Skip to main content
SpringerLink
Log in

Urolithiasis in infants: evaluation of risk factors

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Objective

Urolithiasis in infants is not a very rare situation in Turkey, and the incidence has been increasing in recent years. The purpose of this paper was to investigate the clinical characteristics, metabolic and anatomic risk factors for urolithiasis and microlithiasis in infants.

Methods

The cases of 178 infants (63 girls, 115 boys), who were referred to our department between 1999 and 2009 with urolithiasis, were evaluated.

Results

The mean age at diagnosis of stone disease was 11.5 months (range, 10 days–24 months). The mean follow-up duration was 33.6 months (1.2–110 months). The major clinical symptoms of our patients were restlessness in 24 children (13.5%) and vomiting in 23 (13%). Thirty-five infants (19.7%) had a urinary tract abnormality; vesico-ureteral reflux was the most common abnormality (12.9%). Hypercalciuria and hyperuricosuria were detected in 46 and 56%, respectively. Stone analysis was performed in 56 infants, and calcium oxalate was determined in 36 patients (64.3%). A family history of urolithiasis, presenting symptoms and underlying metabolic abnormalities were similar for patients with microlithiasis and those with larger stones. However, infants with microlithiasis had higher ratios for history of vitamin D administration and feeding with formula. Surgical treatment was performed in 42 infants and extracorporeal shock wave lithotripsy in 30 infants.

Conclusion

Our results showed that urolithiasis in infants may present nonspecific symptoms and may even be asymptomatic and that a positive family history for urolithiasis, urologic abnormalities, metabolic disorders, urinary tract infections, vitamin D administration and feeding with formula may increase the occurrence of urolithiasis in infants.

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. Lopez M, Hoppe B (2008) History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol. doi:10.1007/s00467-008-0960-5

    Google Scholar 

  2. 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  PubMed  CAS  Google Scholar 

  3. Milliner DS (2009) Urolithiasis. In: Avner ED, Harman WE, Niaudet P, Yoshikawa N (eds) Pediatric nephrology, 6th edn. Springer, Berlin, pp 1405–1424

  4. Polito C, Cioce F, La Manna A, Maiello R, Di Toro R (1999) Renal calyceal microlithiasis: clinical presentation may precede sonographic evidence. Clin Pediatr (Phila) 38(9):521–524

    Article  CAS  Google Scholar 

  5. Stapleton FB, Noe HN, Jenkis G, Roy S (1982) Urinary excretion of calcium following an oral calcium loading test in healthy children. Pediatrics 69:594–597

    PubMed  CAS  Google Scholar 

  6. VanDervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra MH et al (2007) Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol 177(6):2300–2305

    Article  PubMed  Google Scholar 

  7. Basaklar AC, Kale N (1991) Experience with childhood urolithiasis, report of 196 cases. Br J Urol 67:203–205

    Article  PubMed  CAS  Google Scholar 

  8. Bensman A, Roubach L, Allouch G, Magny JF, Brun JG, Vasquez MP et al (1983) Urolithiasis in children: presenting signs, etiology, bacteriology and localisation. Acta Pediatr Scand 72:878–879

    Article  Google Scholar 

  9. Jallouli M, Jouini M, Mekki M, Belghith M, Najjar MF, Nouri A (2004) Particularite’ de la lithiase urinaire du nourrisson en Tunisie: a` propos de 64 observation. Prog Urol 14:376–379

    Google Scholar 

  10. Jallouli M, Riadh M, Abdellatif N (2007) Urolithiasis in infants. Pediatr Surg Int 23:295–299

    Article  Google Scholar 

  11. Alpay H, Ozen A, Gokce I, Biyikli N (2009) Clinical and metabolic features of urolithiasis and microlithiasis in children. Pediatr Nephrol 24:2203–2209

    Article  PubMed  Google Scholar 

  12. Güven A, Koyun M, Baysal YE, Akman S, Alimoğlu E, Akbas H et al (2010) Urolithiasis in the first year of life. Pediatr Nephrol 25:129–134

