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Published in: Pediatric Nephrology 11/2020

01-11-2020 | Hematuria | Original Article

Metabolic risk factors in children with kidney stone disease: an update

Authors: Francisco R. Spivacow, Elisa E. del Valle, Juan A. Boailchuk, Gaudencio Sandoval Díaz, Viridiana Rodríguez Ugarte, Zila Arreaga Álvarez

Published in: Pediatric Nephrology | Issue 11/2020

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Abstract

Background

The prevalence of kidney stones in children has significantly increased in the past few decades, with concomitant increased morbidity and healthcare costs worldwide. Assessing metabolic risk factors is essential for diagnosis and specific treatment. The objective of this retrospective study is to identify the epidemiological and clinical characteristics of children under 17 years of age, as well as the metabolic risk factors of nephrolithiasis.

Methods

A total of 300 children with kidney stone disease were included to undergo several clinical tests using a standardized protocol.

Results

The mean age was 11.2 years, and the male:female ratio was 1.15:1.0. Biochemical abnormalities were found in 89.3% of all cases. A single urine metabolic risk factor was present in 52.6% (n = 141) of the patients, and multiple risk factors were present in 36.7% (n = 106). Idiopathic hypercalciuria (alone or in combination) and hypocitraturia (alone or in combination) were the most frequent risk factors identified in 47.0% and 39.6% of these patients, respectively. Renal colic and/or unspecified abdominal pain were the most frequent forms of presentation (76.9%), followed by hematuria in 64.4% with 97.5% of stones located in the upper urinary tract. A positive family history in first-degree and second-degree relatives was found in 64.8% of boys and 61.8% of girls.

