Pediatric Urinary Stone Disease—Does Age Matter?

Abstract

Younger children were more likely to present with renal stones, while older children had more ureteral stones. Overall children 10 years old or younger are as likely to pass stones as older children. Renal stones are more likely to be successfully managed expectantly in younger children. Metabolic abnormalities and stone recurrences are observed at similar rates between younger and older children.

An Update on the Changing Epidemiology and Metabolic Risk Factors in Pediatric Kidney Stone Disease

“…Studies show that calcium is present in 72% to 88% of pediatric kidney stones (20,22). The same studies show uric acid present in only 2% to 3% of stones in pediatric patients, whereas uric acid is present in 11% of kidney stones in adults (31).…”

“…The same studies show uric acid present in only 2% to 3% of stones in pediatric patients, whereas uric acid is present in 11% of kidney stones in adults (31). Although struvite (ammonium magnesium phosphate) stones previously accounted for a more significant proportion of pediatric stones (17% in one study), improvements in the diagnosis and treatment of urinary tract infections have made this type of stone rare (20,22).…”

“…Older children are also more likely to have ureteral stones, whereas younger children more commonly have renal stones (19,20). Regarding spontaneous passage of stones, age typically is not a predictive factor, but stone size, regardless of age, can predict likelihood of spontaneous passage, with stones Ͼ5 mm less likely to pass versus stones Ͻ5 mm (19,20).…”

The increasing pediatric stone disease problem

“…Yet, in more recent series, approximately 7080% of children will present symptomatically with either flank pain or abdominal pain, 1032% will also have gross hematuria, and 420% will have a concomitant urinary tract infection (UTI). The majority of pediatric patients will present with stones in an idiopathic manner, but 924% will have an associated secondary cause such as congenital urinary tract anomaly, metabolic deficiency, or neurologic disease [Alpay et al 2009;Kalorin et al 2009;Dursun et al 2008;Kit et al 2008;VanDervoort et al 2007;Sternberg et al 2005;Alon et al 2004]. Overall, approximately 5060% of patients have stones located in the kidney at the time of diagnosis [Passerotti et al 2009;Palmer et al 2005;Sternberg et al 2005;Kroovand, 1997].…”

Renal stones in children: Evaluation and medical management

“…Younger children more commonly have renal stones which are less likely to pass spontaneously, whereas older children more frequently have ureteral stones 7,8 . Bladder stones have disappeared from the developed world and have been confined to some pockets in the developing world due to lack of dietary phosphates, especially during infancy 9 .…”