Skip to main content
SpringerLink
Log in

Pediatric urolithiasis: etiology, specific pathogenesis and medical treatment

  • Article
  • Published:
Urological Research Aims and scope Submit manuscript

Abstract

Pediatric urolithiasis is an endemic disease in certain parts of the world, namely Turkey and the Far East. As a recurrent pathology which may reveal functional as well and morphologic changes in the urinary tract, environmental factors together with urogenital abnormalities should be evaluated thoroughly in each patient. The aims of management should be complete clearance of stones, treatment of urinary tract infections, preservation of renal function and prevention of stone recurrence. In addition to certain minimally invasive stone removal procedures, treatment of pediatric urolithiasis requires a detailed metabolic evaluation in all patients on an individual basis. Obstructive pathologies have to be corrected immediately and children with a positive family history should be followed carefully with respect to a high likelihood of stone re-growth and recurrence. Although specific management of each metabolic abnormality seems to be the key factor in the medical management of stone disease, as general advice each child should be forced to adequate fluid intake which will reveal the urine volume increase in accordance with the body mass index. Moreover, medical therapeutic agents which increase urine citrate levels should be encouraged.

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

References

  1. Stapleton FB (1989) Nephrolithiasis in children. Pediatr Rev 11:21–30

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  3. Stapleton FB, McKay CP, Noe HN (1987) Urolithiasis in children: the role of hypercalciuria. Pediatr Ann 16:980–992

    PubMed  CAS  Google Scholar 

  4. Choi H, Snyder III HM, Duckett JW (1987) Urolithiasis in childhood: current management. J Pediatr Surg 72:158–164

    Article  Google Scholar 

  5. Gearhart JR, Herzberg GZ, Jeffs RD (1991) Childhood urolithiasis: experiences and advances. Pediatrics 87:445–450

    PubMed  CAS  Google Scholar 

  6. Polinsky MS, Kaiser BA, Baluarte HJ (1987) Urolithiasis in childhood. Pediatr Clin North Am;84:683–710

    Google Scholar 

  7. Ryall RL (1996) Glycosaminoglycans, proteins, and stone formation: adult themes and child’s play. Pediatr Nephrol 10:656–666

    Article  PubMed  CAS  Google Scholar 

  8. Parks JH, Coward M, Coe FL (1997) Correspondence between stone composition and urine saturation in nephrolithiasis. Kidney Int 51:894–900

    Article  PubMed  CAS  Google Scholar 

  9. Battino BS, DeFoor W, Coe F, Tackett L, Erhard M, Wacksman J et al (2002) Metabolic evaluation of children with urolithiasis: are adult references for supersaturation appropriate? J Urol 168:2568–2571

    Article  PubMed  CAS  Google Scholar 

  10. Kruse K, Kracht U, Kruse U (1984) Reference values for urinary calcium excretion and screening for hypercalciuria in children and adolescents. Eur J Pediatr 143:23–31

    Article  Google Scholar 

  11. DeSanto NG, DiIorio B, Capasso G, Paduano C, Stamler R, Langman CB et al (1992) Population based data on urinary excretion of calcium, magnesium, oxalate, phosphate and uric acid in children from Cimitile (southern Italy). Pediatr Nephrol 6:149–157

    Article  PubMed  CAS  Google Scholar 

  12. Ghazali S, Barratt TM (1974) Urinary excretion of calcium and magnesium in children. Arch Dis Child 45:97–101

    Google Scholar 

  13. Stapleton FB, Noe HN, Roy S III, Jerkins GR (1982) Hypercalciuria in children with urolithiasis. Am J Dis Child 136:675–678

    PubMed  CAS  Google Scholar 

  14. Stapleton FB, Noe HN, Jerkins GR, Roy S III (1982) Urinary excretion of calcium following an oral calcium-loading test in healthy children. Pediatrics 69:594–597

