Skip to main content

Advertisement

SpringerLink
Log in

Why is childhood urolithiasis increasing? Etiology, diagnosis and management: a single-center experience

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

Abstract

Background

Globally, urolithiasis is becoming more and more common among children. We aimed to determine the etiology, and the diagnostic and therapeutic approaches in patients with urolithiasis.

Methods

This was a retrospective study which included all patients (aged 1 month-18 years) admitted to the pediatric nephrology clinic in Elazığ Fethi Sekin City Hospital with urolithiasis between November 2019 and 2021. Only patients whose diagnosis of urolithiasis was confirmed by urinary ultrasonography were included in the study, while patients with chronic diseases (neurological diseases such as epilepsy, cerebral palsy, chronic bowel diseases, etc.) predisposing to kidney stone formation were not. Demographic characteristics, serum and urine biochemical parameters, urine metabolic and kidney stone metabolic and chemical analyses, urinary tract ultrasonography findings and treatment modalities were collected.

Results

One hundred ninety-seven patients (91 female and 106 male) were included in the study. Hypervitaminosis D was detected in 4 (2%) patients, suppressed parathyroid hormone in 12 (6%) and hypercalcemia in 27 (14%) patients. Metabolic screening showed hypercalciuria in 69 (35%) patients, hypocitraturia in 39 (20%), hyperoxaluria in 15 (8%) and cystinuria in 6 (3%) patients. Eighty three (42%) patients had a positive family history for kidney stones. One hundred eighteen (60%) patients received potassium citrate treatment, 71 (36%) were given hydration and diet recommendations without medical treatment, 6 (3%) received tiopronin treatment, and 2 (1%) patients were treated surgically.

Conclusions

Our study suggests that Vitamin D supplementation at doses higher than 400 IU/day may be a risk factor for kidney stones in children. We observed that mothers tend not to give water to infants who are breastfed or formula-fed in the first year of life. K-citrate treatment can be a good option for prevention and dissolution of stones by alkalinization.

Graphical Abstract

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

Availability of data and material

Our data and material are available.

References

  1. Scales CD Jr, Smith AC, Hanley JM et al (2012) Prevalence of kidney stones in the United States. Eur Urol 62:160–165

    Article  PubMed  PubMed Central  Google Scholar 

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

    Article  PubMed  Google Scholar 

  3. DeFoor W, Asplin J, Jackson E et al (2006) Urinary metabolic evaluations in normal and stone forming children. J Urol. 176(4):1793–1796

    Article  PubMed  Google Scholar 

  4. Coward RJ, Peters CJ, Duffy PG et al (2003) Epidemiology of paediatric renal stone disease in the UK. Arch Dis Child 88(11):962-965.23

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Penido MG, Srivastava T, Alon US (2013) Pediatric primary urolithiasis. J Urol 189(4):1493–1497

    Article  PubMed  Google Scholar 

  6. Ang AJS, Sharma AA, Sharma A (2020) Nephrolithiasis: approach to diagnosis and management. Indian J Pediatrics. https://doi.org/10.1007/s12098-020-03424-7

    Article  Google Scholar 

  7. Lopez M, Hoppe B (2010) History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol e25(1):49–59

    Article  Google Scholar 

  8. Milliner DS, Murphy ME (1993) Urolithiasis in pediatric patients. Mayo Clin Proc 68:241–248

    Article  CAS  PubMed  Google Scholar 

  9. Karabacak OR, Ipek B, Ozturk U, Demirel F, Saltas H, Altug U (2010) Metabolic evaluation in stone disease metabolic differences between the pediatric and adult patients with stone disease. Urology 76:238–241

    Article  PubMed  Google Scholar 

  10. Spivacow FR, Negri AL, del Valle EE, Calviño I, Zanchetta JR (2010) Clinical and metabolic risk factor evaluation in young adults with kidney stones. Int Urol Nephrol 42:471–475

    Article  PubMed  Google Scholar 

  11. Bastug F, Dusunsel R (2012) Pediatric urolithiasis: causative factors, diagnosis and medical management. Nat Rev Urol. 9(3):138–46. https://doi.org/10.1038/nrurol.2012.4

    Article  CAS  PubMed  Google Scholar 

  12. Prentice A, Branca F, Decsi T et al (2004) Energy and nutrient dietary reference values for children in Europe: methodological approaches and current nutritional recommendations. Br J Nutr 92(Suppl 2):S83–S146

