KMID : 0811820070110020280
|
|
Journal of Korean Society of Pediatric Nephrology 2007 Volume.11 No. 2 p.280 ~ p.287
|
|
Urinary Lithiasis in Children : A Single Center Study
|
|
Lee Hyun-Kyung
Lee Sung-Ha Han Kyung-Hee Lee Beom-Hee Choi Hyun-Jin Ha Il-Soo Cheong Hae-Il Choi Yong
|
|
Abstract
|
|
|
Purpose : Urinary lithiasis is uncommon in children, however, it may lead to chronic renal insufficiency and even end stage renal disease. The etiology of stone formation in children is largely unknown; although the most common causes are known to be associated with congenital anomalies of the genito-urinary(G-U) tract, urinary tract infections(UTI), and metabolic diseases.
Methods : A total of 73 children(male:female=42:31, mean age 6.6+/-5.3 years) presented with urinary lithiasis between Sep. 1998 and Jul. 2007 at Seoul National University Children¡¯s Hospital. The medical records were reviewed retrospectively.
Results : The most common presenting symptoms were gross hematuria(28/73, 38%) and flank or abdominal pain(23/73, 32%). The stones were located in the upper urinary tract in 48 patients(66%), in the bladder in 18(24%), and in both the bladder and upper urinary tract in 2 (3%). Congenital anomalies of the G-U tract with/without UTI were detected in 30 children (41%), hypercalciuria with/without hypercalcemia in 15(20%), and other metabolic diseases in 8(11%). In 17 patients(23%), no underlying cause of stone formation was detected. The majority of stones were infected stones(24/36, 67%), which were followed by calcium stones(8/36, 22%), uric acid stones(3/36, 8%), and cystine stones(1/36, 3%). Thirty-four patients(46%) underwent surgical procedures and/or extracorporeal shockwave lithotripsy for stone removal, and 13(18%) passed stones spontaneously with/without medical management. Stones recurred in 6 patients(8%): 4 with neurogenic bladder augmented by ileocystoplasty, 1 with cystinuria, and 1 with unknown etiology.
Conclusion : The common causes of urinary lithiasis in children were congenital anomalies of the G-U tract with/without UTI and metabolic disorders including hypercalciuria/hypercalcemia. For the management of stones, minimally invasive procedures should be chosen on the basis of accompanying symptoms and the composition, locations and etiology of stones.
|
|
KEYWORD
|
|
Urinary Iithiasis, Presenting symptom, Location, Underlyin cause, Stone analysis, Management, Recurrence, Children
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|