International Urology and Nephrology

, Volume 42, Issue 2, pp 471–475 | Cite as

Clinical and metabolic risk factor evaluation in young adults with kidney stones

  • Francisco R. Spivacow
  • Armando L. NegriEmail author
  • Elisa E. del Valle
  • Irene Calviño
  • José R. Zanchetta
Nephrology - Original Paper



The most frequent urine metabolic risk factor in adults is idiopathic hypercalciuria while in children is hypocitraturia. If there is really a change of metabolic abnormalities with age it would be interesting to study risk factors in the intermediate population: young adults.


We evaluated metabolic risk factors, clinical presentation and family history of stone formers between 17 and 27 years old.


A total of 160 patients (87 males and 73 females) were studied with a standard protocol.


A single urine metabolic risk factor was present in 64% of the patients, and multiple risk factors were present in 27% of them. No metabolic abnormalities were found in the remaining 9%. The most common urine risk factor was idiopathic hypercalciuria (alone or in combination), which was identified in 42.5% followed by hypocitraturia (alone or in combination) found in 32.9% of the patients. In the subgroup of patients of 17–20 years (n = 75; mean age of 18.8 ± 1.0 years), hypocitraturia (alone or in combination) was as frequent as idiopathic hypercalciuria (alone or in combination), which was identified in 38% (n = 30) and 36.7% (n = 29), respectively. The most frequent form of presentation was renal colic (72%). A positive family history of stone disease in first degree and second-degree relatives was found in 32.9 and 34.1%, respectively.


Metabolic abnormalities were found in 91% of young adults with renal lithiasis, similar to our adult series. Hypercalciuria was the most frequent metabolic abnormality found. Yet, hypocitraturia (alone or in combination) was very frequent, and in the subgroup of patients of 17–20 years, it was as frequent as idiopathic hypercalciuria, similar to what we found in children.


Renal lithiasis Metabolic risk factors Hypocitraturia Hypercalciuria Young adults 