    Article  PubMed  Google Scholar 

  13. Dursun I, Poyrazoglu HM, Dusunsel R, Gunduz Z, Gurgoze MK, Demirci D et al (2008) Pediatric urolithiasis: an 8-year experience of single centre. Int Urol Nephrol 40(1):3–9

    Article  PubMed  Google Scholar 

  14. Zvara V (1969) Diagnostic and treatment of urolithiasis in infants and children. Urol Nephrol 1(3):243–250

    Article  Google Scholar 

  15. Lottman H, Archambault F, Traxer O, Mercier Pageyral B, Hellal B (2000) The efficacy and parenchymal consequences of extracorporeal shock wave lithotripsy in infants. Br J Urol 85:311–315

    Article  Google Scholar 

  16. Edvardsson V, Elidottir H, Indrıdason OS, Palsson R (2005) High incidence of kidney stones in Icelandic children. Pediatr Nephrol 20:940–944

    Article  PubMed  Google Scholar 

  17. Ozokutan BH, Kucukaydın M, Gunduz Z, Kabaklioglu M, Okur H, Turan C (2000) Urolithiasis in childhood. Pediatr Surg Int 16:60–63

    Article  PubMed  CAS  Google Scholar 

  18. Sternberg K, Greenfield SP, Williot P, Wan J (2005) Pediatric stone disease: an evolving experience. J Urol 174:1711–1714

    Article  PubMed  Google Scholar 

  19. La Manna A, Polito C, Cioce F, De Maria G, Capacchione A, Rocco CE et al (1998) Calyceal microlithiasis in children: report on 196 cases. Pediatr Nephrol 12(3):214–217

    Article  PubMed  Google Scholar 

  20. Escribano J, Balaguer A, Martin R, Feliu A, Espax R (2004) Childhood idiopathic hypercalciuria, clinical significance of renal calyceal microlithiasis and risk of calcium nephrolithiasis. Scand J Urol Nephrol 38(5):422–426

    Article  PubMed  Google Scholar 

  21. Hoppe B, Roth B, Bauerfed C, Langman CB (1998) Oxalate, citrate, and sulfate concentration in human milk compared with formula preparations: influence on urinary anion excretion. J Pediatr Gastroenterol Nutr 27:383–386

    Article  PubMed  CAS  Google Scholar 

  22. Campfield T, Braden G, Flynn-Valone P, Clark N (1994) Urinary oxalate excretion in premature infants: effect of human milk versus formula feeding. Pediatrics 94:674–678

    PubMed  CAS  Google Scholar 

  23. Erbagci A, Erbagci AB, Yılmaz M, Yagci F, Tarakcioglu M, Yurtseven C et al (2003) Pediatric urolithiasis-evaluation of risk factors in 95 children. Scand J Urol Nephrol 37:129–133

    Article  PubMed  CAS  Google Scholar 

  24. Polito C, La Manna A, Nappi B, Villani J, Di Toro R (2000) Idiopathic hypercalciuria and hyperuricosuria: family prevalence of nephrolithiasis. Pediatr Nephrol 14:1102–1104

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  26. Ali SH, Rifat UN (2005) Etiological and clinical patterns of childhood urolithiasis in Iraq. Pediatr Nephrol 20:1453–1457

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  28. Pietrow PK, Pope JC, Adams MC, Shyr YU, Brock JW (2002) Clinical outcome of pediatric stone disease. J Urol 167:670–673

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Pediatric Nephrology, Faculty of Medicine, Erciyes University, Talas Street, 38039, Kayseri, Turkey

    Funda Baştuğ, Zübeyde Gündüz, Sebahat Tülpar, Hakan Poyrazoğlu & Ruhan Düşünsel

Authors
  1. Funda Baştuğ
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zübeyde Gündüz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sebahat Tülpar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hakan Poyrazoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ruhan Düşünsel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Funda Baştuğ.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baştuğ, F., Gündüz, Z., Tülpar, S. et al. Urolithiasis in infants: evaluation of risk factors. World J Urol 31, 1117–1122 (2013). https://doi.org/10.1007/s00345-012-0828-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-012-0828-y

Keywords

Search

Navigation