Risk factors for development of urinary tract infection in children with nephrolithiasis

Abstract

Aim: Nephrolithiasis is one of the causes of urinary tract infection (UTI). In this study, we investigated risk factors for UTI in children with nephrolithiasis. Methods: The data from the patients with nephrolithiasis were evaluated in this retrospective follow-up study. Patients with a history of UTI before admission and congenital anomaly of kidney or urinary tract were excluded. The patients were divided into two groups: patients with UTI (recurrent UTI and single UTI) and patients without UTI. Results: A total of 599 patients were included in this study. UTI occurred in 181 (30.2%) patients. There was a positive association between the size of stone and UTI (odds ratio (OR): 1.355, P = 0.007). Receiver operating characteristic curve analysis showed that the cut-off value of the size of stone for UTI was 5.3 mm, with a sensitivity of 74.9% and a specificity of 66.1% (area under the curve: 0.572 AE 0.028, P = 0.013). The presence of a metabolic risk factor and age at diagnosis under 2 years were significantly associated with both UTI and recurrence of UTI (OR: 2.272, P = 0.021, OR: 1.809, P = 0.028, respectively, for metabolic risk factor; OR: 1.212, P = 0.041, OR: 1.122, P = 0.046, respectively, for age at diagnosis under 2 years). Hypercalciuria was significantly associated with the recurrence of UTI (OR: 1.854, P = 0.017). Conclusions: The age at diagnosis, the presence of a metabolic risk factor and size of stone are significant risk factors for UTI in children with nephrolithiasis. The patients with idiopathic hypercalciuria, metabolic risk factor and age at diagnosis under 2 years have increased risk of recurrence of UTI.

The Alarming Situation of Hospital Acquired Multi-drug Resistant Urinary Tract Infections in Pediatric Population in Developing World

“…In study done in Taiwan by Huang WY et al, 34% of urinary stone disease had associated UTI [28]. In the study of Cetin N et al, 30.2% of urinary stone disease patients had UTI [29]. The study done in Baghdad by Qadeer DS et al, 24.3% [30] while Hsiao et al found 17.1% [31] and Kasew D et al, in Ethopia 16.3% [32] of urinary stone disease patient with UTI.…”

Association of Kidney Stones and Recurrent UTIs: the Chicken and Egg Situation. A Systematic Review of Literature

“…Similarly, a nationwide study from Taiwan stated that UTI was the most common associated morbidity among 1679 pediatric subjects with newly diagnosed urolithiasis, in 34.1% of all subjects [20]. In a retrospective follow-up study of 599 pediatric patients with nephrolithiasis under 2 years old at diagnosis, presence of a metabolic risk factor and size of stone > 5.3 mm were assessed as significant risk factors for the onset of single and recurrent UTI in children with nephrolithiasis [21].…”

Treatment Characteristics of Kidney Stone Disease in Children

“…Известно, что МКБ связана с идентифицируемой метаболической аномалией примерно у 40-50% детей. При этом гиперкальциурия встречается в 30-40% случаев, гиперурикозурия -в 4-30% (зависит от возраста и страны проживания), гипероксалурия -в 2-15%, гипоцитратурияв 30-70%, гипомагнезурия -до 42% случаев [71,72]. При этом у большинства детей с МКБ отмечены питание с повышенным содержанием простых углеводов, жиров и натрия, низкий объем потребляемой воды на фоне увеличенного потребления сладких и газированных напитков [73].…”