Pediatric urolithiasis: What role does metabolic evaluation has to play?

Authors

  • Sonia Bhatt Department of Pediatrics, FH Medical College, NH-2, Tundla, Uttar Pradesh
  • Nalini Bhaskaranand Department of Pediatrics, Kasturba Medical College, Manipal, Karnataka
  • Dilip Kumar Mishra Department of Urology, Kasturba Medical College, Manipal, Karnataka

DOI:

https://doi.org/10.18203/2320-6012.ijrms20162321

Keywords:

Urinary calculi, Child, Metabolic evaluation, Urological abnormalities

Abstract

Background Pediatric urolithiasis is a perplexing problem faced by pediatricians as well as urologists across the globe. By early diagnosis and treatment of these risk factors, future stone formation may be prevented. Aim: To evaluate the clinical, biochemical and metabolic characteristics of the patients and the interventions required to prevent recurrence.

Methods: In this retrospective study, cohort of pediatric patients presenting with urolithiasis at Kasturba Medical College, Manipal formed the study population. Patient’s records served as study tools. Medical records department was approached and data was collected. Metabolic evaluation was done in all children. Urine tests included urinalysis, urine culture, 24 hours urinary pH, volume, calcium, oxalate, citrate, uric acid, and creatinine. Finally a total of 58 pediatric urolithiasis cases were included in this study.

Results: Mean age of study subjects was 6.85±1.27 years. Top three presentations of pediatric urolithiasis were symptoms of Urinary tract infection (UTI), abdominal pain and flank pain in 29.3%, 24.1% and 17.2% children respectively. Gross hematuria was observed in 15.5% of cases. 82.6% of stones were renal stones. Calcium oxalate stone was most common (50%) variety found. Hyperoxaluria was the most common (79.3%) metabolic abnormality detected. 31% had stone recurrence during follow up and 8 of these had >1 metabolic abnormality. Only 6/28 (21.4%) patients managed conservatively had stone recurrence whereas 12/30 (40%) managed with a procedure had stone recurrence.

Conclusions: Metabolic evaluation for urolithiasis helps us to identify children those at increased risk for recurrent stone disease. Thus metabolic evaluation is a must in all pediatric patients as it helps in segregating patients needing medical therapy.

 

References

Mohamed J, Riadh M, Abdellatif N. Urolithiasis in infants. Pediatr Surg Int. 2007;23:295-9.

Milliner DS. Urolithiasis. In: Avner ED, HarmonWE, Niaudet P, ediors. Pediatric nephrology. Philadelphia: Lippinccot Williams and Wilkins; 2004. p. 1091-111.

Erbagci A, Erbagci AB, Yilmaz M, Yagci F, Tarakcioglu M, Yurtseven C. Pediatric urolithiasis-evaluation of risk factors in 95 children. Scand J Urol Nephrol. 2003;37(2):129-33.

López M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol. 2010;25:49-59.

Spivacow FR, Negri AL, del Valle EE, Calvino I, Fradinger E, Zanchetta JR. Metabolic risk factors in children with kidney stone disease. Pediatr Nephrol. 2008;23:1129-33.

Zakaria M, Azab S, Rafaat M. Assessment of risk factors of pediatric urolithiasis in Egypt. Transl Androl Urol 2012;1(4):209-15.

Alpay H, Ozen A, Gokce I, Biyikli N. Clinical and metabolic features of urolithiasis and microlithiasis in children. Pediatr Nephrol. 2009;24:2203-09.

Thomas S, Stapleton FB. Pediatric urolithiasis: diagnosis and management. In: Gonzales E, Bauer SB, eds. Pediatric urology practice. Philadelphia (PA): Lippincott-Raven Press, 1999:607-21.

Kroovand RL. Pediatric urolithiasis. Urol Clin North Am. 1997;24:173-84.

Sternberg K, Greenfield SP, Williot P, et al. Pediatric stone disease: an evolving experience. J Urol 2005;174:1711-4.

Ali SH, Rifat UN. Etiological and clinical patterns of childhood urolithiasis in Iraq. Pediatr Nephrol 2005;20:1453-7.

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Published

2017-01-04

How to Cite

Bhatt, S., Bhaskaranand, N., & Mishra, D. K. (2017). Pediatric urolithiasis: What role does metabolic evaluation has to play?. International Journal of Research in Medical Sciences, 4(8), 3509–3512. https://doi.org/10.18203/2320-6012.ijrms20162321

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Section

Original Research Articles