Metabolic Evaluation in Pediatric Urolithiasis: Our Experience
Journal of Pediatric Nephrology,
Vol. 6 No. 1 (2018),
4 May 2018
,
Page 1-5
https://doi.org/10.22037/jpn.v6i1.17630
Abstract
Introduction: Pediatric urolithiasis is a morbid condition that is often associated with underlying metabolic disorders. It is essential to diagnose and manage the underlying metabolic disorder along with management of urolithiasis to prevent stone recurrence and decrease the morbidity.
Materials and Methods: This retrospective observational study was conducted in 50 patients below 15 years of age with urolithiasis. Urine collection was done for 24 hours in toilet-trained children and spot samples were taken from younger children. The urinary parameters that were evaluated included calcium, oxalate, citrate, uric acid, and total urine volume. The serum levels of calcium, phosphorus, creatinine, uric acid, electrolytes, parathormone, and albumin were also measured. Stone analysis was done whenever possible.
Results: There were 32 males and 18 females. Sixty-two percent of the patients had a low calcium intake and 70% of the children had a history of low water intake and had a low urine volume over 24 hours. Half of the children had serum metabolic abnormalities, including hypocalcaemia (n=19,38%), hypocalcaemia with hyperphosphatemia (n=2, 4%), hypercalcemia (n=2, 4%), and hyperuricemia (n=2,4%). Urinary abnormalities were detected in 42% of the children (n=21). These abnormalities included hypocitraturia in 11 patients (50%), hypercalciuria in 7 patients (30%), hyperoxaluria in 1 patient (6%), and hyperuricosuria in 2 patients (12%). Stone analysis was done in 18 patients. Fifteen patients (30%) had calcium oxalate stones, two patients (4%) had uric acid stones, and one patient had a mixed stone.
Conclusions: It is important to maintain an optimal blood calcium level and increase fluid intake to prevent stone formation in children.
Keywords: Urolithiasis; Pediatric; Metabolic Disorders.- Urolithiasis
- Paediatric
- Metabolic Disorders
How to Cite
References
Partalis N, Sakellaris G. Pediatric urolithiasis. Essentials in PediatrUrol 2012;79-88 ISBN:978-81-308-0511-5.
Gajengi AK, Wagaskar VG, Tanwar HV, Mhaske S, Patwardhan SK. Metabolic evaluation in paediatric urolithiasis: A 4-year open prospective study. J ClinDiag Research, 2016 (Feb);10(2):PC04-PC06.
Spivacow FR, Negri AL, del Valle EE, Calvino I, Fradinger E, Zanchetta JR. Metabolic risk factors in children with kidney stone disease. PediatrNephrol. 2008;23:1129-33.
Nicoletta JA, Lande MB. Medical evaluation and treatment of urolithiasis. Pediatric Clinics of North America. 2006 Jun 30;53(3):479-91.
Davis ID, Avner ED, Behrman RE, Kliegman RM, Jenson HB. Nelson textbook of Pediatrics. 17 ed, Philadelphia, Saunders. 2004, pp:1822-25.
Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh Urology: Expert Consult Premium Edition: Enhanced Online Features and Print, 4-Volume Set. Elsevier Health Sciences; 2011 Aug 25.
Dursun I, Poyrazoglu HM, Dusunsel R, Gunduz Z, Gurgoze MK, Demirci D, et al. Pediatricurolithiasis: an 8-year experience of single centre. IntUrolNephrol. 2008;40:3-9.
Sternberg K, Green eld SP, Williot P, Wan J. Pediatric stone disease: an evolving experience. J Urol. 2005;174:1711-14.
Alpay H, Ozen A, Gokce I, Biyikli N. Clinical and metabolic features of urolithiasis and microlithiasis in children. PediatrNephrol. 2009;24:2203-09.
Bioci M, Saraga M, Kuzmi AC, Bahtijarevi Z, Budimir D, Todori J, et al. Pediatricurolithiasis in Croatia. CollAntropol. 2003;27:745-52.
Tefekli A, Esen T, Ziylan O, et al. Metabolic risk factors in pediatric and adult calcium oxalate urinary stone formers: is there any difference? Urol Int. 2003;70(4):273-77.
Craven BL, Passman C, Assimos DG. Hypercalcemic States Associated with Nephrolithiasis. Rev Urol. 2008;10(3):218–26.
Borghi L, Schianchi T, Meschi T, Guerra A, Allegri F, Maggiore U, et al. Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med. 2002;346(2):77-84.
Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol. 1996;155(3):83943.
Naseri M, Varasteh AR, Alamdaran SA. Metabolic factors associated with urinary calculi in children. Iran J Kidney Dis. 2010;4(1):32-38.
Erbagci A, Erbagci AB, Yilmaz M, et al. Pediatric urolithiasis-evaluation of risk factors in 95 children. Scand J UrolNephrol. 2003;37(2):129-33.
Milliner DS. Urolithiasis. In: Pediatric nephrology. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 1104.
- Abstract Viewed: 398 times
- PDF Downloaded: 253 times