Skip to main content
SpringerLink
Log in

Metabolic disturbances in Chinese children with urolithiasis: a single center report

  • Original Paper
  • Published:
Urolithiasis Aims and scope Submit manuscript

Abstract

Urinary stones and urine composition are the first steps in the process of recurrence prevention, but data concerning the association between the two compositions are scarce in Chinese children with urolithiasis. We retrospectively analyzed the records of children (age range 0–18 years) with urolithiasis in our center between March 2004 and December 2013. Stone analysis was carried out in 382 children and 24-hour urine analysis in 80 children. Analysis of both stone and 24-hour urine composition was completed in 56 children. Stone samples were analyzed by Fourier transform-infrared spectrometry. The major stone constituents were calcium oxalate (78.8 %). Of 80 children with 24 h urine analysis, only 2.5 % were without urinary metabolic abnormalities. Hypocitraturia was recorded in 97.5 %, high sodium excretion in 50.0 %, cystinuria in 48.7 %, hypercalciuria in 18.8 %, small urine volumes in 12.5 %, hyperoxaluria in 5.0 % and hyperuricosuria in 1.3 %. Interestingly, higher urine volumes were recorded in girls than in boys (73.2 ± 58.5 vs 51.3 ± 45.3 mL/kg, p = 0.036). Urine sodium (p = 0.002) and oxalate (p = 0.004) were significantly higher in children >9 year old. Moreover, compared with calcium oxalate stone formers, the urine volume (p = 0.040), citrate (p = 0.007) and cystine (p = 0.004) were higher in patients with cystine stones. Hypocitraturia was the common abnormality among Chinese children with urolithiasis. The surprisingly high incidence of cystinuria is of note.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Spivacow FR, Negri AL, del Valle EE, Calviño I, Fradinger E, Zanchetta JR (2008) Metabolic risk factors in children with kidney stone disease. Pediatr Nephrol 23:1129–1133

    Article  PubMed  Google Scholar 

  2. Sas DJ, Hulsey TC, Shatat IF, Orak JK (2010) Increasing incidence of kidney stones in children evaluated in the emergency department. J Pediatr 157:132–137

    Article  PubMed  Google Scholar 

  3. VanDervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M et al (2007) Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol 177:2300–2305

    Article  PubMed  Google Scholar 

  4. Lao M, Kogan BA, White MD, Feustel PJ (2014) High recurrence rate at 5-year follow-up in children after upper urinary tract stone surgery. J Urol 191:440–444

    Article  PubMed  Google Scholar 

  5. Curhan GC, Willett WC, Speizer FE, Stampfer MJ (2001) Twenty-four-hour urine chemistries and the risk of kidney stones among women and men. Kidney Int 59:2290–2298

    Article  CAS  PubMed  Google Scholar 

  6. Kovacevic L, Wolfe-Christensen C, Edwards L, Sadaps M, Lakshmanan Y (2012) From hypercalciuria to hypocitraturia—a shifting trend in pediatric urolithiasis? J Urol 188:1623–1627

    Article  CAS  PubMed  Google Scholar 

  7. Cameron MA, Sakhaee K, Moe OW (2005) Nephrolithiasis in children. Pediatr Nephrol 20:1587–1592

    Article  PubMed  Google Scholar 

  8. Kamoun A, Daudon M, Abdelmoula J, Hamzaoui M, Chaouachi B, Houissa T et al (1999) Urolithiasis in Tunisian children: a study of 120 cases based on stone composition. Pediatr Nephrol 13:920–925

    Article  CAS  PubMed  Google Scholar 

  9. Sarkissian A, Babloyan A, Arikyants N, Hesse A, Blau N, Leumann E (2001) Pediatric urolithiasis in Armenia: a study of 198 patients observed from 1991 to 1999. Pediatr Nephrol 16:728–732

    Article  CAS  PubMed  Google Scholar 

  10. Knoll T, Schubert AB, Fahlenkamp D, Leusmann DB, Wendt-Nordahl G, Schubert G (2011) Urolithiasis through the ages: data on more than 200,000 urinary stone analyses. J Urol 185:1304–1311

    Article  PubMed  Google Scholar 

  11. Wu W, Yang B, Ou L, Liang Y, Wan S, Li S et al (2014) Urinary stone analysis on 12,846 patients: a report from a single center in China. Urolithiasis 42:39–43

    Article  PubMed  Google Scholar 

  12. Rizvi SA, Naqvi SA, Hussain Z, Hashmi A, Hussain M, Zafar MN et al (2002) Pediatric urolithiasis: developing nation perspectives. J Urol 168:1522–1525

    Article  CAS  PubMed  Google Scholar 

  13. Ertan P, Tekin G, Oger N, Alkan S, Horasan GD (2011) Metabolic and demographic characteristics of children with urolithiasis in Western Turkey. Urol Res 39:105–110

    Article  PubMed  Google Scholar 

  14. Penido MG, Srivastava T, Alon US (2013) Pediatric primary urolithiasis: 12-year experience at a Midwestern Children’s Hospital. J Urol 189:1493–1497

    Article  PubMed  Google Scholar 

  15. Le JD, Eisner BH, Tseng TY, Chi T, Stoller ML (2011) Laterality of nephrocalcinosis in kidney stone formers with severe hypocitraturia. BJU Int 107:106–110