    PubMed  CAS  Google Scholar 

  15. Coe FL, Parks JH, Moore ES (1979) Familial idiopathic hypercalciuria. N Engl J Med 300:337–340

    Article  PubMed  CAS  Google Scholar 

  16. Stapleton FB (1990) Idiopathic hypercalciuria: association with isolated hematuria and risk for urolithiasis in children. Kidney Int 37:807–811

    Article  PubMed  CAS  Google Scholar 

  17. Dent CE, Friedman M (1964) Hypercalciuric rickets associated with renal tubular damage. Arch Dis Child 39:240–249

    PubMed  CAS  Google Scholar 

  18. Igarashi T, Hayakawa H, Shiraga H, Kawato H, Yan K, Kawaguchi H et al (1995) Hypercalciuria and nephrocalcinosis in patients with idiopathic low molecular weight proteinuria in Japan. Nephron 69:242–247

    Article  PubMed  CAS  Google Scholar 

  19. Furth SL, Casey JC, Pyzik PL, New AM, Docimo SG, Vining EPG et al (2000) Risk factors for urolithiasis in children on the ketogenic diet. Pediatr Nephrol 15:125–8

    Article  PubMed  CAS  Google Scholar 

  20. Herzberg GZ, Fivush BA, Kinsman SL, Gearhart JP (1990) Urolithiasis associated with the ketogenic diet. J Pediatr 117:743–745

    Article  PubMed  CAS  Google Scholar 

  21. Asplin JR (2002) Hyperoxaluric calcium nephrolithiasis. Endocrinol Metab Clin N Am 31:927–949

    Article  CAS  Google Scholar 

  22. Pietrow PK, Pope JC, Adams MC, Shyr Y, Brock III JW (2002) Clinical outcome of pediatric stone disease. J Urol 167:670–673

    Article  PubMed  Google Scholar 

  23. Kroovand RL (1997) Pediatric urolithiasis. Urol Clin North Am 24(1):173–185

    Article  PubMed  CAS  Google Scholar 

  24. Cohen TD, Ehreth J, King LR, Preminger GM (1996) Pediatric urolithiasis: medical and surgical management. Urology 47(3):292–305

    Article  PubMed  CAS  Google Scholar 

  25. Milliner DS, Murphy ME (1993) Urolithiasis in pediatric patients. Mayo Clin Proc 68:241–244

    PubMed  CAS  Google Scholar 

  26. Erbağcı A, Erbağcı BA, Yılmaz M, Yağcı F, Tarakçıoğlu M, Yurtseven C, Köylüoğlu O, Sarıca K (2003) Pediatric urolithiasis. Scand J Urol Nephrol 37:127–133

    Google Scholar 

  27. Rizvi SAH, Naqvi SAA, Hussain Z, Hashmi A, Hussain M, Zafar MN, Sultan S, Mehdi H (2002) Pediatric urolithiasis: developing nation perspectives. J Urol 168:1522–1525

    Article  PubMed  CAS  Google Scholar 

  28. Tefekli A, Esen T, Ziylan O, Erol B, Armağan A, Ander H, Akıncı M (1993) Metabolic risk factors in pediatric and adult calcium oxalate urinary stone formers: Is there any difference? Urol Int 70:273–277

    Article  CAS  Google Scholar 

  29. Noe HN (2000) Hypercalciuria and pediatric stone recurrences with and without structural abnormalities. J Urol part 2 164:1094–1096

    CAS  Google Scholar 

  30. Diamond DA, Menon M, Lee PH et al (1989) Etiological factors in pediatric stone recurrence. J Urol part 2 142:606–608

    CAS  Google Scholar 

  31. Hoppe B, Jahnen A, Bach D, Hesse A (1997) Urinary calcium oxalate saturation in healthy infants and children. J Urol 158:557–559

    Article  PubMed  CAS  Google Scholar 

  32. Drach GW (1995) Metabolic evaluation of pediatric patients with stones. Urol Clin North Am 22:95–102

    PubMed  CAS  Google Scholar 

  33. Stapleton B (1996) Clinical approach to children with urolithiasis. Semin Urol 16(5):389–397

    CAS  Google Scholar 

  34. Tekin A, Tekgül S, Atsu N, Şahin A, Özen H, Bakkaloğlu M (2000) A study of the etiology of idiopathic calcium urolithiasis in children. Hypocitraturia is the most important risk factor. J Urol 164:162–165

