OBJECTIVE: Data on urolithiasis in preschool-age children are limited.
The aim of this study was to investigate the metabolic etiology and clinical findings of preschool-age children with urolithiasis.
METHODS: The medical records of 143 preschool-age children (81 boys, 62 girls, aged 2-6 years) with urolithiasis were retrospectively analyzed. Results of physical examination, serum biochemistry, and urine metabolic evaluation (including urinary citrate, oxalate, calcium, uric acid, cystine, and magnesium) were recorded.
RESULTS: The mean age at diagnosis was 3.7 ± 1.3 years. A family history of stone disease was found in 79.7% of patients, and 37% of parents had consanguineous marriages. The most common presenting symptoms were hematuria (33%) and urinary tract infection (UTI; 29%). Metabolic abnormalities were found in 119 (83.2%) patients, including hyperuricosuria in 24.5%, hypocitraturia in 23.8%, hyperoxaluria in 21.7%, hypercalciuria in 21.0%, cystinuria in 7.7%, and hypomagnesuria in 1.4%. Multiple metabolic abnormalities were found in 24 (16.8%) patients. Results of 28 stone analyses revealed calcium oxalate or phosphate, cystine, and uric acid in 15, nine, and four of the patients, respectively. 99mTechnetium-dimercaptosuccinic acid renal scintigraphy revealed that 27.8% of the children with UTI had renal parenchymal scarring, with only four of them having vesicoureteral reflux.
CONCLUSION: The most frequent metabolic abnormalities in preschool-age children with urolithiasis were hyperuricosuria and hypocitraturia. A comprehensive investigation of stone disease in children presenting with hematuria and UTI is important to prevent the development of renal parenchymal scarring.
Written by:
Elmacı AM, Ece A, Akın F. Are you the author?
Dr. Faruk Sukan Obstetric and Children's Hospital, Department of Pediatric Nephrology, Selcuklu, TR-42060 Konya, Turkey.
Reference: J Pediatr Urol. 2013 Nov 21. pii: S1477-5131(13)00317-3.
doi: 10.1016/j.jpurol.2013.11.004
PubMed Abstract
PMID: 24314604
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