  1. 1.
    Barilla SE, Zerwekh JE, Pak CYC (1979) A critical evaluation of the role of phosphate in the pathogenesis of absorptive hypercalciuria. Min Electolyte Metab 2:302Google Scholar
  2. 2.
    Pak CYC, Britton F, Peterson R, Ward D, Northcutt C, Breslau NA, McGuire J, Sakhace K, Bush S, Nicar M, Norman D, Peters P (1980) Ambulatory evaluation of nephrolithisis: classification, clinical presentation and diagnostic criteria. Am J Med 69:19–30CrossRefPubMedGoogle Scholar
  3. 3.
    del Valle EE, Spivacow FR, Zanchetta JR (1995) Metabolic evaluation at the time of the first renal lithiasis episode. Medicina (Bs As) 55(1):69–74Google Scholar
  4. 4.
    Tefekli A, Esen T, Ziylan O, Erol B, Armagan A, Ander H, Akinci M (2000) Metabolic risk factors in pediatric and adult calcium oxalate urinary stone formers: is there any difference? Urol Int 459:1–10Google Scholar
  5. 5.
    VanDrvoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M, Trachman H (2007) Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol 77(6):2300–2305CrossRefGoogle Scholar
  6. 6.
    Smith LH (1989) The medical aspects of urolithiasis: an overview. J Urol 141:707PubMedGoogle Scholar
  7. 7.
    Borghi L, Ferretti PP, Elia GF, Amato F, Melloni E, Trapassi MR, Novarini A (1990) Epidemiological study of urinary tract stones in a Northern Italian City. Br J Urol 65:231CrossRefPubMedGoogle Scholar
  8. 8.
    Vahlensieck EW, Bach D, Hesse A (1982) Incidence, prevalence mortality of urolithiasis in the German Federal Republic. Urol Res 10:161PubMedGoogle Scholar
  9. 9.
    Serio A, Fraioli A (1999) Epidemiology of nephrolithiasis. Nephron 81(suppl 1):26CrossRefPubMedGoogle Scholar
  10. 10.
    Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63:1817CrossRefPubMedGoogle Scholar
  11. 11.
    Soucie JM, Thon MJ, Coates RJ, McClellan W, Austin H (1994) Demographic and geographic variability of kidney stones in the United States. Kidney Int 46:893CrossRefPubMedGoogle Scholar
  12. 12.
    Trinchieri A, Coppi F, Montanari E, Del Nero A, Zanetti G, Pisani E (2000) Increase in the prevalence of symptomatic upper urinary tract stones during de last ten years. Eur Urol 37(1):23–25CrossRefPubMedGoogle Scholar
  13. 13.
    Ljunghall S, Hedstrand H (1975) Epidemiology of renal stones in a middle-aged male population. Acta Med Scand 197(6):439–445PubMedGoogle Scholar
  14. 14.
    Tellaloğlu S, Ander H (1984) Stones in children. Turk J Ped 26:51–54Google Scholar
  15. 15.
    Edvardsson V, Elidottir H, Indridason O, Palsson R (2005) High incidence of kidney stones in icelandic children. Pediatr Nephrol 20(7):940–944CrossRefPubMedGoogle Scholar
  16. 16.
    Brown J (2006) Diagnosis and treatment patterns for renal colic in US Emergency departments. Int Urol Nephrol 38:87–92CrossRefPubMedGoogle Scholar
  17. 17.
    Levy FL, Adams-Huet B, Pak CYC (1995) Ambulatory evaluation of nephrolithiasis: an update of a 1980 protocol. Am J Med 98:50–59CrossRefPubMedGoogle Scholar
  18. 18.
    Weisinger JR, Bellorín-Font E (1995) Experiencia Latino–Americana em Litíase Renal Venezuela. En: Schor N, Pfeferman Heilberg I (eds) Calculose renal. Fisiopatologia, Diagnóstico.Tratamiento. Sarvier, Sao Paulo, pp 354–359Google Scholar
  19. 19.
    Spivacow FR, Negri AL, del Valle EE, Calviño I (2008) Fradinger, and Zanchetta JR metabolic risk factors in children with kidney stone disease. Pediatr Nephrol 32:1129–1133CrossRefGoogle Scholar
  20. 20.
    Kalorin CM, Zabinski A, Okpareke I, White M, Kogan BA (2009) Pediatric urinary stone disease—does age matter? J Urol 181(5):2267–2271CrossRefPubMedGoogle Scholar
  21. 21.
    Zanchetta JR, Plotkin H, Alvarez Filgueira ML (1995) Bone mass in children: normative values for the 2–20-year-old population. Bone 6(4 Suppl):393S–399SGoogle Scholar
  22. 22.
    Ferretti JL, Capozza RF, Cointry GR, García SL, Plotkin H, Alvarez Filgueira ML, Zanchetta JR (1998) Gender-related differences in the relationship between densitometric values of whole-body bone mineral content and lean body mass in humans between 2 and 87 years of age. Bone 22(6):683–690CrossRefPubMedGoogle Scholar
  23. 23.
    Churchill DN, Maloney CM, Nolan R, Gault MH (1980) Winsor G pediatric urolithiasis in the 1970 s. J Urol 123:237–238PubMedGoogle Scholar
  24. 24.
    Milliner DS, Murphy ME (1993) Urolithiasis in pediatric patients. Mayo Clinic Proceed 68:241–248Google Scholar
  25. 25.
    Stapleton FB, McKay CP, Noe HN (1987) Urolithiasis in children: the role of hypercalciuria. Pediatr Ann 16:980–981PubMedGoogle Scholar
  26. 26.
    Polito C, La Manna A, Nappi B, Villani J, Di Toro R (2000) Idiopathic hypercalciuria and hyperuricosuria: family prevalence of nephrolithiasis. Pediatr Nephrol 14:1102–1104CrossRefPubMedGoogle Scholar
  27. 27.
    Dursum I, Poyrazoglu HM, Dusunsel R, Gunduz Z, Gurgoze MK, Demirci D, Kucukaydin M (2008) Pediatric urolithiasis: an 8-year experience of single centre. Int Urol Nephrol 40(1):3–9CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, B.V. 2009

Authors and Affiliations

  • Francisco R. Spivacow
    • 1
  • Armando L. Negri
    • 1
    Email author
  • Elisa E. del Valle
    • 1
  • Irene Calviño
    • 1
    • 2
  • José R. Zanchetta
    • 1
  1. 1.Instituto de Investigaciones Metabólicas, Universidad del SalvadorBuenos AiresArgentina
  2. 2.Nephrology SectionHospital General de Agudos “Juan A Fernandez”Buenos AiresArgentina

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