The clinical course of urolithiasis in children under 3 years of age
Languages of publication
Purpose: Certain risk factors of urolithiasis may be diagnosed in 75% of children with stones. They include genetic, anatomic, metabolic and nutrition causes. The diagnostics' evaluation should determine and rule out anatomic factors and establish metabolic disorders. The treatment is based on an increased fluid intake, and alterations in the nutrition pattern. The aim was to analyze the clinical course of urolithiasis in children below 3, and detect the possible factors affecting the success of therapy. Materials and methods: Between 2009 and 2013, we retrospectively investigated the cases of 68 children (34 boys and 34 girls) under 3 years who were treated in the clinic. Urolithiasis was diagnosed at the mean age of 10 months; the average follow-up lasted 26 months until reaching 3 years. The retrospective analysis was based on medical documentation and direct contact with parents. Results: Among the risk factors, the most common was hyperciuria. The treatment of children was based on an increased daily fluid intake and dietary recommendations. Among the specific treatments, the most common were citrates (51%). In the majority of cases, the therapy lasted over a year after the clinical absence of stones. This therapy was successful in 62% of children. The factors contributing to the success of the treatment were: a negative family history of urolithiasis, unilateral stones, normal urinalysis, decrease of the Ca/Cr index, and compliance of dietary and medical recommendations. Conclusions: The treatment is based on the elimination of risk factors, and alterations in the dietary pattern. High percentage of parents did not respect the medical recommendations.
- Baştuğ F, Düşünsel R. Pediatric urolithiasis: causative factors, diagnosis and medical management. Nat Rev Urol. 2012 Feb 7;9(3):138-46.
- Sas DJ. An update on the changing epidemiology and metabolic risk factors in pediatric kidney stone disease. Clin J Am Soc Nephrol. 2011 Aug;6(8):2062-8.
- Bik A, Aaslid A, Tkaczyk M. Retrospektywna analiza kliniczna kamicy dróg moczowych u dzieci do 3 roku życia. Med Og Nauk Zdr. 2013; 19(1): 21-4.
- Sarkissian A, Babloyan A, Arikyants N, Hesse A, Blau N, Leumann E. Pediatric urolithiasis in Armenia: a study of 198 patients observed from 1991 to 1999. Pediatr Nephrol. 2001 Sep;16(9):728-32.
- Alpay H, Ozen A, Gokce I, Biyikli N. Clinical and metabolic features of urolithiasis and microlithiasis in children. Pediatr Nephrol. 2009 Nov;24(11):2203-9.
- Sarica K. Pediatric urolithiasis: etiology, specific pathogenesis and medical treatment. Urol Res. 2006 Apr;34(2):96-101.
- Acar B, Inci Arikan F, Emeksiz S, Dallar Y. Risk factors for nephrolithiasis in children. World J Urol. 2008 26:627–30.
- Dursun I, Poyrazoglu HM, Dusunsel R, Gunduz Z, Gurgoze MK, Demirci D, Kucukaydin M. Pediatric urolithiasis: an 8-year experience of single Centre. Int Urol Nephrol. 2008;40(1):3-9.
- Gürgöze MK, Sarı MY. Results of medical treatment and metabolic risk factors in children with urolithiasis. Pediatr Nephrol. 2011 Jun;26(6):933-7.
- Ertan P, Tekin G, Oger N, Alkan S, Horasan GD. Metabolic and demographic characteristics of children with urolithiasis in Western Turkey. Urol Res. 2011 Apr;39(2):105-10.
- Ozgür BC, Irkilata L, Ekici M, Hoscan MB, Sarici H, Yücetürk CN, Karakan T, Atilla MK, Hasçiçek AM, Eroglu M. Pediatric extracorporeal shock wave lithotripsy: Multi-institutional results. Urologia. 2014 Feb 26.
- Baştuğ F1, Gündüz Z, Tülpar S, Poyrazoğlu H, Düşünsel R. Urolithiasis in infants: evaluation of risk factors. World J Urol. 2013 Oct;31(5):1117-22.
- Akhavan-Sepahi M, Sharifian M, Mohkam M, Vafadar M, Hejazi S. Biochemical Risk Factors for Stone Formation in Healthy School Children. Acta Med Iran. 2012;50(12):814-8.
- Porowski T, Kirejczyk JK, Konstantynowicz J, Kazberuk A, Plonski G, Wasilewska A, Laube N. Correspondence between Ca2+ and calciuria, citrate level and pH of urine in pediatric urolithiasis. Pediatr Nephrol. 2013 Jul;28(7):1079-84.
- Zawadzki J. Kamica układu moczowego u dzieci. Med Prakt Pediatr. 2013/03
- Alon US. Medical treatment of pediatric urolithiasis. Pediatr Nephrol. 2009 Nov;24(11):2129-35.
- Curhan GC, Willett WC, Rimm EB, Spiegelman D, Stampfer MJ. Prospective study of beverage use and the risk of kidney stones. Am J Epidemiol. 1996 Feb 1;143(3):240-7.
- Osorio AV, Alon US. The relationship between urinary calcium, sodium and potassium excretion and the role of potassium in treating idiopathic hypercalciuria. Pediatrics. 1997 Oct;100(4):675-81.
- Borghi L, Schianchi T, Meschi T, Guerra A, Allegri F, Maggiore U, Novarini A. Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med. 2002 Jan 10;346(2):77-84.
- Lotan Y, Buendia Jiménez I, Lenoir-Wijnkoop I, Daudon M, Molinier L, Tack I, Nuijten MJ. Increased water intake as a prevention strategy for recurrent urolithiasis: major impact of compliance on cost-effectiveness. J Urol. 2013 Mar;189(3):935-9.
- Escribano J, Balaguer A, Roqué i Figuls M, Feliu A, Ferre N. Dietary interventions for preventing complications in idiopathic hypercalciuria. Cochrane Database Syst Rev. 2014 Feb 11;2:CD006022
Publication order reference