Pediatric Stone Disease: An Evolving Experience

Abstract

The majority of patients had no congenital abnormalities. Early diagnosis of urological abnormalities and urinary infection, and appropriate management of neurogenic bladder may have reduced the incidence in those groups. Most stones are calcium based but occur in the absence of metabolic disturbances. More patients presented in the fall, perhaps reflecting the increased concentration of urine in the summer. Half of the patients passed the stones and shock wave lithotripsy was curative in most others. Ureteroscopy, percutaneous nephrostolithotomy and open surgery were rarely required.

The increasing pediatric stone disease problem

“…Yet, in more recent series, approximately 7080% of children will present symptomatically with either flank pain or abdominal pain, 1032% will also have gross hematuria, and 420% will have a concomitant urinary tract infection (UTI). The majority of pediatric patients will present with stones in an idiopathic manner, but 924% will have an associated secondary cause such as congenital urinary tract anomaly, metabolic deficiency, or neurologic disease [Alpay et al 2009;Kalorin et al 2009;Dursun et al 2008;Kit et al 2008;VanDervoort et al 2007;Sternberg et al 2005;Alon et al 2004]. Overall, approximately 5060% of patients have stones located in the kidney at the time of diagnosis [Passerotti et al 2009;Palmer et al 2005;Sternberg et al 2005;Kroovand, 1997].…”

Dietary and Lifestyle Factors and its Risk to Kidney Stone Disease: A Case Control Study at UKM Medical Centre

“…These are some of the factors that contribute to the geographical pattern that has characterized the North American and Afro-Asian stone belts. Also, in a given population, stone recurrence is higher in summer and fall than in winter and spring (Sternberg et al 2005). In a North American study, the prevalence of stones tends to increase in line with the average annual temperature (5.2°C in North Dakota to 22°C in Florida) and sunlight index (14.6 in Washington state to 39.7 in Florida) (Soucie et al 1996).…”

Pediatric urolithiasis: What role does metabolic evaluation has to play?

“…9,10 Metabolic evaluation can lead to identification of metabolic abnormalities present in patients and help one to establish effective therapy. Type and extent of evaluation depends on the severity and type of calculus, presence and absence of systemic diseases, risk factors of recurrent calculus formation, and family history of nephrolithiasis (considered as a significant risk factor of relapse).…”