Systematic radiologic detection of kidney stones in Canadian children: a new era of asymptomatic stones?

Cassim, Raisa; Walraven, Carl van; Lavallée, Luke T.; McAlpine, Kristen; Highmore, Kerri; Leonard, Michael P.; Guerra, Luis; Grandpierre, Viviane; Vethamuthu, Jennifer; Keays, Mélise

doi:10.1016/j.jpurol.2019.05.012

Cited by 10 publications

(3 citation statements)

References 14 publications

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“…Apart from pain or restlessness, these patients may experience hematuria, dysuria, urgency symptoms suggestive of UTI, and nausea/vomiting (16). Fifteen to 20% of children with urinary tract stones are asymptomatic, mainly young children whose stones are detected when abdominal imaging is performed for other purposes (17). In our study, 9% of the patients were children whose stones were detected incidentally while examined for another reason.…”

Section: Discussionmentioning

confidence: 53%

Metabolic Risk Factors in Children with Urinary System Stones

Çivilibal,

Sılay

2024

New J Urol.

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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.

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Section: Discussionmentioning

confidence: 53%

Metabolic Risk Factors in Children with Urinary System Stones

Çivilibal,

Sılay

2024

New J Urol.

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“…22,27,28 El diagnóstico incidental se reporta hasta en un 13% de los casos. 8,29 El principal método diagnóstico sigue siendo el ultrasonido de vías urinarias. Sin embargo hay centros que utilizan la tomografía axial computarizada (TAC) dada la posibilidad de detectar litos de menor tamaño (3,7 mm), frecuentes en menores de 1 año; se puede justificar además, el uso del TAC, por tener una sensibilidad y una especificidad casi del 100%, además de brindar información anatómica útil en casos quirúrgicos.…”

Section: Discussionunclassified

Litiasis renal en niños

Chacón-Retana¹,

Rojas²

2021

AMC

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Justificación y objetivo: la litiasis renal se debe a la precipitación de cristales por un desequilibrio en la orina entre sustancias promotoras y las sustancias inhibitorias. Es una patología con una prevalencia entre 2-10% en la población pediátrica, con una incidencia que ha aumentado en los últimos 25 años; razón por la cual este estudio pretende conocer la prevalencia, las manifestaciones clínicas y metabólicas de la litiasis renal en la población pediátrica del Hospital Nacional de Niños de Costa Rica. Métodos: Es un estudio retrospectivo, descriptivo y observacional, mediante la revisión de expedientes de pacientes menores a 18 años con el diagnóstico de litiasis renal, atendidos en el Hospital Nacional de Niños, en el periodo comprendido entre enero del año 2000 al 2018. Resultados: se incluyeron un total de 106 pacientes. El 57,5% hombres, la edad promedio al diagnóstico de 6,6 ± 3,8 años; la frecuencia de casos se ha incrementado en 5,5 veces en los últimos 5 años. Factores de riesgo detectados: anormalidades del tracto urinario 22,6% y antecedentes familiares de litiasis 17,9%. El análisis metabólico mostró un gasto urinario bajo en el 74,3%, hiperfosfaturia en un 43,2%, hipomagnesuria 39,2% e hipercalciuria 37,8%. Etiologías determinadas: metabólica 54,7%, malformaciones de las vías urinarias 16% e idiopática en un 30,9%. La litotricia intracorpórea se aplicó en un 61,2%. La recidiva se observó en el 28,5% de los casos, se encontró relación entre la incidencia de recidiva con el tamaño del lito (p = 0,001) y el tratamiento quirúrgico. (p = 0,010). Conclusiones: Existe un aumento en la frecuencia de casos de litiasis pediátrica con una etiología multifactorial en el Hospital Nacional de Niños de Costa Rica.

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“…Renal stones have a high recurrence ratio, patients may need multiple scans, therefore making them more prone to the risks associated with excessive radiation dosage 7 . In countries like Pakistan, India, Nepal, and Bangladesh, where geographical factors contribute to the prevalence and recurrence of renal stones, the economic burden of diagnostic modalities and stone removal procedures is unaffordable for more than 60% of the population [7][8][9] . American Urological Association (AUA) has indicated to avoid multiple CT scans and excessive radiation exposure, however, the usage of CT KUB is still in priority 6,10,11 .…”

Section: Introductionmentioning

confidence: 99%

All That Glitter is not Gold: Computed Tomography-Kidney Ureter Bladder (CT-KUB) is not necessary for a Safe Percutaneous Nephrolithotomy

2022

PJMD

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Background: Diagnosis of renal stones is tricky and appropriate diagnosis requires exact location and size identification of renal stones along with the degree of obstruction and hydronephrosis. This study aimed to compare the difference between Ultrasound and Computed tomography Kidney ureter Bladder (CT KUB) groups for stone clearance, diagnostic accuracy, laboratory parameters, and complications. Methods: This is a cross-sectional, comparative effectiveness trial; patients (n=100) with suspected renal stones were randomly assigned with a 1:1 ratio in two different imaging groups, Group A (n=50) participants had ultrasonography and group B (n=50) patients had Computed tomography as a diagnostic imaging modality. The complications and operative differences were compared with the help of student t-test and chi-square tests, a p-value of 0.05 was considered statistically significant. Results: The mean age of the patients was 37.3 ± 17 years and 45.8 ± 14.7 years in group A and group B, respectively. The study found no difference (0.3 and 0.1) between pre-operative stone size measurements of the renal unit by ultrasound and CT [(2.4±0.9 cm and 2.7±1.8cm (right) 1.8±1.0 cm and 1.9±0.7 cm (left)]. The sensitivity and specificity of USG for renal stone diagnosis was 84.8%, while CT indicated 86% accuracy, X-Ray KUB was used for radiopaque stones only and showed 78.6% sensitivity and specificity. Conclusion: The pre-operative stone sizes indicated in ultrasonography and CT were similar in intra-operative, retrograde pyelogram (RPG) measurements, referred to the accuracy of stone size prediction. Simple x-ray and ultrasonography are cost-effective, easily available in hospitals, with minimal radiation exposure. Keywords: Percutaneous Nephrolithotomy; Ultrasonography; Kidney Stones.

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Systematic radiologic detection of kidney stones in Canadian children: a new era of asymptomatic stones?

Cited by 10 publications

References 14 publications

Metabolic Risk Factors in Children with Urinary System Stones

Metabolic Risk Factors in Children with Urinary System Stones

Litiasis renal en niños

All That Glitter is not Gold: Computed Tomography-Kidney Ureter Bladder (CT-KUB) is not necessary for a Safe Percutaneous Nephrolithotomy

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