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Educational review: role of the pediatric nephrologists in the work-up and management of kidney stones

  • Educational Review
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Abstract

Background

The incidence of nephrolithiasis in children and adolescents is increasing and appears to double every 10 years. The most important role of the pediatric nephrologist is to diagnose and modify various metabolic and non-metabolic risk factors, as well as prevent long-term complications especially in the case of recurrent nephrolithiasis.

Objective

The purpose of this review is to summarize the existing literature on the etiology and management of pediatric nephrolithiasis.

Results

The incidence of kidney stones is increasing; dietary and environmental factors are probably the main causes for this increased incidence. In most pediatric patients, the etiology for the kidney stones can be identified. Metabolic factors, such as hypercalciuria and hypocitraturia, urinary tract infection, and urinary stasis, constitute leading causes. Herein, we review the etiologies, diagnostic work-up, and treatment options for the most prevalent causes of kidney stones. The detrimental effects of excessive dietary sodium, reduced fluid intake, and the benefits of plant-based over animal-based protein consumption on urinary crystal formation are discussed. We also review the long-term complications.

Conclusions

Pediatric nephrologists have an important role in the diagnostic work-up and prevention of recurring nephrolithiasis.

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Authors and Affiliations

  1. Department of Pediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, N6A 5W9, Canada

    Carmen Inés Rodriguez Cuellar & Guido Filler

  2. Instituto Nacional de Pediatría, 04530, Ciudad de México, Mexico

    Carmen Inés Rodriguez Cuellar

  3. Universidad Autónoma de México, 04530, Ciudad de México, Mexico

    Carmen Inés Rodriguez Cuellar

  4. Lilibeth Caberto Kidney Clinical Research Unit, London Health Sciences Centre; and Department of Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, N6A 5W9, Canada

    Carmen Inés Rodriguez Cuellar & Guido Filler

  5. Department of Surgery, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, N6A 5W9, Canada

    Peter Zhan Tao Wang

  6. Department of Pediatrics, Division of Pediatric Nephrology, University of Miami Miller School of Medicine, Miami, FL, USA

    Michael Freundlich

  7. Department of Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, N6A 5W9, Canada

    Guido Filler

  8. Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N5A 5A5, Canada

    Guido Filler

  9. Children’s Health Research Institute, University of Western Ontario, London, Ontario, N6C 2V5, Canada

    Guido Filler

  10. Children’s Hospital, London Health Science Centre, University of Western Ontario, 800 Commissioners Road East, London, ON, N6A 5W9, Canada

    Guido Filler

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  1. Carmen Inés Rodriguez Cuellar
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  2. Peter Zhan Tao Wang
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  3. Michael Freundlich
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  4. Guido Filler
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Correspondence to Guido Filler.

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1. e; 2. b; 3. b; 4. d; 5. d

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Rodriguez Cuellar, C.I., Wang, P.Z.T., Freundlich, M. et al. Educational review: role of the pediatric nephrologists in the work-up and management of kidney stones. Pediatr Nephrol 35, 383–397 (2020). https://doi.org/10.1007/s00467-018-4179-9

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  • DOI: https://doi.org/10.1007/s00467-018-4179-9

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