Top

Published in:

01-12-2024 | Urolithiasis | Research

Urolithiasis in children; The importance of stone localization in treatment and follow-up

Authors: Nimet Öner, Funda Baştuğ, Büşra Özkan, Mustafa Özçatal, Çiğdem Karakükçü

Published in: Urolithiasis | Issue 1/2024

Abstract

To evaluate the demographic, etiologic, treatment, and follow-up differences in stones according to their location within the kidney. This retrospective study comprised 337 patients with urolithiasis between 2015 and 2019. Patients were classified into 2 groups according to stone location as lower pole stones (LPS) and upper-middle pole stones (UMPS). The patient’s data were recorded at 3-month intervals for one year. One hundred and eighty-three (54.3%) female and 154 (45.7%) men were included in the study. One hundred and twenty-nine (38.3%) of the stones were in the LPS and 208 (61.7%) in the UMPS. UMPS was more common in patients aged > 12 months (p < 0.01). At least one metabolic risk factor was present in 93 (72.1%) patients with LPS and 164 (78.4%) with UMPS. The most common urinary metabolic risk factors were hyperoxaluria (31.8%) in patients with LPS and hypocitraturia (34.1%) in patients with UMPS. ROC analysis results showed that cut-off values of 5.5 mm for LPS and 6.1 mm for UMPS did not provide improve with medical treatment. At the 6- and 12-month follow-ups, the improvement rates were higher in the UMPS group than in the LPS group (p < 0.05). During the follow-up, recurrence was detected in 43 patients: 29% of patients with LPS and 5.8% of patients with UMPS (p < 0.01). Patients with small stones can be followed up. Surgical treatment may be considered for small stones in the LPS. In addition, the risk of recurrence is higher in patients with LPS, and close follow-up is required.

Clayton DB, Pope JC (2011) The increasing pediatric stone disease problem. Ther Adv Urol 3(1):3–12. https://doi.org/10.1177/1756287211400491CrossRefPubMedPubMedCentral

Baştuğ F, Düşünsel R (2012) Pediatric urolithiasis: causative factors, diagnosis and medical management. Nat Rev Urol 9(3):138–146. https://doi.org/10.1038/nrurol.2012.4CrossRefPubMed

Rizvi SA, Naqvi SA, Hussain Z, Hashmi A, Hussain M, Zafar MN, Sultan S, Mehdi H (2002) Pediatric urolithiasis: developing nation perspectives. J Urol 168(4 Pt 1):1522–1525. https://doi.org/10.1016/S0022-5347(05)64509-0CrossRefPubMed

Milliner DS, Murphy ME (1993) Urolithiasis in pediatric patients. Mayo Clin Proc 68(3):241–248. https://doi.org/10.1016/s0025-6196(12)60043-3CrossRefPubMed

Ertan P, Tekin G, Oger N, Alkan S, Horasan GD (2011) Metabolic and demographic characteristics of children with urolithiasis in Western Turkey. Urol Res 39(2):105–110. https://doi.org/10.1007/s00240-010-0306-1CrossRefPubMed

Chand RB, Shah AK, Pant DK, Paudel S (2013) Common site of urinary calculi in kidney, ureter and bladder region. Nepal Med College J NMCJ 15(1):5–7

Alam R, Matlaga BR, Alam A, Winoker JS (2021) Contemporary considerations in the management and treatment of lower pole stones. Int Braz J Urol 47(5):957–968. https://doi.org/10.1590/S1677-5538.IBJU.2021.0010CrossRefPubMedPubMedCentral

Telli O, Hamidi N, Bagci U, Demirbas A, Hascicek AM, Soygur T, Burgu B (2017) What happens to asymptomatic lower pole kidney stones smaller than 10 mm in children during watchful waiting? Pediat Nephrol (Berlin, Germany) 32(5):853–857. https://doi.org/10.1007/s00467-016-3570-7CrossRef

Ozgor F, Sahan M, Yanaral F, Savun M, Sarilar O (2018) Flexible ureterorenoscopy is associated with less stone recurrence rates over Shockwave lithotripsy in the management of 10–20 millimeter lower pole renal stone: medium follow-up results. Int Braz J Urol 44(2):314–322. https://doi.org/10.1590/S1677-5538.IBJU.2017.0483CrossRefPubMedPubMedCentral

10.

Dos Santos J, Lopes RI, Veloso AO, Harvey E, Farhat WA, Papanikolaou F (2016) Outcome analysis of asymptomatic lower pole stones in children. J Urol 195(4 Pt 2):1289–1293. https://doi.org/10.1016/j.juro.2015.11.038CrossRefPubMed

11.

La Manna A, Polito C, Cioce F, De Maria G, Capacchione A, Rocco CE, Papale MR, Romei L (1998) Calyceal microlithiasis in children: report on 196 cases. Pediat Nephrol (Berlin, Germany) 12(3):214–217. https://doi.org/10.1007/s004670050440CrossRef

12.

Pınar A (2020) Laboratory reference values in childhood. In: Hasanoğlu E, Düşünsel R, Bideci A, Boduroğlu K (eds), Essential Pediatrics Book, 2nd edn. Güneş kitabevi, İstanbul, pp 3109–3145

13.

Andropoulos DB (2012) Pediatric normal laboratory values. In: Gregory GA, Andropoulos DB (eds), Gregory’s Pediatric Anesthesia, 5th edn. Blackwell Publishing Ltd, pp 1263–1280

14.

Zomorrodi A, Buhluli A, Fathi S (2010) Anatomy of the collecting system of lower pole of the kidney in patients with a single renal stone: a comparative study with individuals with normal kidneys. Saudi J Kidney Dis Transplant 21(4):666–672

15.