    Article  PubMed  CAS  Google Scholar 

  35. Perrone HC, dos Santos DR, Santos MV (1992) Urolithiasis in childhood: metabolic evaluation. Pediatr Nephrol 6:54–59

    Article  PubMed  CAS  Google Scholar 

  36. Pietrow PK, Pope JC, Adams MC, Shyr Y, Brock JW (2002) Clinical outcome of pediatric stone disease. J Urol 160:670–73

    Google Scholar 

  37. Özokutan BH, Küçükaydın M, Gündüz Z et al (2000) Urolithiasis in childhood. Pediatr Surg Int 16:60–63

    Article  PubMed  Google Scholar 

  38. Soygur T, Akbay A, Kupeli S (2002) Effect of potassium citrate therapy on stone recurrence and residual fragments after shockwave lithotripsy in lower caliceal calcium oxalate urolithiasis: a randomized controlled trial. J Endourol 16(3):149–152

    Article  PubMed  Google Scholar 

  39. Whalley NA, Meyers AM, Martins M, Margolius LP (1996) Long-term effects of potassium citrate therapy on the formation of new stones in groups of recurrent stone formers with hypocitraturia. Br J Urol 78(1):10–14

    PubMed  CAS  Google Scholar 

  40. Pak CYC, Fuller C, Sakhaee K et al (1985) Long-term treatment of calcium nephrolithiasis with potassium citrate. J Urol 134:11–14

    PubMed  CAS  Google Scholar 

  41. Barcelo B, Wahl O, Semitge E, Rousaud A, Pak CYC (1993) Randomized double-blind study on potassium citrate in idiopathic hypocitraturic calcium nephrolithiasis. J Urol 150:1761–1764

    PubMed  CAS  Google Scholar 

  42. Borghi L, Meschi T, Amato F, Briganti A, Navarini A, Giannini A (1996) Urine volume, water and recurrences in idiopathic calcium nephrolithiasis. A 5-year randomized prospective study. J Urol 155:839–843

    Article  PubMed  CAS  Google Scholar 

  43. Hoskin DH, Erickson SD, van der Berg CJ, Wilson DM, Smith LH (1983) The stone clinic effect in patients with idiopathic calcium nephrolithiasis. J Urol 13:1115–1118

    Google Scholar 

  44. Tekin A, Tekgul S, Atsu N, Bakkaloglu M, Kendi S (2002) Oral potassium citrate treatment for idiopathic hypocitruria in children with calcium urolithiasis. J Urol 168(6):2572–2574

    Article  PubMed  CAS  Google Scholar 

  45. Stapleton FB, Kroovand RL (1996) Stones in childhood. In: Coe FL, Favres MJ, Pak CYC, Parks JH, Preminger GM (eds) Kidney stones: medical and surgical management. Lippencott-Raven, Philadelphia, pp 1065–1080

    Google Scholar 

  46. Cohen TD, Ehreth J, King LR, Preminger GM (1996) Pediatric urolithiasis: medical and surgical management. Urology 47(3):292–305

    Article  PubMed  CAS  Google Scholar 

  47. Asplin JR (2002) Hyperoxaluric calcium nephrolithiasis. Endocrinol Metab Clin N Am 31:927–949

    Article  CAS  Google Scholar 

  48. Coulthard MG, Richardson J, Fleetwood A (1995) The treatment of cystinuria with captopril. Am J Kidney Dis 25:661–662

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Medical School, Þahinbey Medical Center, Department of Urology, University of Gaziantep, Gaziantep, Turkey

    K. Sarica

Authors
  1. K. Sarica
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K. Sarica.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sarica, K. Pediatric urolithiasis: etiology, specific pathogenesis and medical treatment. Urol Res 34, 96–101 (2006). https://doi.org/10.1007/s00240-005-0018-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-005-0018-0

Keywords

Search

Navigation