Urinary Lithiasis in Children : A Single Center Study.
- Author:
Hyun Kyung LEE
1
;
Sung Ha LEE
;
Kyoung Hee HAN
;
Beom Hee LEE
;
Hyun Jin CHOI
;
Il Soo HA
;
Hae Il CHEONG
;
Yong CHOI
Author Information
1. Department of Pediatrics, Seoul National University Childrens Hospital, Seoul, Korea. cheonghi@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Urinary lithiasis;
Presenting symptom;
Location;
Underlying cause;
Stone analysis;
Management;
Recurrence;
Children
- MeSH:
Calcium;
Child*;
Cystine;
Cystinuria;
Humans;
Hypercalcemia;
Hypercalciuria;
Kidney Failure, Chronic;
Lithotripsy;
Medical Records;
Metabolic Diseases;
Recurrence;
Renal Insufficiency, Chronic;
Retrospective Studies;
Seoul;
Uric Acid;
Urinary Bladder;
Urinary Bladder, Neurogenic;
Urinary Tract;
Urolithiasis*
- From:Journal of the Korean Society of Pediatric Nephrology
2007;11(2):280-287
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Urinary lithiasis is uncommon in children, however, it may lead to chronic renal insufficiency and even end stage renal disease. The etiology of stone formation in children is largely unknown; although the most common causes are known to be associated with congenital anomalies of the genito-urinary(G-U) tract, urinary tract infections(UTI), and metabolic diseases. METHODS: A total of 73 children(male:female=42:31, mean age 6.6+/-5.3 years) presented with urinary lithiasis between Sep. 1998 and Jul. 2007 at Seoul National University Children's Hospital. The medical records were reviewed retrospectively. RESULTS: The most common presenting symptoms were gross hematuria(28/73, 38%) and flank or abdominal pain(23/73, 32%). The stones were located in the upper urinary tract in 48 patients(66%), in the bladder in 18(24%), and in both the bladder and upper urinary tract in 2 (3%). Congenital anomalies of the G-U tract with/without UTI were detected in 30 children (41%), hypercalciuria with/without hypercalcemia in 15(20%), and other metabolic diseases in 8(11%). In 17 patients(23%), no underlying cause of stone formation was detected. The majority of stones were infected stones(24/36, 67%), which were followed by calcium stones(8/36, 22%), uric acid stones(3/36, 8%), and cystine stones(1/36, 3%). Thirty-four patients(46%) underwent surgical procedures and/or extracorporeal shockwave lithotripsy for stone removal, and 13(18%) passed stones spontaneously with/without medical management. Stones recurred in 6 patients(8%): 4 with neurogenic bladder augmented by ileocystoplasty, 1 with cystinuria, and 1 with unknown etiology. CONCLUSION: The common causes of urinary lithiasis in children were congenital anomalies of the G-U tract with/without UTI and metabolic disorders including hypercalciuria/hypercalcemia. For the management of stones, minimally invasive procedures should be chosen on the basis of accompanying symptoms and the composition, locations and etiology of stones.