    Article  CAS  PubMed  Google Scholar 

  13. Hernandez JD, Jonathan S, Ellison S et al (2015) Current trend, evaluation and management of pediatric nephrolithiasis. JAMA Pediatric 169:961–964

    Article  Google Scholar 

  14. Porowski T, Kirejczyk JK, Konstantynowicz J et al (2013) Correspondence between Ca2+ and calciuria, citrate level and pH of urine in pediatric urolithiasis. Pediatr Nephrol 28(7):1079–1084

    Article  PubMed  PubMed Central  Google Scholar 

  15. Sampath A, Kossoff EH, Furth SL, Pyzik PL, Vining EP (2007) Kidney stones and the ketogenic diet: risk factors and prevention. J Child Neurol 22:375–378

    Article  PubMed  Google Scholar 

  16. Guan N et al (2009) Melamine-contaminated powdered formula and urolithiasis in young children. N Engl J Med 360:1067–1074

    Article  CAS  PubMed  Google Scholar 

  17. Akın Y, Uçar M, Yücel S (2013) Current medical treatment in pediatric urolithiasis. Turk J Urol 39:253–263

    Article  PubMed  PubMed Central  Google Scholar 

  18. Leumann EP, Hoppe B (1997) Urolithiasis in childhood. In: Proesmans W (ed) Therapeutic strategies in children with renal disease. Baillieres Clinical Paediatrics, pp 653–674.

  19. Ennis JL (2016) The role of the 24-H urine collection in the management of nephrolithiasis. Int Surg 36:633–637

    Article  Google Scholar 

  20. Skolarikos A, Straub M, Knoll T, Sarica K, Seitz C, Petřík A, Türk C (2015) Metabolic evaluation and recurrence prevention for urinary stone patients: EAU guidelines. Eur Urol 67:750–763

    Article  PubMed  Google Scholar 

  21. Worcester EM, Coe FL (2008) Nephrolithiasis. Prim Care 35:369–391

    Article  PubMed  PubMed Central  Google Scholar 

  22. Sirin A, Emre S, Alpay H, Nayir A, Bilge I, Tanman F (1995) Etiology of chronic renal failure in Turkish children. Pediatr Nephrol 9:549–552

    Article  CAS  PubMed  Google Scholar 

  23. Alpay H, Gokce I, Ozen A, Bıyıklı N (2013) Urinary stone disease in the first year of life: is it dangerous? Pediatr Surg Int 29:311–316

    Article  PubMed  Google Scholar 

  24. Andriolia V, Highmoreb K, Leonardo MP, Guerra LA, Tangc K, Vethamuthud J, Meyersa V, Sullivana KJ, August MAK (2017) Infant nephrolithiasis and nephrocalcinosis: natural history and predictors of surgical intervention. J Pediatr Urol 13(4):355.e1-355.e6

    Article  Google Scholar 

  25. Zafar MN, Ayub S, Tanwri H, Naqvi SAA, Rizvi SAH (2018) Composition of urinary calculi in infants: a report from an endemic country. Urolithiasis 46(5):445–452

    Article  CAS  PubMed  Google Scholar 

  26. Bastug F, Celik B (2021) Is medical treatment necessary for infants with small urinary stones? Urolithiasis. https://doi.org/10.1007/s00240-021-01248-4

    Article  PubMed  Google Scholar 

Download references

Funding

No financial support has been received for this study.

Author information

Authors and Affiliations

  1. Pediatric Nephrology, Adiyaman University Faculty of Medicine, Adiyaman, Turkey

    Gunes Isik

  2. Radiology, Elazig Fethi Sekin City Hospital, Elazığ, Turkey

    Pınar Gundogan Bozdag

Authors
  1. Gunes Isik
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pınar Gundogan Bozdag
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

GI designed the research and analyzed the data, GI and PGB conducted the study and drafted the paper. Both authors read and approved the final manuscript.

Corresponding author

Correspondence to Gunes Isik.

Ethics declarations

Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical approval

Approval for the study was obtained from the Local Ethical Committee of Elazig City Hospital (25.10.2022-11840).

Informed consent

Consent is given by the families of the participants.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Isik, G., Bozdag, P.G. Why is childhood urolithiasis increasing? Etiology, diagnosis and management: a single-center experience. J Nephrol 36, 1599–1604 (2023). https://doi.org/10.1007/s40620-023-01638-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40620-023-01638-4

Keywords

Search

Navigation