BACKGROUND: Renal calyceal microlithiasis is hyperechogenic spot in renal calyces detected less than 3 mm in diameter by renal sonography.
These spots possibly represent the first step in calculus formation. The aim of this study was to analyse the clinical presentation, predisposing factors, prognosis and clinical importance of these hyperechogenic spots in renal calyces, renal calyceal microlithiasis, during childhood.
METHODS: The data of 292 children (135 girls, 157 boys) with microlithiasis diagnosed between January 1998 and December 2010 was evaluated retrospectively. Demographic data, serum biochemistry, urinary metabolic factors, renal sonography results of the patients were obtained from patient files. 228 Patients have been re-evaluated at least 6 months after the first observation of RCM and at 6-12 months intervals thereafter.
RESULTS: Mean age was 16.8±14.9 months, and mean follow-up duration was 14.6±5.9 months. Presenting symptoms were abdominal or flank pain (41.1%), hematuria (35.6%), dysuria (24.7%) and urinary tract infection (34.6%). Previous ultrasounds were normal in 35% of the children. Metabolic and anatomic abnormalities were found in 55.5% and 17.8%, respectively. Hypercalciuria was the most common metabolic abnormality (88.9%). Among 228 patients who had been re-evaluated, microlithiasis disappeared in 37.7%, decreasing in the number or size was determined in 23.7%, progressing to the renal stone formation was observed in 10.6%, increasing in the number of microlithiasis was established in 19.0% and radiologic image remained unchanged in 9.0%.
CONCLUSION: Renal calyceal microlithiasis may represent a spectrum of various clinical situations and different underlying metabolic abnormalities that need further investigation in children.
Written by:
Bilge I, Yilmaz A, Kayiran SM, Emre S, Kadioglu A, Yekeler E, Sucu A, Sirin A. Are you the author?
Istanbul University, Istanbul Medical Faculty, Pediatric Nephrology Department, Istanbul, Turkey.
Reference: Pediatr Int. 2013 Aug 6. Epub ahead of print.
doi: 10.1111/ped.12186
PubMed Abstract
PMID: 23919534
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