Infant nephrolithiasis and nephrocalcinosis: Natural history and predictors of surgical intervention

Andrioli, Veridiana; Highmore, Kerri; Leonard, Michael P.; Guerra, Luis; Tang, Kenneth; Vethamuthu, Jennifer; Meyers, Victoria; Sullivan, Katrina; Keays, Mélise

doi:10.1016/j.jpurol.2017.06.010

Cited by 12 publications

(4 citation statements)

References 17 publications

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“…However stones >6 mm are less likely to resolve and will need surgical intervention. Other indications of surgery include symptomatic obstruction, sepsis and stone growth during the follow up ( 15 ). In the current study the renal stones were larger than 1 cm and symptomatic for which mini PCNL was performed.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of minimally invasive percutaneous nephrolithotomy for infantile nephrolithiasis. Single centre experience from Pakistan

Ahmad

Minallah²,

Khaliq³

et al. 2023

Front. Pediatr.

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ObjectiveTo assess the efficacy and safety of mini-percutaneous nephrolithotomy (PCNL) for small renal stones 1–2 cm in size in infants less than one year.Material and MethodsThis descriptive case series was conducted in the department of pediatric urology Institute of Kidney Diseases Peshawar, Pakistan, from March 2019 to March 2022. All the patients underwent mini-PCNL in prone position under GA with 14 Fr access sheath and 10 Fr nephroscope. Stone clearance was assessed by non-contrast CT KUB at 30th postoperative day. Patients with no residual fragments on the non-contrast CT KUB were defined as stone-free. Patients with residual fragments of any size were defined as procedure failure. Safety was determined in terms of intra and postoperative complications.ResultsA total of 51 infants were included in the study. The mean age of patients was 9.6 + 1.8 (5–12 month). The mean stone size was 15.8 + 2.7 (10–21) mm in length and 12.3 + 2.2 (8–17) mm in width. PCNL mean operative time was 51.6 ± 7.1 (40–70) minutes. Complete stone clearance at one month was observed in 46 (90.2%) patients. Residual fragments were seen in 5(9.8%) patients with a mean size of 1.6 + 0.4 (0.9–2.0) mm. None of the patients required any additional procedure for clearance of stones. In 7 (13.7%) patients, some post-operative complications were observe, all were grade I complications, including fever in 5(9.8%) and transient hematuria in 2(3.9%) patients.ConclusionMini-PCNL is a safe and effective treatment for renal stones in infants measuring 1–2 cm with high SFR and an acceptable complication rate.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of minimally invasive percutaneous nephrolithotomy for infantile nephrolithiasis. Single centre experience from Pakistan

Ahmad

Minallah²,

Khaliq³

et al. 2023

Front. Pediatr.

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“…In this case, given the infant's relatively mild symptoms and nephrocalcinosis, she had chronic rather than acute hypercalcemia. Nephrocalcinosis or nephrolithiasis in infants has a median age of diagnosis at 2.9 months, suggesting that it takes some time for hypercalciuria to cause nephrocalcinosis [ 5 ]. However, there are also cases of nephrocalcinosis noted as early as 1 month of age [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Severe Hypercalcemia due to Hypervitaminosis D in a Breastfed Infant

2023

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Vitamin D is one of the most commonly recommended dietary supplements and is often the first medication ever prescribed in infancy. However, with the variety of concentrations available, including many over-the-counter formulations, dosing errors can easily occur. We present a case of a breastfed infant with a calcium level greater than 23 mg/dL (5.75 mmol/L), whose severe hypercalcemia was due to hypervitaminosis D from accidentally overdosed vitamin D supplementation. We consider the differential diagnosis for her presentation and review the interventions required for treatment of her hypercalcemia. Notably, we reinforce the importance of carefully reviewing dosing of vitamin D supplementation with families. We also discuss the management of hypercalcemia, including the role of fluids, diuretics, and glucocorticoids, as well as the long-term sequalae of severe hypercalcemia.

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“…Urolithiasis in children can present with ill-defined symptoms, which can vary with age. Older children can present clinically with haematuria, flank pain, and recurrent UTIs [28], whereas, in infants, the symptoms can be vomiting, irritability, and crying [29].…”

Section: Paediatric Populationmentioning

confidence: 99%

Urological Guidelines for Kidney Stones: Overview and Comprehensive Update

Akram,

Jahrreiss,

Skolarikos

et al. 2024

JCM

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Background: Evidence-based guidelines are published by urological organisations for various conditions, including urolithiasis. In this paper, we provide guidance on the management of kidney stone disease (KSD) and compare the American Urological Association (AUA) and European Association of Urologists (EAU) guidelines. Methods: We evaluate and appraise the evidence and grade of recommendation provided by the AUA and EAU guidelines on urolithiasis (both surgical and medical management). Results: Both the AUA and EAU guidelines provide guidance on the type of imaging, treatment options, and medical therapies and advice on specific patient groups, such as in paediatrics and pregnancy. While the guidelines are generally aligned and based on evidence, some subtle differences exist in the recommendations, but both are generally unanimous for the majority of the principles of management. Conclusions: We recommend that the guidelines should undergo regular updates based on recently published material, and while these guidelines provide a framework, treatment plans should still be personalised, respecting patient preferences, surgical expertise, and various other individual factors, to offer the best outcome for kidney stone patients.

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Infant nephrolithiasis and nephrocalcinosis: Natural history and predictors of surgical intervention

Cited by 12 publications

References 17 publications

Safety and efficacy of minimally invasive percutaneous nephrolithotomy for infantile nephrolithiasis. Single centre experience from Pakistan

Safety and efficacy of minimally invasive percutaneous nephrolithotomy for infantile nephrolithiasis. Single centre experience from Pakistan

Severe Hypercalcemia due to Hypervitaminosis D in a Breastfed Infant

Urological Guidelines for Kidney Stones: Overview and Comprehensive Update

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