Abstract
The incidence of urolithiasis in infants is unknown. The aim of this study was to investigate clinical characteristics, nutrition, calcium, phosphate, 25-hydroxyvitamin D (25(OH)D), alkaline phosphate, and parathyroid hormone in infants with urolithiasis. There were 32 infants (23 boys and 9 girls) of the mean age of 6.4 ± 3.7 months (range 2–12 months), with diagnosis of urolithiasis enrolled into the study. Boys were younger than girls (5.3 vs. 9.1 months, respectively; p < 0.05). The infants were receiving prophylactic vitamin D3. Twenty-one of them were fed with milk formula, 9 were breastfed, and 2 were on a mixed diet. The major clinical symptoms consisted of irritability in 19 (59%) and urinary tract infection in 6 (19%) infants. Hypercalcemia and hyperphosphatemia were detected in the serum in 30 (94%) and 19 (60%) infants, respectively. The serum calcium level was higher in boys than girls (10.8 vs. 9.8 mg/dL, respectively; p < 0.05). Four (12.5%) infants had increased activity of alkaline phosphatase. The serum level of 25(OH)D was high in 3 (9%), low in 2 (6%), and normal in 27 (85%) infants. Parathyroid hormone was low in eight (25%) infants. Hypercalciuria and hyperphosphaturia were found in 11 (34%) boys and 8 (25%) girls. Family history of urolithiasis was positive in eight (25%) infants. We conclude that urolithiasis occurs in infancy more often in boys fed with milk formula and in those who received vitamin D supplementation. Hypercalcemia, hyperphosphatemia, and hypercalciuria are the most common changes present in clinical metabolic tests.
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References
Ammenti A, Neri E, Agistri R, Beseghi U, Bacchini E (2006) Idiopathic hypercalciuria in infants with renal stones. Pediatr Nephrol 21(12):1901–1903
Dinour D, Beckerman P, Ganon L, Tordjaman K, Eisenstein Z, Holtzman EJ (2013) Loss-of–function mutations of CYP24A1, the vitamin D 24–hydroxylase gene, cause long–standing hypercalciuric nephrolitiasis and nephrocalcinosis. J Urol 190(2):552–557
Ergon EY, Akil İO, Taneli F, Oran A, Ozyurt BC (2017) Etiologic risk factors and vitamin D receptor gene polymorphisms in under one–year–old infants with urolithiasis. Urolithiasis 46(4):349–356
Fallahzadeh MH, Zare J, GH A–H, Derakhshan A, Basiratnia M, Arasteh MM, Fallahzadeh MA, Fallahzadeh MK (2012) Elevated serum levels of Vitamin D in infants with urolithiasis. Iran J Kidney Dis 6(3):186–191
Gigante M, Santangelo L, Diella S, Caridi G, Argentiero L, D’Alessandro MM, Martino M, Stea ED, Ardissino G, Carbone V, Pepe S, Scrutinio D, Maringhini S, Ghiggeri GM, Grandaliano G, Giordano M, Gesualdo L (2016) Mutational spectrum of CYP21A1 gene in a cohort of Italian patients with idiopathic infantile hypercalcemia. Nephron 133(3):193–204
Habbig S, Beck BB, Hoppe B (2011) Nephrocalcinosis and urolithiasis in infants. Kidney Int 80(12):1278–1291
Hesse A (2005) Reliable data from diverse regions of the world exist to show that there has been a steady increase in the prevalence of urolithiasis. World J Urol 23:302–303
Holick MF, Binkley NC, Bischoff–Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM, Endocrine Society (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930
Hoppe B, Kemper MJ (2010) Diagnostic examination of the child with urolithiasis or nephrocalcinosis. Pediatr Nephrol 25:403–413
IOM (2011) Dietary reference intakes for calcium and vitamin D. Institute of Medicine of the US National Academy of Sciences. The National Academic Press, Washington, DC
Jobs K, Straż-Żebrowska E, Placzyńska M, Zdanowski R, Kalicki B, Lewicki S, Jung A (2014) Interleukin–18 and NGAL in assessment of ESWL treatment safety in infants with urolithiasis. Cent Eur J Immunol 39(3):384–391
Ketha H, Wadams H, Lteif A, Singh RJ (2015) Iatrogenic vitamin D toxicity in an infant – a case report and review of literature. J Steroid Biochem Mol Biol 148:14–18
López M, Hoppe B (2010) History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol 25(1):49–59
Marzuillo P, Guarino S, Apicella A, La Manna A, Polito C (2017) Why we need a higher suspicion index of urolithiasis in infants. J Pediatr Urol 13(2):164–171
Milliner DS, Murphy ME (1993) Urolithiasis in pediatric patients. Mayo Clin Proc 68:241–248
Nesterova G, Malicdan MC, Yasuda K, Sakaki T, Vilboux T, Ciccone C, Horst R, Huang Y, Golas G, Introne W, Huizing M, Adams D, Boerkoel CF, Collins MT, Gahl WA (2013) 1,25–(OH)2D–24 hydroxylase (CYP24A1) deficiency as a cause of nephrolithiasis. Clin J Am Soc Nephrol 8(4):649–657
Pludowski P, Holick MF, Grant WB, Konstantynowicz J, Mascarenhas MR, Haq A, Povoroznyuk V, Balatska N, Barbosa AP, Karonova T, Rudenka E, Misiorowski W, Zakharova I, Rudenka A, Łukaszkiewicz J, Marcinowska–Suchowierska E, Łaszcz N, Abramowicz P, Bhattoa HP, Wimalawansa SJ (2018) Vitamin D supplementation guidelines. J Steroid Biochem Mol Biol 175:125–135
Skalova S, Lutilek S (2006) High urinary N–Acetyl–beta–d–glokosaminidase activity and normal calciuria in infants with nocturnal enuresis. Indian Pediatr 43:655–656
Tang J, Chonchol MB (2013) Vitamin D and kidney stone disease. Curr Opin Nephrol Hypertens 22(4):383–389
Unal AD, Tarcin O, Parildar H, Cigerli O, Eroglu H, Nilgun Guvener Demirag NG (2014) Vitamin D deficiency is related to thyroid antibodies in autoimmune thyroiditis. Cent Eur J Immunol 39(4):493–497
Van’t Hoff WG (2004) Aetiological factors in paediatric urolithiasis. Nephron Ciln Pract 98:c45–c48
Walther PC, Lamm D, Kaplan GW (1980) Pediatric urolithiasis: a ten–year review. Pediatrics 65:1068–1072
Weigert A, Hoppe B (2018) Nephrolithiasis and nephrocalcinosis in childhood–risk factor–related current and future treatment options. Front Pediatr 6:98
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
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The authors declare that they have no conflicts of interest in relation to this article.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all parents/guardians of all the individual participants included in the study.
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Szmigielska, A., Pańczyk-Tomaszewska, M., Borowiec, M., Demkow, U., Krzemień, G. (2019). Vitamin D and Calcium Homeostasis in Infants with Urolithiasis. In: Pokorski, M. (eds) Advances in Medicine and Medical Research. Advances in Experimental Medicine and Biology(), vol 1133. Springer, Cham. https://doi.org/10.1007/5584_2018_310
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DOI: https://doi.org/10.1007/5584_2018_310
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