamic abnormality. Sixty percent of 91 children with upper urinary tract calculi could be classified into 4 similarly sized etiological groups: an underlying urodynamic abnormality; urinary tract infection without a urodynamic abnormality; metabolic disorders; idiopathic hypercalciuria. An underlying abnormality was not found in 32% of cases. A painless presentation occurred in 39% of those with upper tract calculi. A family history of urinary calculi occurred in approximately one-half of children with either an idiopathic calculus or a calculus associated with cystinuria or idiopathic hypercalciuria. We conclude that urinary tract calculi, though rare in children, require extensive investigation to rule out urodynamic, infective and metabolic abnormalities. If such abnormalities are not found, the recurrence rate in the remainder is small and conservative treatment can usually be recommended.