Current Trends, Evaluation, and Management of Pediatric Nephrolithiasis

Hernandez, Joel D.; Ellison, Jonathan S.; Lendvay, Thomas S.

doi:10.1001/jamapediatrics.2015.1419

Cited by 100 publications

(83 citation statements)

References 75 publications

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“…Mixed calcium oxalate and calcium phosphate are present in more than 10% and magnesium ammonium phosphate (infection related) stone is reported in more than 17% of patients (33,36,37).…”

Section: Clinical Presentationmentioning

confidence: 99%

“…The risk of recurrence is more common in patients aged less than ten years, for whom a metabolic disorder is common (34,35). Among them, hypercalciuria, hyperuricosuria and cystinuria make 34 to 50%, 20% and 20% of metabolic abnormalities, respectively in pediatric nephrolithiasis (36)(37)(38). In the recurrence of nephrolithiasis, we need to evaluate the patients for inherited disorder such as PH, cystinuria, Dent disease and familial hypomagnesemia (20,39).…”

Section: Risk Factors and Causes Of Nephrolithiasismentioning

confidence: 99%

“…Hematuria, microscopic or macroscopic can occur in up to 90% of cases. In addition, urinary infection (UTI) in children less than five years old could be the main presentation (36). Nonspecific and localized pain is typical of infants and young children with nephrolithiasis.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…However, the size and location of stone must be considered seriously as a stone less than 4 mm has a chance to pass spontaneously in all patients. In children, renal stones pass spontaneously in 50% of cases (36,58). In this situation, conservative management may be enough.…”

Section: Acute Managementmentioning

confidence: 99%

“…Previous studies demonstrated that in children, the stone with a size more than 5 mm rarely passes spontaneously. Different studies revealed that about 22% of patients would need surgical therapeutic approach during the next six months after initiation of disease (36,61,63). The choice of each procedure depends on patient's characteristic.…”

Section: Surgical Managementmentioning

confidence: 99%

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Pediatric Nephrolithiasis: Trend, Evaluation and Management: A Systematic Review

Moudi¹,

Ghaffari²,

Moradi

2016

J Pediatr Rev

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Context: Pediatric nephrolithiasis is a noticeable cause of morbidity among children. Although, nephrolithiasis is a common disease in adults, its incidence has had a rising trend in children.Objectives: Here in, we reviewed the current state regarding evaluation and management of children with nephrolithiasis in the last decade. Data Sources: The current literature regarding incidence and trend, along with diagnostic evaluation and management of children aged less than 18 years old with nephrolithiasis was searched on MEDLINE and Google scholar from January 2005 to March 2016. Study Selection and Data Extraction:The search terms included, "kidney stone OR nephrolithiasis OR urolithiasis and Pediatric OR children". English language and human studies were included. Expert opinions, editorials and case reports were excluded. Consequently, the authors independently reviewed the abstracts and the papers, which matched the inclusion criteria.Results: From a total of 1050 studies identified through the database search, 71 articles were selected for the review. According to the results of this review, pediatric nephrolithiasis has an increasing rate worldwide. Recent studies in this regard indicated that the number of girls with nephrolithiasis has increased. The change of life style, diet, obesity and metabolic syndrome and popular imaging study along with referral of the patients to pediatric centers could be contributed to this trend. Conclusions:Evaluation of patients, particularly young children, includes metabolic assessment. Stone analysis and 24-urine collection analysis are very helpful for determining underlying diseases. Medical as well as surgical approaches are used to prevent kidney injuries.Keywords: Nephrolithiasis, Children, Incidence, Management ContextOver the past decades, the prevalence of pediatric nephrolithiasis has increased by 70% in adults and has become the third top urinary tract disease, and the gender gap between males and females is narrowing in many countries, as about 10% and 5% of males and females, respectively, complain of this condition during their life (1-3). Sas et al. (4) reported in their study that during the last couple of decades, the incidence of pediatric nephrolithiasis has increased by approximately 6 to 10% annually and has actually reached 50 per 100000 in adolescents.This situation may cause some complications and has subsequent health care and medical costs. Pearle et al. (5) estimated that more than two billion dollars is incurred annually for nephrolithiasis in the United States. This condition causes further chronic conditions requiring health care services in pediatric medicine. Moreover, recent studies revealed that this disorder has a genderrelated distribution in this context by more inclination toward nephrolithiasis. In addition, race and geographic location may play a role in nephrolithiasis development. African countries have low prevalence and the Middle East, Pakistan and India have higher incidence of urolithiasis (6, 7). ObjectivesThis review...

