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Demographic characteristics and metabolic risk factors in Croatian children with urolithiasis

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Abstract

The aim of this study was to assess demographic data, clinical presentation, metabolic features, and treatment in 76 children with urolithiasis presented from 2002 to 2011. Urolithiasis is responsible for 2.5/1,000 pediatric hospitalizations, with new cases diagnosed in 1.1/1,000 admissions. From the observed period, two-fold rise of incidence rate was observed. Compiling the data from other pediatric institutions in our country, we estimated present overall incidence rate in Croatia as 6.5/100,000 children under 18 years. There were 41 boys and 35 girls (ratio 1.17:1). The mean age at diagnosis was 9.7 (range 0.8–16) years and follow-up duration was 5.3 (range 1.8–10) years. Renal colic (75.0 %) and hematuria (57.89 %) were the main symptoms. In 65.78 % of children, stones were unilateral. Stones were located in kidney in 52.63 %, in the ureter in 26.32 %, and in bladder in 6.58 % cases. Stone analysis showed calcium oxalate in 75.0 % of the cases. Associated urinary tract abnormalities were found in 19.73 % children. Most common metabolic disturbances were hypercalciuria (47.37 %) and idiopathic or mild hyperoxaluria (18.42 %). Urine saturation (EQUIL2) was elevated in 61.84 % cases. Spontaneous stone evacuation occurred in 51.21 % children. Extracorporeal shock wave lithotripsy, surgical evacuation, and endoscopic removal of calculi were performed in 21.0, 6.58, and 5.26 % of cases, respectively. Follow-up conservative therapy, consisting of fluid/diet recommendations and additional potassium citrate and/or chlorothiazide in children with increased risk, was sufficient for stone recurrence prevention in 92.1 % of children. In conclusion, the study gave insight in epidemiology and metabolic disturbances of urinary stone disease in Croatian children.

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Conflict of interest

We, the authors, declare that we do not received financial support from any organization for this article.

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Authors and Affiliations

  1. University Children’s Hospital, University of Zagreb School of Medicine and Clinical Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia

    Danko Milošević, Danica Batinić & Danko Batinić

  2. University Clinic for Anesthesiology and Intensive Care, University of Zagreb School of Medicine and Clinical Hospital Center Zagreb, Zagreb, Croatia

    Marija Topalović-Grković

  3. University Children’s Hospital, University of Zagreb School of Medicine, Kišpatićeva 12, 10000, Zagreb, Croatia

    Daniel Turudić & Ivan Pavao Gradiški

Authors
  1. Danko Milošević
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  2. Danica Batinić
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Correspondence to Danko Milošević.

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Milošević, D., Batinić, D., Turudić, D. et al. Demographic characteristics and metabolic risk factors in Croatian children with urolithiasis. Eur J Pediatr 173, 353–359 (2014). https://doi.org/10.1007/s00431-013-2165-6

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  • DOI: https://doi.org/10.1007/s00431-013-2165-6

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