Conclusions

We conclude that specific urinary metabolic risk factors can be found in most children with kidney stones, with hypercalciuria and hypocitraturia being the most common diagnoses.
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Literature
1.
go back to reference Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63:1817–1823CrossRef Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63:1817–1823CrossRef
2.
go back to reference Trinchieri A, Coppi F, Montanari E, Del Nero A, Zanetti G, Pisani E (2000) Increase in the prevalence symptomatic upper urinary tract stones during the past ten years. Eur Urol 37:23–25CrossRef Trinchieri A, Coppi F, Montanari E, Del Nero A, Zanetti G, Pisani E (2000) Increase in the prevalence symptomatic upper urinary tract stones during the past ten years. Eur Urol 37:23–25CrossRef
3.
go back to reference Serio A, Fraioli A (1999) Epidemiology of nephrolithiasis. Nephron 81:26–30CrossRef Serio A, Fraioli A (1999) Epidemiology of nephrolithiasis. Nephron 81:26–30CrossRef
4.
go back to reference Sas DJ (2011) An update on the changing epidemiology and metabolic risk factors in pediatric kidney stone disease. Clin J Am Soc Nephrol 6:2062–2068CrossRef Sas DJ (2011) An update on the changing epidemiology and metabolic risk factors in pediatric kidney stone disease. Clin J Am Soc Nephrol 6:2062–2068CrossRef
5.
go back to reference Dwyer ME, Krambeck AE, Bergstralh EJ, Milliner DS, Lieske JC, Rule AD (2012) Temporal trends in incidence of kidney stones among children: a 25-year population-based study. J Urol 188:247–252CrossRef Dwyer ME, Krambeck AE, Bergstralh EJ, Milliner DS, Lieske JC, Rule AD (2012) Temporal trends in incidence of kidney stones among children: a 25-year population-based study. J Urol 188:247–252CrossRef
6.
go back to reference Matlaga BR, Schaeffer AJ, Novak TE, Trock BJ (2010) Epidemiologic insights into pediatric kidney stone disease. Urol Res 38:453–457CrossRef Matlaga BR, Schaeffer AJ, Novak TE, Trock BJ (2010) Epidemiologic insights into pediatric kidney stone disease. Urol Res 38:453–457CrossRef
7.
go back to reference Tasian GE, Ross ME, Song L, Sas DJ, Keren R, Denburg MR, Chu DI, Copelovitch L, Saigal CS, Furth SL (2016) Annual incidence of nephrolithiasis among children and adults in South Carolina from 1997 to 2012. Clin J Am Soc Nephrol 11:488–496CrossRef Tasian GE, Ross ME, Song L, Sas DJ, Keren R, Denburg MR, Chu DI, Copelovitch L, Saigal CS, Furth SL (2016) Annual incidence of nephrolithiasis among children and adults in South Carolina from 1997 to 2012. Clin J Am Soc Nephrol 11:488–496CrossRef
8.
go back to reference Yousefichaijan P, Azami M, Ranjbaran M, Azami S, Rahmati S (2017) Clinical signs, causes, and risk factors of pediatric kidney stone disease: a hospital-based case-control study. Nephro-urology Mon 9:e41668 Yousefichaijan P, Azami M, Ranjbaran M, Azami S, Rahmati S (2017) Clinical signs, causes, and risk factors of pediatric kidney stone disease: a hospital-based case-control study. Nephro-urology Mon 9:e41668
9.
go back to reference Stoller ML (2008) Urinary stone disease. In: Tanagho EA, McAninch JW (eds) Smith’s general urology, 17th edn. McGraw-Hill, New York, pp 246–290 Stoller ML (2008) Urinary stone disease. In: Tanagho EA, McAninch JW (eds) Smith’s general urology, 17th edn. McGraw-Hill, New York, pp 246–290
10.
go back to reference Spivacow FR, Negri AL, del Valle EE, Calviño I, Fradinger E, Zanchetta JR (2008) Metabolic risk factors in children with kidney stone disease. Pediatric Nephrol 23:1129–1133CrossRef Spivacow FR, Negri AL, del Valle EE, Calviño I, Fradinger E, Zanchetta JR (2008) Metabolic risk factors in children with kidney stone disease. Pediatric Nephrol 23:1129–1133CrossRef
11.
go back to reference Stapleton FB, Kroovand RL (1996) Stones in childhood. In: Coe FL, Favus MJ, Pak CYC, Parks JH, Preminger GM (eds) Kidney stones: medical and surgical management. Lippincott-Raven, Philadelphia, pp 1065–1080 Stapleton FB, Kroovand RL (1996) Stones in childhood. In: Coe FL, Favus MJ, Pak CYC, Parks JH, Preminger GM (eds) Kidney stones: medical and surgical management. Lippincott-Raven, Philadelphia, pp 1065–1080
12.
go back to reference Ghazali S, Barrat TM (1974) Urinary excretion of calcium and magnesium in children. Arch Dis Child 49:97–101CrossRef Ghazali S, Barrat TM (1974) Urinary excretion of calcium and magnesium in children. Arch Dis Child 49:97–101CrossRef
13.
go back to reference Milliner DS, Murphy ME (1993) Urolithiasis in pediatric patients. Mayo Clin Proc 68:241–248CrossRef Milliner DS, Murphy ME (1993) Urolithiasis in pediatric patients. Mayo Clin Proc 68:241–248CrossRef
14.
go back to reference Bush NC, Xu L, Brown BJ, Holzer MS, Gingrich A, Schuler B, Tong L, Baker LA (2010) Hospitalizations for pediatric stone disease in United States, 2002–2007. J Urol 183:1151–1156CrossRef Bush NC, Xu L, Brown BJ, Holzer MS, Gingrich A, Schuler B, Tong L, Baker LA (2010) Hospitalizations for pediatric stone disease in United States, 2002–2007. J Urol 183:1151–1156CrossRef
15.
go back to reference Borghi L, Ferretti PP, Elia GF, Amato F, Melloni E, Trapassi MR, Novarini A (1990) Epidemiological study of urinary tract stones in a northern Italian city. Br J Urol 65:231–235CrossRef Borghi L, Ferretti PP, Elia GF, Amato F, Melloni E, Trapassi MR, Novarini A (1990) Epidemiological study of urinary tract stones in a northern Italian city. Br J Urol 65:231–235CrossRef
16.
go back to reference Vahlensieck EW, Bach D, Hesse A (1982) Incidence, prevalence and mortality of urolithiasis in the German Federal Republic. Urol Res 10:161–164PubMed Vahlensieck EW, Bach D, Hesse A (1982) Incidence, prevalence and mortality of urolithiasis in the German Federal Republic. Urol Res 10:161–164PubMed
17.
