Calyceal microlithiasis in children: report on 196 cases

Manna, Angela La; Polito, Cesare; Cioce, Fabrizio; Maria, G. De; Capacchione, Antonio; Rocco, Claudia; Papale, Maria; Romei, L.

doi:10.1007/s004670050440

Cited by 28 publications

(45 citation statements)

References 13 publications

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“…Calyceal microlithiasis was defined by the finding of hyperechogenic spots in renal calyces. These were usually devoid of a shade cone and were ≤3 mm in diameter [15]. A single scan is not enough when it is necessary to distinguish with certainty between microcalculi and similar surrounding structures.…”

Section: Methodsmentioning

confidence: 99%

Urinary Sodium and Potassium Excretion in Idiopathic Hypercalciuria of Children

Polito¹,

Manna²,

Maiello³

et al. 2002

Nephron

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Background: An increased spot urine Na/K ratio (UNa/K) has been found to be related to urinary stone disease in adults with a history of nephrolithiasis and in children with idiopathic hypercalciuria (HC). However, the respective role played by Na and K excretion in the rise of the UNa/K in growing individuals is not well clarified. Methods: The urinary excretion of Na and K was evaluated in fasting morning and 24-hour urine samples of 37 consecutive children with HC and of 21 previously HC children who were normocalciuric at the time of the study (ExHC). None of them had received any dietary or specific drug prescription. Results: In the HC and in the ExHC group, respectively, the Na excretion was 4 ± (SD) 2.4 and 2.9 ± 1.3 mmol/kg/day (p = 0.009); the K excretion was 1.1 ± 0.4 and 1.2 ± 0.7 mmol/kg/day (p = 0.86); the fasting UNa/K was 3 ± 1.6 and 2.1 ± 1 mmol/mmol (p = 0.044), and the 24-hour UNa/K was 4.2 ± 3.9 and 2.8 ± 1.5 mmol/ mmol (p = 0.045). The 24-hour UNa/K was significantly higher than the fasting UNa/K in both HC (p = 0.002) and ExHC (p = 0.002) subjects. The 24-hour UNa/K significantly increased with age in both HC (p = 0.02) and ExHC (p = 0.015) children. The K excretion significantly decreased with age in HC (p = 0.0001) and ExHC (p = 0.005) subjects, as well as with body weight gain in HC (p = 0.005) and ExHC (p = 0.0001) children and with increasing body height in HC (p = 0.006) and ExHC (p = 0.001) subjects. In neither group was the K excretion significantly related to body mass index Z score nor to height Z score. No significant relation resulted between Na excretion and age, body weight and height, and body mass index Z score and height Z score. Conclusions: HC children have a higher Na excretion as well as a higher fasting and 24-hour UNa/K than ExHC children, but no different K excretion. Meals are accompanied by a significant rise in UNa/K. The rise in UNa/K with age is mostly due to a decrease in K excretion which possibly depends on childhood body growth.

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Section: Methodsmentioning

confidence: 99%

Urinary Sodium and Potassium Excretion in Idiopathic Hypercalciuria of Children

Polito¹,

Manna²,

Maiello³

et al. 2002

Nephron

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“…In 1998, La Manna et al [7] in their study of children with urinary symptoms, for the first time, used the term ‘renal calyceal microlithiasis' (RCM) for the echogenic shadows <3 mm in the ultrasound imaging of the urinary system. They suggested that RCM might be the first step in calculus formation [7]. Since then, there is a lot of controversy regarding the RCM and its clinical importance; some studies showed that RCM has got a benign course that does not increase the risk of stone formation.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Comparison between Clinical and Metabolic Features of Renal Calyceal Microlithiasis and Overt Urolithiasis in Different Pediatric Age Groups

Fahimi¹,

Zoham²,

Sheikh³

et al. 2015

Urol Int

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Introduction: This study assesses the differences in the presentations, complications and metabolic abnormalities of children with renal calyceal microlithiasis (RCM) and overt urolithiasis in different pediatric ages. Materials and Methods: A total of 465 children with urolithiasis were investigated retrospectively. Patients were categorized based on their ages to infancy, early childhood, middle childhood and adolescence. When the hyperechogenic spots on ultrasound imaging were <3 mm, they were considered RCM, and if they were ≥3 mm, they were considered overt urolithiasis. Results: Metabolic abnormalities were detected in 71%; hyperuricosuria in infants, hyperoxaluria in younger children and hypocitraturia in older children were the most common metabolic abnormalities. Hypercalciuria was the only metabolic abnormality that was significantly associated with overt urolithiasis in all pediatric ages (OR 2.25, 95% CI 1.21-4.19). The clinical presentations were not significantly different between RCM and overt urolithiasis; however, complications such as urinary tract infection was significantly higher with overt urolithiasis in infancy (p = 0.01), early childhood (p = 0.02), middle childhood (p = 0.007) and adolescence (p = 0.01). Also, growth retardation was significantly higher with overt urolithiasis in infancy and early childhood (p = 0.02). Conclusions: Most children with urolithiasis have underlying urinary metabolic abnormalities that differ according to the child's age. Despite these differences, hypercalciuria is significantly associated with overt urolithiasis in all pediatric ages. Clinical and laboratory features cannot differentiate RCM and overt urolithiasis; however, complications are significantly higher with overt urolithiasis.

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“…77 Çapı 3 mm'den daha küçük olan bu lekelenmeler renal kalikseal mikrolitiyaz (RKM) olarak adlandırıl-maktadır. 78 RKM'ye daha çok karın ağrısı, İYE ve hematüri, dizüri gibi semptomu olan çocuklarda rastlanmaktadır; ancak hiçbir semptomun olmadığı çocuklar da olabilmektedir. 77,79 Hastalar, daha büyük renal taşı olan çocuk hastalara göre genellikle daha küçüktür (infantil dönem).…”

Section: Nütrisyonel Nedenlerunclassified

“…77,79 RKM'ler renal taş oluşumunun ilk basamağı olarak kabul edilmektedir ve ilerleyen yaşlarda sıklıkla renal taş oluşumu ile birliktedir. 78,80 Ancak Türkiye'den bildirilen iki çalış-mada, RKM'nin %37 hastada, diğer çalışmada ise %29 hastada zaman içerisinde kendiliğinden kaybolduğu saptanmıştır. 77,79 RKM oluşumunda daha çok metabolik anomaliler, daha az olarak da anatomik anomaliler nedendir.…”

Section: Nütrisyonel Nedenlerunclassified

Urolithiasis in Childhood: Review

Zeybek¹,

Orman²

2017

Turkiye Klinikleri J Pediatr

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Calyceal microlithiasis in children: report on 196 cases

Cited by 28 publications

References 13 publications

Urinary Sodium and Potassium Excretion in Idiopathic Hypercalciuria of Children

Urinary Sodium and Potassium Excretion in Idiopathic Hypercalciuria of Children

A Comparison between Clinical and Metabolic Features of Renal Calyceal Microlithiasis and Overt Urolithiasis in Different Pediatric Age Groups

Urolithiasis in Childhood: Review

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