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“…Mixed calcium oxalate and calcium phosphate are present in more than 10% and magnesium ammonium phosphate (infection related) stone is reported in more than 17% of patients (33,36,37).…”

Section: Clinical Presentationmentioning

confidence: 99%

Section: Risk Factors and Causes Of Nephrolithiasismentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Acute Managementmentioning

confidence: 99%

Section: Surgical Managementmentioning

confidence: 99%

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Pediatric Nephrolithiasis: Trend, Evaluation and Management: A Systematic Review

Moudi¹,

Ghaffari²,

Moradi

2016

J Pediatr Rev

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Atorvastatin inhibits renal inflammatory response induced by calcium oxalate crystals via inhibiting the activation of TLR4/NF‐κB and NLRP3 inflammasome

et al. 2020

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This study aimed to investigate the renal protective effect of atorvastatin (ATV) on the kidney inflammation induced by calcium oxalate (CaOx) crystals. A cell model of cell‐crystal interactions and a rat model of CaOx kidney stone were established. The expressions of TLR4, NF‐κB, NLRP3, and cleaved caspase‐1 in cells and rat kidney tissues were detected using Western blot, immunohistochemical, and/or immunofluorescence. The concentrations of malondialdehyde (MDA), superoxide dismutase (SOD), reactive oxygen species (ROS) in cells, and lactic acid dehydrogenase (LDH) in the culture medium were measured. The secreted levels of interleukin (IL)‐1β, IL‐18, IL‐6, and tumor necrosis factor‐α (TNF‐α) were examined by ELISA. The serum levels of creatinine (CRE) and blood urea nitrogen (BUN) were measured. von Kossa staining was used for the evaluation of renal lens deposition. The CaOx model group showed significantly decreased SOD level; increased concentrations of MDA; ROS and LDH; elevated expressions of TLR4, NF‐κB, NLRP3, and cleaved caspase‐1; and the elevated release of IL‐1β, IL‐18, IL‐6, and TNF‐ α as compared to the control group. The treatment with ATV significantly inhibited the formation of CaOx kidney stone by increasing the level of SOD; downregulating MDA, ROS, and LDH; inhibiting the expressions of TLR4, NF‐κB, NLRP3 and cleaved caspase‐1; and blocking the secretion of inflammatory cytokines. In addition, the serum levels of CRE and BUN, and the intrarenal crystal deposition were also significantly decreased in ATV‐treated rats. In summary, oxidative stress, TLR4/NF‐κB, and NLRP3 inflammasome pathways are involved in renal inflammatory responses induced by CaOx crystals. ATV treatment significantly suppressed oxidative stress, inhibited the activation of TLR4/NF‐κB and NLRP3 inflammasome pathways, and decreased the release of inflammatory mediators, thereby ameliorating CaOx crystal‐induced damage and crystal deposition in HK‐2 cells and rat kidney tissues.

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Causes and management of urinary system problems in children on long‐term home invasive mechanical ventilation

Soylu,

Kavukcu

2024

Pediatric Pulmonology

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Many ventilator‐dependent children have comorbid conditions including urinary tract disorders. We aimed to present a focused review of the literature describing the causes and management of urinary system problems in children with long‐term home mechanical ventilation. We performed a literature search in PubMed/MEDLINE, Scopus, and Web of Science with keywords “children,” “home mechanical ventilation,” “urinary system,” “urinary tract,” “neurogenic bladder,” “clean intermittent catheterization,” “urinary tract infection,” “urolithiasis,” and “acute kidney injury.” We included original articles, reviews, guidelines, and case reports published in English. Ventilator‐dependent children may have neurogenic bladder/bowel dysfunction which renders them prone to urinary tract infection, high bladder pressure, vesicoureteral reflux, hydronephrosis, and renal dysfunction. These children require bladder catheterization, medications affecting parasympathetic/sympathetic nervous systems, or surgical procedures to prevent urinary infections, and to maintain continence and renal functions. However, bladder catheterization or surgical procedures like augmentation cystoplasty may also be complicated with urinary infections, urolithiasis, or urethral strictures. Urolithiasis frequency is also increased due to immobilization‐related hypercalciuria, hypocitraturia caused by antiepileptic drugs, urinary stasis, and urinary infections. On the other hand, mechanical ventilation can impair renal function by reduction of cardiac output, redistribution of intrarenal blood flow and stimulation of sympathetic and hormonal pathways. Children requiring long‐term invasive home mechanical ventilation may have other comorbid conditions, including urinary system diseases, which become manifest as these patients are being kept alive due to the advances in ventilation strategies. These children must be carefully observed for urological complications and managed accordingly to prevent kidney injury.

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Current Trends, Evaluation, and Management of Pediatric Nephrolithiasis

Cited by 100 publications

References 75 publications

Pediatric Nephrolithiasis: Trend, Evaluation and Management: A Systematic Review

Pediatric Nephrolithiasis: Trend, Evaluation and Management: A Systematic Review

Atorvastatin inhibits renal inflammatory response induced by calcium oxalate crystals via inhibiting the activation of TLR4/NF‐κB and NLRP3 inflammasome

Causes and management of urinary system problems in children on long‐term home invasive mechanical ventilation

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