Abstract
Objective
The objective was to investigate the clinical features and metabolic and anatomic risk factors for kidney stone formation in our patient group.
Methods
Between 1998 and 2005, 179 children (94 girls, 85 boys) followed in our department because of urolithiasis were enrolled to participate in our study. Clinical presentation, urinary tract infection, stone localisation, positive family history, stone composition, presence of anatomic abnormalities and urinary metabolic risk factors, and treatment modality were evaluated retrospectively.
Results
The mean age at diagnosis of stone disease was 4.5 years (range 0.25–15.3 years). The mean follow-up duration was 8 months (range 1–98). The major clinical presentations of our patients were abdominal pain and/or flank pain in 100 children (55.9%) and macroscopic hematuria in 25 (14%). Urinary tract infection was detected in 20% of patients on admission. Forty-three children (24%) had a urinary tract abnormality and ureteropelvic junction obstruction was the most common abnormality. A family history of stone disease was recorded in 98 patients (54.7%). Stones were located within the renal parenchyma in 90 patients. Hypercalciuria and hyperuricosuria were detected in 42.3 and 54.8% respectively. Stone analysis was performed in 63 children and calcium oxalate was a major mineral. Surgical treatment was performed in 49 children and extracorporeal shock wave lithotripsy (ESWL) in 41 children.
Conclusion
We think that urolithiasis remains a serious problem in children in our country. Family history of urolithiasis, urologic abnormalities (especially under the age of 5 years), metabolic disorders and urinary tract infections tend to indicate childhood urolithiasis.
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References
Elder JS (2000) Urinary lithiasis. In: Behrman ER, Kliegman MR, Jenson BH (eds) Nelson textbook of pediatrics, 16th edn. Saunders, Philadelphia, pp 1655–1658
Remzi D, Çakmak F, Erkan I (1980) A study on urolithiasis incidence in school age children. J Urol 123:608–610
Turkey National Hemodialysis, Transplantation and Nephrology Registry Report of Turkey 2003. Istanbul 2004, 38. Webpage: http://www.tsn.org.tr/registry/Registry_2003_Tr_Eng.pdf
Stapleton FB (1996) Clinical approach to children with urolithiasis. Semin Nephrol 16:389–397
Ghazali S, Barratt TM (1974) Urinary excretion of calcium and magnesium in children. Arch Dis Child 49:97–101
Stapleton FB, Noe HN, Jenkis G et al (1982) Urinary excretion of calcium following an oral calcium loading test in healthy children. Pediatrics 69:594–597
Milliner DS (2004) Urolithiasis. In: Avner ED, Harman WE, Niaudet P (eds) Pediatric nephrology, 5th edn. Lippincott Williams & Wilkins, Philadelphia, pp 1091–1112
Edvardsson V, Elidottir H, Indrıdason OS, Palsson R (2005) High incidence of kidney stones in Icelandic children. Pediatr Nephrol 20:940–944
Ozokutan BH, Kucukaydın M, Gunduz Z, Kabaklioglu M, Okur H, Turan C (2000) Urolithiasis in childhood. Pediatr Surg Int 16:60–63
Erbagcı A, Erbagcı AB, Yılmaz M et al (2002) Pediatric urolithiasis. Evaluation of risk factors in 95 children. Scand J Urol Nephrol 37:129–133
Faerber GJ (2001) Pediatric urolithiasis. Curr Opin Urol 11:385–389
Sternberg K, Greenfield SP, Williot P, Wan J (2005) Pediatric stone disease: an evolving experience. J Urol 174:1711–1714
Biyikli NK, Alpay H, Guran T (2005) Hypercalciuria and recurrent urinary tract infections: incidence and symptoms in children over 5 years of age. Pediatr Nephrol 20:1435–1438
Sinno K, Boyce WH, Resnick MI (1979) Childhood urolithiasis. J Urol 121:662–664
Tekin A, Tekgul S, Atsu N, Sabin A, Ozen H, Bakkaloglu M (2000) A study of the etiology of idiopathic calcium urolithiasis in children: hypocitraturia is the most important factor. J Urol 164:162–165
Tuncbilek E (1997) Genetic services in Turkey. Eur J Hum Genet 5 [Suppl 2]:178–182
Hulton SA (2001) Evaluation of urinary tract calculi in children. Arch Dis Child 84:320–323
Pak CYC, Poindexter JR, Huet BA, Paerle MS (2003) Predictive value of kidney stone composition in the detection of metabolic abnormalities. Am J Med 115:26–32
Milliner DS, Murphy ME (1993) Urolithiasis in pediatric patients. Mayo Clin Proc 68:241–248
Polinsky MS, Kaiser BA, Baluerte HJ (1987) Urolithiasis in childhood. Pediatric Clin N Am 34:683–710
Neuhaus TJ, Belzer T, Blau N et al (2000) Urinary oxalate excretion in Urolithiasis and nephrocalcinosis. Arch Dis Child 83:322–326
Pietrow PK, Pope JCI, Adams MC, Shyr Y, Brock JWI (2002) Clinical outcome of pediatric stone disease. J Urol 167:670–673
Choi H, Synder HM, Duckett JW (1987) Urolithiasis in childhood: current management. J Pediatr Surg 22:158–164
Malek RS, Kelalis PP (1975) Pediatric nephrolithiasis. J Urol 113:545–551
Noe HN, Stapleton FB, Jerkins GR, Roy S (1983) Clinical experience with pediatric urolithiasis. J Urol 129:1166–1168
Selimoglu MA, Alp H, Bitlisli H, Orhan Z, Energin M, Karakelleoglu C (1998) Urinary calcium excretion of children living in east region of Turkey. Turk J Pediatr 40:399–404
Lampel DS, Lampel A (2001) The surgical management of stones in children. BJU Int 87:732–740
Demirci D, Altıok E, Gülmez I, Ekmekcioglu O, Poyrazoglu MH (2006) Stepwise shock wave lithotripsy: results of initial study for the treatment of urinary stones in childhood. Int Urol Nephrol 38:189–192
Jayanthi VR, Arnold PM, Koff SA (1999) Strategies for managing upper tract calculi in young children. J Urol 162:1234
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Dursun, I., Poyrazoglu, H.M., Dusunsel, R. et al. Pediatric urolithiasis: an 8-year experience of single centre. Int Urol Nephrol 40, 3–9 (2008). https://doi.org/10.1007/s11255-007-9234-6
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DOI: https://doi.org/10.1007/s11255-007-9234-6