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Pediatric urolithiasis in the 1970s
Insights
This retrospective study of pediatric urolithiasis found that most cases were idiopathic. Recommended investigations include voiding cystography and urine metabolic evaluation for calcium, oxalate, and uric acid.
Area of Science:
- Pediatric Nephrology
- Urology
Background:
- Urolithiasis in children presents diagnostic challenges.
- Understanding the etiology of pediatric kidney stones is crucial for effective management.
Purpose of the Study:
- To retrospectively analyze the characteristics and predisposing factors of urolithiasis in a pediatric cohort.
- To identify key diagnostic tools for investigating pediatric urolithiasis.
Main Methods:
- Retrospective review of 38 children with urolithiasis (1970-1977).
- Analysis of patient demographics, family history, urinary tract abnormalities, and metabolic evaluations.
- Inclusion of voiding cystography and urine chemistry under home diet conditions.
Main Results:
- The mean age was 9.4 years, with a 1:1 sex ratio.
- 18% had predisposing urinary tract abnormalities, often requiring voiding cystography.
- 74% of cases were idiopathic urolithiasis, with 38% of these showing idiopathic hypercalciuria.
Conclusions:
- Pediatric urolithiasis investigation should incorporate voiding cystography.
- Measurement of urine calcium, oxalate, and uric acid under normal dietary conditions is recommended.
- Early identification of metabolic abnormalities can guide treatment and prevent recurrence.
Abstract:
We studied retrospectively 38 children who presented with urolithiasis between 1970 and 1977. The sex ratio was 1:1 and the mean age was 9.4 years. A positive family history was found in 36 per cent. Urinary tract abnormalities predisposing to infective urolithiasis was found in 7 children (18 per cent) but required voiding cystography for detection in 5. Hypercalcemia was found in 3 of 32 (8 per cent), while 28 of the 38 patients (74 per cent) had idiopathic urolithiasis. Idiopathic hypercalciuria was found in 5 of 13 patients (38 per cent) with idiopathic urolithiasis. Investigation of urolithiasis in children should include voiding cystography and measurement of urine calcium, as well as oxalate and uric acid, under home diet conditions.