Gurocak S, Kupeli B, Acar C, Tan MO, Karaoglan U, Bozkirli I (2008) The impact of pelvicaliceal features on problematic lower pole stone clearance in different age groups. Int Urol Nephrol 40(1):31–37. https://doi.org/10.1007/s11255-007-9220-zCrossRefPubMed

16.

Kit LC, Filler G, Pike J, Leonard MP (2008) Pediatric urolithiasis: experience at a tertiary care pediatric hospital. Canad Urol Assoc J 2(4):381–386. https://doi.org/10.5489/cuaj.804CrossRef

17.

Pietrow PK, Pope JC 4th, Adams MC, Shyr Y, Brock JW 3rd (2002) Clinical outcome of pediatric stone disease. J Urol 167(2 Pt 1):670–673. https://doi.org/10.1016/S0022-5347(01)69121-3CrossRefPubMed

18.

Barroso U, Jednak R, Fleming P, Barthold JS, González R (2000) Bladder calculi in children who perform clean intermittent catheterization. BJU Int 85(7):879–884. https://doi.org/10.1046/j.1464-410x.2000.00625.xCrossRefPubMed

19.

Burgher A, Beman M, Holtzman JL, Monga M (2004) Progression of nephrolithiasis: long-term outcomes with observation of asymptomatic calculi. J Endourol 18(6):534–539. https://doi.org/10.1089/end.2004.18.534CrossRefPubMed

20.

Koh LT, Ng FC, Ng KK (2012) Outcomes of long-term follow-up of patients with conservative management of asymptomatic renal calculi. BJU Int 109(4):622–625. https://doi.org/10.1111/j.1464-410X.2011.10329.xCrossRefPubMed

21.

Spivacow FR, Del Valle EE, Boailchuk JA, Sandoval Díaz G, Rodríguez Ugarte V, Arreaga Álvarez Z (2020) Metabolic risk factors in children with kidney stone disease: an update. Pediat Nephrol (Berlin, Germany) 35(11):2107–2112. https://doi.org/10.1007/s00467-020-04660-xCrossRef

22.

Penido MG, Srivastava T, Alon US (2013) Pediatric primary urolithiasis: 12-year experience at a Midwestern Children’s Hospital. J Urol 189(4):1493–1497. https://doi.org/10.1016/j.juro.2012.11.107CrossRefPubMed

23.

Tohidi MR, Seyedzadeh A, Seyedzadeh MS, Ahmadian R, Hookari S (2020) Prevalence of metabolic risk factors affecting childhood nephrolithiasis: a report from a university hospital in west of Iran. Int J Pediatrics 8(8):11691–11699. https://doi.org/10.22038/ijp.2020.49179.3936

24.

Karabacak OR, Ipek B, Ozturk U, Demirel F, Saltas H, Altug U (2010) Metabolic evaluation in stone disease metabolic differences between the pediatric and adult patients with stone disease. Urology 76(1):238–241. https://doi.org/10.1016/j.urology.2010.01.036CrossRefPubMed

25.

Kovacevic L (2022) Diagnosis and Management of Nephrolithiasis in Children. Pediatr Clin North Am 69(6):1149–1164. https://doi.org/10.1016/j.pcl.2022.07.008CrossRefPubMed

26.

Raman JD, Pearle MS (2008) Management options for lower pole renal calculi. Curr Opin Urol 18(2):214–219. https://doi.org/10.1097/MOU.0b013e3282f517eaCrossRefPubMed

27.

Dropkin BM, Moses RA, Sharma D, Pais VM Jr (2015) The natural history of nonobstructing asymptomatic renal stones managed with active surveillance. J Urol 193(4):1265–1269. https://doi.org/10.1016/j.juro.2014.11.056CrossRefPubMed

28.

Trinchieri A, Esposito N, Castelnuovo C (2009) Dissolution of radiolucent renal stones by oral alkalinization with potassium citrate/potassium bicarbonate. Archivio Italiano di Urologia Andrologia 81(3):188–191

29.

Robinson MR, Leitao VA, Haleblian GE, Scales CD Jr, Chandrashekar A, Pierre SA, Preminger GM (2009) Impact of long-term potassium citrate therapy on urinary profiles and recurrent stone formation. J Urol 181(3):1145–1150. https://doi.org/10.1016/j.juro.2008.11.014CrossRefPubMed

30.

Doizi S, Poindexter JR, Pearle MS, Blanco F, Moe OW, Sakhaee K, Maalouf NM (2018) Impact of potassium citrate vs citric acid on urinary stone risk in calcium phosphate stone formers. J Urol 200(6):1278–1284. https://doi.org/10.1016/j.juro.2018.07CrossRefPubMedPubMedCentral

Title: Urolithiasis in children; The importance of stone localization in treatment and follow-up
Authors: Nimet Öner
Funda Baştuğ
Büşra Özkan
Mustafa Özçatal
Çiğdem Karakükçü
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keyword: Urolithiasis
Published in: Urolithiasis / Issue 1/2024
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI: https://doi.org/10.1007/s00240-023-01518-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Urolithiasis in children; The importance of stone localization in treatment and follow-up

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2024

Ureteral stricture formation after endoscopic removal of obstructing stones: could it be predicted with well-assessed radiological parameters?

The impact of crystal phase transition on the hardness and structure of kidney stones

Develop a radiomics-based machine learning model to predict the stone-free rate post-percutaneous nephrolithotomy

A randomized controlled trial comparing infectious complications using mini perc with and without suction for renal stones less than 3 cm in size

Analysis of factors affecting intraoperative hemorrhage during percutaneous nephrolithotomy and establishment of nomogram model

The association between renal pelvis urine density and the risk of severe infectious complications in patient with symptom-free hydronephrosis after shock wave lithotripsy: a multi-center prospective study