Current medical treatment in pediatric urolithiasis

Abstract

Although the prevalence of urolithiasis is nearly 2-3% in childhood, the risk of recurrence may range from 6.5-54%. There has been an increase in urinary stone disease among pediatric age groups, and stone disease has a multifactorial etiology. After the diagnosis, detailed metabolic evaluation is required. High recurrence rates, therapeutic irregularities and deficiency in diagnosis may lead to comorbidities such as loss of kidney function. Following diagnosis, the requirement for surgery, such as stone extraction and correction of anatomical anomalies, is determined. Medical and supportive treatments are also needed to prevent recurrence and urinary tract infections and to preserve renal function. Supportive care includes increased fluid intake and dietary modifications. Medical treatment is dependent on the cause of the urinary stone disease. The morbidities associated with pediatric urolithiasis can be prevented by early diagnosis, detailed metabolic analysis, regular follow-up and medical treatment protocols.

Case of vertebral fracture with nephrolithiasis and hypocitraturia

“…Hypocitraturia is a condition in which there is <1.6 mmol/1.73 m 2 of urinary citrate in females or <1.9 mmol/1.73 m 2 in males in a 24-h period. 1 Aetiologies include chronic diarrhoea, medications, distal renal tubular acidosis and ketogenic diets, 4 which were not found in this patient. Hypocitraturia is managed with potassium citrate supplementation.…”

Treatment Characteristics of Kidney Stone Disease in Children

“…Только полноценная нормализация нарушений пуринового обмена позволяет добиться эффективного литолиза, в связи с чем важно контролировать уровень урикемии. Цитратные смеси не могут оказать влияния на все звенья пуринового обмена, поэтому при гиперурикемии необходимо применять ингибиторы ксантиноксидазы, например аллопуринол, который приводит к снижению содержания мочевой кислоты в сыворотке крови и моче [70].…”

Çocuklarda Üriner Sistem Taş Hastalıkları

“…Üriner sistem taşlarının tedavisindeki temel hedefler taşın ve taşa bağlı gelişen enfeksiyon ve obstruksiyon gibi komplikasyonların ortadan kaldırılması, tekrar taş oluşumunun önlenmesi, böbrek fonksiyonlarının korunması, enfeksiyonların önlenmesi ve en önemlisi özellikle çocukluk çağında altta yatan anatomik ve metabolik problemlerinin düzeltilmesi olmalıdır (Tablo 3) [16].…”