Risk factors evaluation for urolithiasis among children

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• 作者：Francisco Velá ; squez-Forero^a ; ^{fcovelfor@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Mariela Esparza^a ; Alejandro Salas^b ; Mara Medeiros^c ; Georgina Toussaint^c ; ^&dagger ; ; Francisco Llach^d
• 关键词：Hypocitraturia ; Hypomagnesuria ; Hypercalciuria ; Pediatric urolithiasis ; Systemic metabolic acidosis ; Urolithiasis risk factors
• 刊名：Boletín Médico del Hospital Infantil de México
• 出版年：2016
• 出版时间：July-August 2016
• 年：2016
• 卷：73
• 期：4
• 页码：228-236
• 全文大小：824 K

文摘

The prevalence of pediatric urolithiasis varies from 0.01–0.03%. Urolithiasis may be caused by anatomical, metabolic and environmental factors. Recurrence varies between 16 to 67%, and it is frequently associated with metabolic abnormalities. The objective of the present work was the identification of risk factors that promote urolithiasis in a child population.

Methods

This study included 162 children with urolithiasis and normal renal function (mean age 7.5 years). Risk factors were investigated in two stages. In the first stage, 24-hour urine, and blood samples were analyzed to assess metabolic parameters and urinary tract infection. During the second stage, the effect of calcium restriction and a calcium load on renal Ca excretion were evaluated. Data were statistically analyzed.

Results

Urolithiasis was observed in 0.02% of children, 50% of them with family history of urinary stones. There were multiple risk factors for urolithiasis including hypocitraturia (70%), hypomagnesuria (42%), hypercalciuria (37%; in 11/102 was by intestinal hyperabsorption, in 13/102 was unclassified. Ca resorption or renal Ca leak were not detected). We also detected alkaline urine (21%), systemic metabolic acidosis (20%), urinary infections (16%), nephrocalcinosis with urolithiasis (11%), oliguria (8%), urinary tract anomalies, hyperuricosemia and hypermagnesemia (7% each one), hypercalcemia (6%), hyperoxaluria (2%) and hypercystinuria (0.61%).

Conclusions

Hypocitraturia and hypomagnesuria were the most frequent risk factors associated with urolithiasis, followed by hypercalciuria. High PTH values were excluded. Children presented two or more risk factors for urolithiasis.