Treatment of Pediatric Urolithiasis Between 1984 and 1994

Lim, David J.; Walker, R. Dixon; Ellsworth, Pamela; Newman, Robert C.; Cohen, Marc; Barraza, Mark A.; Stevens, Peter S.

doi:10.1016/s0022-5347(01)65790-2

Cited by 64 publications

(27 citation statements)

References 19 publications

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“…In 14% of the pediatric urolithiasis cases in Europe, no cause was identified, while in the USA this rate was reported to be 18.7-28.3% [15,31,39]. In our country a study held in 1997 reported the rate of idiopathic urolithiasis as 12%.…”

Section: Discussionmentioning

confidence: 75%

The metabolic etiology of urolithiasis in Turkish children

et al. 2009

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Pediatric urolithiasis is an endemic disease, especially in certain developing regions of the world, such as the Far East, and to a certain extent the Middle East and Turkey. The aim of the study is to determine the metabolic etiology and the prevalence of formation of urinary calculi in Turkish pediatric patients with urolithiasis. Seventy-two pediatric patients diagnosed as having urolithiasis were studied from 1999-2005 in Dr. Behcet Uz Child Disease and Surgery Education and Research Hospital Nephrology Department, Izmir, according to their presenting signs and clinical and laboratory findings. The other necessary tests were also applied to detect the etiology of the calculi formation. Of the 72 patients, 50 (69.4%) were male and 22 (30.6%) were female, with ages ranging from 2 to 168 months (mean age 72 +/- 35.7 months), and the male-to-female ratio of patients was 2.3. Twenty-four (33%) of them were diagnosed as having metabolic urolithiasis, 21 (30%) anatomic, 19 (26%) infectious and 8 (11%) idiopathic. The age at which urolithiasis was first diagnosed was found to be low in the metabolic and anatomic etiology groups (P = 0.028). Thirteen patients (18%) with urolithiasis were known to have a family history of stone disease, and in all of them metabolic etiology was considered to be the reason (P < 0.001). In all of the groups, the localization of the stone was found to be the upper urinary system most of the time, and in 17 (24%) with bilateral multiple stones, the etiology was found to be metabolic (P < 0.001). All of the patients were followed up for 3-72 months (mean 29.2 +/- 13.7 months), and four of them (5.5%) had recurrences. In order to prevent renal damage and recurrences in pediatric patients with urolithiasis in Turkey in whom the etiology is mostly metabolic, the illnesses must be investigated very cautiously, and their early diagnosis and treatment modalities must be considered.

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Section: Discussionmentioning

confidence: 75%

The metabolic etiology of urolithiasis in Turkish children

et al. 2009

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“…Other abnormalities were hyperoxaluria (26.5%), hyperuricosuria (25.4%) hyperphosphaturia (20.8%) and cystinuria (5.7%). Among the published studies, a metabolic cause of pediatric urolithiasis is described in -95% of cases, depending on the study [20,[26][27][28][29]. In a multicenter study, Stapleton et al [30] reported a significant association of idiopathic hypercalciuria with a high risk of future urolithiasis in children with hematuria.…”

Section: Discussionmentioning

confidence: 99%

Clinical and metabolic features of urolithiasis and microlithiasis in children

et al. 2009

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We evaluated the clinical, radiological and metabolic features of 162 children with urolithiasis or microlithiasis who had been referred to our pediatric nephrology clinics between 1998 and 2008 with suspected urolithiasis. The medical histories of these children (78 girls, 84 boys), who ranged in age from 2 months to 16 years (mean age 5.59 +/- 0.35 years), were reviewed retrospectively for clinical and metabolic features of urinary tract calculi. Urinary tract infections (UTI) were present in 45.9% of the cases. The most common presenting symptoms were flank pain or restlessness (25.3%) and hematuria (21.6%), followed by UTI (16%), whereas 23.5% of the cases were detected incidentally during evaluation for other medical conditions. Other symptoms at presentation included dysuria, passing stones, penile edema, enuresis, vomiting and anorexia. Urine analysis revealed metabolic abnormalities in 87% of the cases, including hypercalciuria (33.8%), hypocitraturia (33.1%), hyperoxaluria (26.5%), hyperuricosuria (25.4%), hypocitraturia + hypercalciuria (21.1%), hyperphosphaturia (20.8%) and cystinuria (5.7%). Almost 50% of the patients had a positive family history for urolithiasis. The most frequently involved site was in the kidneys (86%). Ureters and bladder were involved in 12 and 2% of the cases, respectively. A family history of urolithiasis, presenting symptoms and underlying metabolic abnormalities were similar for microlithiasis and the patients with larger stones. However, in our study population, microlithiasis was mainly a disease of young infants, with a greater chance for remission and often not associated with structural changes. The presenting symptoms of urolithiasis show a wide spectrum, so that a high index of suspicion is important for early detection. A metabolic abnormality can be identified in 87% of cases of urolithiasis. Detection of microlithiasis may explain a number of symptoms, thus reducing invasive diagnostic procedures and allowing early recognition of metabolic abnormalities. These results draw attention to the importance of screening for UTIs in patients with urolithiasis.

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“…In children under 1 year of age, restlessness is a common presenting symptom [10]. If the stone is in the lower urinary tract, other urinary symptoms may be present such as lower quadrant pain, groin/scrotal pain, dysuria, or difficulty voiding [11,12].…”

Section: Clinical Presentation Of Pediatric Urolithiasismentioning

confidence: 99%

“…Urinary tract abnormalities predisposing to stasis are a risk factor for urolithiasis [11]. Urinary obstruction due to ureteropelvic junction obstruction may result in stasis and predispose to stone formation.…”

Section: Medical Historymentioning

confidence: 99%

Approach to Stone Formation in the Pediatric Population

Baum

2011

Clinic Rev Bone Miner Metab

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Pediatric urolithiasis is more common than previously reported. All children with urolithiasis deserve a thorough evaluation after their initial presentation. With careful assessment, metabolic risk factors may be found in the majority of children, leading to appropriate medical therapy of modifiable risk factors and prevention of further stone formation. Furthermore, early identification of inborn errors of metabolism is important to prevent morbidities associated with these disorders, such as end-stage renal disease. This review discusses the etiologies of pediatric urolithiasis, the metabolic evaluation, and treatment options.

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Treatment of Pediatric Urolithiasis Between 1984 and 1994

Abstract: 2016-12-26T15:09:09

Cited by 64 publications

References 19 publications

The metabolic etiology of urolithiasis in Turkish children

The metabolic etiology of urolithiasis in Turkish children

Clinical and metabolic features of urolithiasis and microlithiasis in children

Approach to Stone Formation in the Pediatric Population

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