go back to reference Kliegman RM (2000) Urinary lithiasis. In: Behrman (ed) Nelson textbook of pediatrics. Saunders, St Louis, pp 1655–1658 Kliegman RM (2000) Urinary lithiasis. In: Behrman (ed) Nelson textbook of pediatrics. Saunders, St Louis, pp 1655–1658
18.
go back to reference Tellaloğlu S, Ander H (1984) Stones in children. Turk J Pediatr 26:51–60PubMed Tellaloğlu S, Ander H (1984) Stones in children. Turk J Pediatr 26:51–60PubMed
19.
go back to reference Polinsky MS, Kaiser BA, Baluarte HJ (1987) Urolithiasis in childhood. Pediatr Clin N Am 34:683–710CrossRef Polinsky MS, Kaiser BA, Baluarte HJ (1987) Urolithiasis in childhood. Pediatr Clin N Am 34:683–710CrossRef
20.
go back to reference Basaklar AC, Kale N (1991) Experience with childhood urolithiasis. Report of 196 cases. Br J Urol 67:203–205CrossRef Basaklar AC, Kale N (1991) Experience with childhood urolithiasis. Report of 196 cases. Br J Urol 67:203–205CrossRef
21.
go back to reference Spivacow FR, del Valle EE, Negri AL, Fradinger E, Abib A, Paula R (2015) Biochemical diagnosis in 3040 kidney stone formers in Argentina. Urolithiasis 4:323–330CrossRef Spivacow FR, del Valle EE, Negri AL, Fradinger E, Abib A, Paula R (2015) Biochemical diagnosis in 3040 kidney stone formers in Argentina. Urolithiasis 4:323–330CrossRef
22.
go back to reference Elmaci AM, Ece A, Akin F (2014) Clinical characteristics and metabolic abnormalities in preschool-age children with urolithiasis in Southeast Anatolia. J Pediatr Urol 10:495–499CrossRef Elmaci AM, Ece A, Akin F (2014) Clinical characteristics and metabolic abnormalities in preschool-age children with urolithiasis in Southeast Anatolia. J Pediatr Urol 10:495–499CrossRef
23.
go back to reference Stapleton FB, McKay CP, Noe HN (1987) Urolithiasis in children: the role of hypercalciuria. Pediatr Ann 16:980–981CrossRef Stapleton FB, McKay CP, Noe HN (1987) Urolithiasis in children: the role of hypercalciuria. Pediatr Ann 16:980–981CrossRef
24.
go back to reference Ertan P, Tekinm G, Öger N, Alkan S, Horasan GD (2011) Metabolic and demographic characteristics of children with urolithiasis in Western Turkey. Urol Res 39:105–110CrossRef Ertan P, Tekinm G, Öger N, Alkan S, Horasan GD (2011) Metabolic and demographic characteristics of children with urolithiasis in Western Turkey. Urol Res 39:105–110CrossRef
25.
go back to reference Tabel Y, Akin IM, Tekin S (2009) Clinical and demographic characteristics of children with urolithiasis. Single-centre experience from eastern Turkey. Urol Int 83:217–221CrossRef Tabel Y, Akin IM, Tekin S (2009) Clinical and demographic characteristics of children with urolithiasis. Single-centre experience from eastern Turkey. Urol Int 83:217–221CrossRef
26.
go back to reference Lieberman E (1993) Importance of metabolic contributions to urolithiasis in pediatric patients. Mayo Clin Proc 68:313–315CrossRef Lieberman E (1993) Importance of metabolic contributions to urolithiasis in pediatric patients. Mayo Clin Proc 68:313–315CrossRef
27.
go back to reference Edvardsson V, Elidottir H, Olafur S, Palsson IR (2005) High incidence of kidney stones in Icelandic children. Pediatr Nephrol 20:940–944CrossRef Edvardsson V, Elidottir H, Olafur S, Palsson IR (2005) High incidence of kidney stones in Icelandic children. Pediatr Nephrol 20:940–944CrossRef
28.
go back to reference Tefekli A, Esen T, Ziylan O, Erol B, Armagan A, Ander H, Akinci M (2003) Metabolic risk factors in pediatric and adult calcium oxalate urinary stone formers: is there any difference? Urol Int 70:273–277CrossRef Tefekli A, Esen T, Ziylan O, Erol B, Armagan A, Ander H, Akinci M (2003) Metabolic risk factors in pediatric and adult calcium oxalate urinary stone formers: is there any difference? Urol Int 70:273–277CrossRef
29.
go back to reference Van Dervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M, Trachtman H (2007) Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol 177:2300–2305CrossRef Van Dervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M, Trachtman H (2007) Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol 177:2300–2305CrossRef
30.
go back to reference del Valle EE, Spivacow R, Zanchetta JR (1999) Alteraciones Metabólicas en 2612 pacientes con Litiasis Renal. Medicina 59:417–422PubMed del Valle EE, Spivacow R, Zanchetta JR (1999) Alteraciones Metabólicas en 2612 pacientes con Litiasis Renal. Medicina 59:417–422PubMed
31.
go back to reference Penido MGMG, Srivastava T, Alon US (2013) US pediatric primary urolithiasis: 12-year experience in a midwestern children’s hospital. J Urol 189:1493–1497CrossRef Penido MGMG, Srivastava T, Alon US (2013) US pediatric primary urolithiasis: 12-year experience in a midwestern children’s hospital. J Urol 189:1493–1497CrossRef
32.
go back to reference Rellum DM, Feitz WF, van Herwaarden AE, Schreuder MF (2014) Pediatric urolithiasis in a non-endemic country: a single center experience from the Netherlands. J Pediatr Urol 10:155–161CrossRef Rellum DM, Feitz WF, van Herwaarden AE, Schreuder MF (2014) Pediatric urolithiasis in a non-endemic country: a single center experience from the Netherlands. J Pediatr Urol 10:155–161CrossRef
33.
34.
go back to reference Sakhaee K (2009) Recent advances in the pathophysiology of nephrolithiasis. Kidney Int 75:585–595CrossRef Sakhaee K (2009) Recent advances in the pathophysiology of nephrolithiasis. Kidney Int 75:585–595CrossRef
Metadata
Title
Metabolic risk factors in children with kidney stone disease: an update
Authors
Francisco R. Spivacow
Elisa E. del Valle
Juan A. Boailchuk
Gaudencio Sandoval Díaz
Viridiana Rodríguez Ugarte
Zila Arreaga Álvarez
Publication date
01-11-2020
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 11/2020
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-020-04660-x

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