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[Risk factors in calcium urolithiasis]
G Lama1, E Amendola, A M Aurino
1Dipartimento di Pediatria II, Università degli Studi, Napoli.
Insights
In children with calcium urolithiasis, the combination of hypercalciuria and low urinary citrate levels significantly increases the risk of stone formation and recurrence. Monitoring citrate levels is crucial for managing pediatric kidney stones.
Area of Science:
- Pediatric Nephrology
- Urology
- Biochemistry
Context:
- Urolithiasis is a significant health concern in children.
- Identifying pathogenetic factors is key to understanding stone formation and recurrence.
- Previous studies have explored individual risk factors, but the combined effect needs further elucidation.
Purpose:
- To retrospectively evaluate if the association of different pathogenetic factors in urolithiasis increases stone formation and recurrences in children.
- To analyze the relationship between hypercalciuria, citraturia, and stone recurrence in pediatric patients.
Summary:
- This retrospective study analyzed 41 children (aged 3-15) with urolithiasis, assessing renal function, electrolytes, pH, oxalaturia, and glycosaminoglycans.
- Results indicated that hypercalciuric children with decreased urinary citrate (citraturia) experienced more than two stone recurrences.
- Conversely, hypercalciuric children without stones showed increased citraturia, suggesting a protective effect.
Impact:
- The findings highlight that the co-occurrence of hypercalciuria and low citraturia is a critical risk factor for calcic urolithiasis and its recurrence in children.
- This underscores the importance of assessing both calcium and citrate levels in the management and prevention strategies for pediatric kidney stones.
- The study provides valuable insights for clinical practice in pediatric nephrology and urology regarding risk stratification and personalized treatment approaches.
Abstract:
The aim of the study has been to evaluate, retrospectively, if the association of urolithiasis different pathogenetic factors increases stone formation and recurrences. The study included 41 children, 20 males and 21 females, aged 3-15 years, divided into three groups: patients with hypercalciuric or normocalciuric urolithiasis and isolated hypercalciuria. In all of them renal function, blood and urinary pH, serum and urinary electrolytic levels, citraturia (dosed with anenzymatic quantitative method), oxalaturia (enzymatic colorimetric method), urinary glycosaminoglycans (dosed by means of cetylpyridinum chloride precipitation and quantitative analysis) have been considered. Statistical analysis was done using Student's "t"-test, with p < 0.05. In all children with hypercalciuric urolithiasis who during the follow-up presented a decreased citraturia, the number of recurrences increased and was above two. The children who during the follow-up remained hypercalciuric without urolithiasis, in spite of the high familiarity, presented an increased citraturia. In conclusion the association between hypercalciuria and low citraturia increases the risk of stone formation and recurrences in children with calcic urolithiasis.