Metabolic Risk Factors in Children with Urinary System Stones

Abstract

Objective: To diagnose, treat, and prevent stone recurrence, it is important to determine the metabolic risk factors that play a role in developing urinary system stone disease in children. This study assessed children with urinary system stones’ clinical, radiological, and metabolic characteristics. Material And Methods: A retrospective study was conducted on the records of pediatric patients who applied to our pediatric outpatient nephrology clinic for various reasons between February 2018 and December 2023 and were diagnosed with urinary system stones. Results: Of the 122 patients with a mean age of 4.40±4.16 years (1 month-17 years), 63 (51.6%) were boys and 59 (48.4%) were girls. In 61.4% of the children, a family history was identified. The most common presenting symptom was abdominal/flank pain or restlessness (47.5%). In 25.4% of the patients, the stones were ≤3 mm (microlithiasis), and most stones were in the upper system. One or more metabolic abnormalities have been detected during urine analysis for 58.2% of patients. The most frequent metabolic abnormalities were hypercalciuria (20.5%) and hypocitraturia (17.2%). In 74.6% of patients, the size of stones decreased or completely disappeared with medical treatment based on underlying metabolic abnormalities, and in 17.2%, they did not change at all. Only eight (6.6%) patients required interventional procedures. Conclusion: Metabolic causes should be investigated first in all children with urinary tract stones. Special medical treatments designed to alter metabolism reduce the need for invasive stone procedures.