    Article  PubMed  PubMed Central  Google Scholar 

  16. Byer K, Khan SR (2005) Citrate provides protection against oxalate and calcium oxalate crystal induced oxidative damage to renal epithelium. J Urol 173:640–646

    Article  CAS  PubMed  Google Scholar 

  17. Kurtz MP, Eisner BH (2011) Dietary therapy for patients with hypocitraturic nephrolithiasis. Nat Rev Urol 8:146–152

    Article  CAS  PubMed  Google Scholar 

  18. Wu W, Yang D, Tiselius HG, Ou L, Liang Y, Zhu H et al (2014) The characteristics of the stone and urine composition in Chinese stone formers: primary report of a single-center results. Urology 83:732–737

    Article  PubMed  Google Scholar 

  19. Barcelo P, Wuhl O, Servitge E, Rousaud A, Pak CY (1993) Randomized double-blind study of potassium citrate in idiopathic hypocitraturic calcium nephrolithiasis. J Urol 150:1761–1764

    CAS  PubMed  Google Scholar 

  20. Sfoungaristos S, Hakim R, Katz R, Gofrit ON, Landau EH, Yutkin V et al (2015) Cystine stones: a single tertiary center experience. J Endourol 29:362–366

    Article  PubMed  Google Scholar 

  21. Kalorin CM, Zabinski A, Okpareke I, White M, Kogan BA (2009) Pediatric urinary stone disease—does age matter? J Urol 181:2267–2271

    Article  PubMed  Google Scholar 

  22. Elmacı AM, Ece A, Akın F (2014) Pediatric urolithiasis: metabolic risk factors and follow-up results in a Turkish region with endemic stone disease. Urolithiasis 42:421–426

    Article  PubMed  Google Scholar 

  23. Tiselius HG (2002) Medical evaluation of nephrolithiasis. Endocrinol Metab Clin North Am 31:1031–1050

    Article  CAS  PubMed  Google Scholar 

  24. Dello Strologo L, Pras E, Pontesilli C, Beccia E, Ricci-Barbini V, de Sanctis L et al (2002) Comparison between SLC3A1 and SLC7A9 cystinuria patients and carriers: a need for a new classification. J Am Soc Nephrol 13:2547–2553

    Article  PubMed  Google Scholar 

  25. Saravakos P, Kokkinou V, Giannatos E (2014) Cystinuria: current diagnosis and management. Urology 83:693–699

    Article  PubMed  Google Scholar 

  26. Krombach P, Wendt-Nordahl G, Knoll T (2011) Cystinuria and cystine stones. In: Rao PN, Kavanagh JP, Preminger GM (eds) Urinary tract stone disease. Springer-Verlag, London, pp 207–215

    Google Scholar 

  27. Tasic V, Lozanovski VJ, Ristoska-Bojkovska N, Sahpazova E, Gucev Z (2011) Nephrotic syndrome occurring during tiopronin treatment for cystinuria. Eur J Pediatr 170:247–249

    Article  CAS  PubMed  Google Scholar 

  28. Mattoo A, Goldfarb DS (2008) Cystinuria. Semin Nephrol 28:181–191

    Article  CAS  PubMed  Google Scholar 

  29. Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A (1996) Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol 155:839–843

    Article  CAS  PubMed  Google Scholar 

  30. Nouvenne A, Meschi T, Prati B et al (2010) Effects of a low-salt diet on idiopathic hypercalciuria in calcium-oxalate stone formers: a 3-mo randomized controlled trial. Am J Clin Nutr 91:565–570

    Article  CAS  PubMed  Google Scholar 

  31. Siener R, Ebert D, Nicolay C et al (2003) Dietary risk factors for hyperoxaluria in calcium oxalate stone formers. Kidney Int 63:1037–1043

    Article  PubMed  Google Scholar 

  32. Eisner BH, Eisenberg ML, Stoller ML (2009) Impact of urine sodium on urine risk factors for calcium oxalate nephrolithiasis. J Urol 182:2330–2333

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Guangdong Key Laboratory of Urology, Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, China

    Dong Yang, Chuangxin Lan, Dong Chen, Kang Chen, Lili Ou, Yang Liu, Shaohong Xu, Guohua Zeng, Ming Lei & Wenqi Wu

  2. Department of Urology, The People’s Hospital of Hanchuan City, Hubei, China

    Dong Yang

  3. Division of Urology, Department of Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

    Hans-Göran Tiselius

Authors
  1. Dong Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hans-Göran Tiselius
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chuangxin Lan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dong Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lili Ou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yang Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shaohong Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Guohua Zeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ming Lei
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Wenqi Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wenqi Wu.

Ethics declarations

Statement of financial support

This work was supported by a grant from General Guide Project of Guangzhou City Bureau of Education (No. 20123C055) and Science and Technology Planning Project of Guangdong Province, China (No. 2014A020209085).

Conflict of interest

No competing financial interests exist.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yang, D., Tiselius, HG., Lan, C. et al. Metabolic disturbances in Chinese children with urolithiasis: a single center report. Urolithiasis 45, 285–290 (2017). https://doi.org/10.1007/s00240-016-0910-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-016-0910-9

Keywords

Search

Navigation