Multidimensional Analysis of Urinary Stone Diseases in Pediatric Patients

Özet

Objectives: Urinary tract stones are less common in children than in adults. Determining the etiology is the most important stepto achieve successful treatment and prevent future recurrence. The aim of this study was to investigate the clinical characteristicsand possible risk factors for urinary stone disease in pediatric patients.Methods: The data of 126 patients with urinary stone disease who were treated in a pediatric nephrology clinic between 2000 and2014 were analyzed retrospectively. A total 126 patients were enrolled in the study: 70 (55%) male and 56 (45%) female patientswere included. The complaints, age of diagnosis, family histories, and stone location were examined. Direct urine microscopicexamination, complete urinalysis, and urine culture were performed for all of the patients. Calcium, uric acid, oxalate, citrate, magnesium, and cystine levels were measured in urine collected in a 24-hour period. Serum electrolyte, blood urea nitrogen, creatinine, calcium, phosphorus, uric acid, and albumin levels were measured. Urinary ultrasound was performed. Stone analysis wasconducted using the X-ray diffraction method. The mean age of the patients was 55 months (range: 1-162 months) at presentation.Results: In all, 34% of the patients had a family history of urinary stone disease. The rate of previous urinary tract infection was 26%.It was determined that 34% of the patients had been taking vitamin D and 5% had been taking a high dose. Metabolic risk factorsdetermined were: hypercalciuria in 41%, hypocitraturia in 30%, hyperoxaluria in 14%, hyperuricosuria in 10%, and cystinuria in 5%.Among the group, 81% of the patients had kidney stones, 6.5% had ureter stones, and 2.5% had bladder stones. Furthermore, itwas determined that 45% of the stones were composed of calcium oxalate, 35% had calcium phosphate stones, 14.2% had uricacid stones, and 13.3% had cystine stones. In 52% of the cases, extracorporeal shock wave lithotripsy was performed, and 71%underwent surgical treatment.Conclusion: Metabolic evaluation and stone analysis should be performed to prevent future recurrences in children with urinarystone disease and lifelong follow-up should be emphasized.