Perfil Clínico-Epidemiológico De 106 Pacientes Pediátricos Portadores De Urolitíase No Rio De Janeiro

Abstract

Objective: To describe the frequency, clinical profile and treatment of patients with urolithiasis in the Pediatric Nephrology Department of a public state hospital in Rio de Janeiro, Brazil.Methods: Retrospective study. Data from pediatric patients (age: 1 month - 18 years) with urolithiasis admitted between January/2012 and December/2014 were reviewed from hospital charts. The studied variables were: demographic and anthropometric data, clinical status, family history of urolithiasis, urinary tract infection and use of lithogenic drugs, diagnostic procedures, associated abnormalities, metabolic disorders, treatment and recurrence.Results: The frequency of urolithiasis was 13.6%. Main characteristics of the patients: male gender, white race, eutrophy, aged between 5 and 10 years, family history of urolithiasis, previous urinary infection and spontaneous stone passage. Abdominal and flank pain and macroscopic hematuria were the most common complaints. The most frequent metabolic disorders were hypercalciuria, hyperuricosuria and hypocitraturia. Hypocitraturia was associated with previous urinary infection (p=0.004). Abdomen/urinary tract ultrasonography was the most commonly used diagnostic test. Hydronephrosis occurred in 54.4% of the cases, 81.1% of the stones were in the kidneys, and bilateral stones were associated to a family history of urolithiasis (p=0.030). Recurrence rate was 29.3% (most patients had a metabolic disorder). In 12.3%, the patients underwent lithotripsy, 24.5% were surgically treated (mainly pyelolithotomy), and only 7.6% had their stones analyzed (calcium oxalate was the main finding in the examined stones).Conclusions: The frequency of urolithiasis in these pediatric patients was similar to that reported by the literature. A metabolic evaluation is required and the composition of stones should be better evaluated.

Risk factors for recurrence in pediatric urinary stone disease

“…Children generally do not have any complaints about stones [ 9 , 16 , 17 ]. The most common reasons for referral in children are urinary tract infections (36–37%) and abdominal pain (32–58%) [ 14 , 16 , 18 ]. Besides, stone disease is detected incidentally in 11–24% of the patients in childhood [ 14 , 16 , 18 ].…”

“…The most common reasons for referral in children are urinary tract infections (36–37%) and abdominal pain (32–58%) [ 14 , 16 , 18 ]. Besides, stone disease is detected incidentally in 11–24% of the patients in childhood [ 14 , 16 , 18 ]. The most common complaint of our patients was UTI, seen in more than one-fifth of the patients, followed by discoloration of the urine and abdominal pain whereas 22% of the patients were referred due to the incidental detection of stones on USG.…”

“…The most common complaint of our patients was UTI, seen in more than one-fifth of the patients, followed by discoloration of the urine and abdominal pain whereas 22% of the patients were referred due to the incidental detection of stones on USG. The family history of urinary stone disease in children with urolithiasis has been reported to be 40–85% [ 11 , 14 , 18 ]. Consistent with this range, 62% of our patients had a family history of stone disease.…”

Perfil epidemiológico da nefrolitíase na faixa etária pediátrica no Distrito Federal

“…No entanto, na faixa etária pediátrica sua prevalência é menor, acometendo menos de 5% das crianças e dos adolescentes. Apesar disso, nas últimas décadas, essa condição tem apresentado um crescimento significativo e ganhado destaque dentro da urologia pediátrica (2).…”

“…Apesar disso, alguns fatores de risco associados à formação de cálculos no sistema urinário já são conhecidos, como componentes genéticos, evidenciada por história familiar positiva, alterações anatômicas, fatores ambientais e nutricionais (2,(4)(5)(6).…”