Kidney Stone in Children: Is Hypocitratury Underdiagnosed?
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Original Investigation
P: 184-188
April 2021

Kidney Stone in Children: Is Hypocitratury Underdiagnosed?

GMJ 2021;32(2):184-188
1. Ankara Yıldırım Beyazıt Üniversitesi, Yenimahalle Eğitim ve Araştırma Hastanesi, Çocuk Sağlığı ve Hastalıkları ABD, Çocuk Nefrolojisi Kliniği, Ankara, Türkiye
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Received Date: 12.02.2020
Accepted Date: 30.07.2020
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ABSTRACT

Objective:

The frequency of kidney stones is gradually increasing and it is endemic in our country. The aim of our study is to evaluate the clinical, laboratory, radiological and follow-up findings of children with kidney stones and to investigate the etiology and factors affecting prognosis.

Methods:

The files of 209 children who were followed up in the pediatric nephrology outpatient clinic for kidney stones were analyzed retrospectively. Demographic data, laboratory and radiological findings, and follow-up data of the patients were recorded. The patients were grouped by age and the groups were compared in terms of demographic characteristics and underlying metabolic abnormalities. Multivariate logistic regression analysis was used to determine the factors that may affect the resolution of the stone at the end of the follow-up.

Results:

Of the 209 children included in the study, 107 were girls and 102 were boys. The median age was 18 months (1-214 months). Kidney stones were present in the family in 56% of the patients. It was noteworthy that approximately half of the patients were diagnosed at the first two years of age, and the most common symptom was restlessness. At least one metabolic abnormalities were detected in 52% of the patients, the most common metabolic disorders were hypocitraturia (34.3%) and hypercalciuria (27%). In follow-up, the frequency of stone disappearance was significantly higher in children with microlithiasis (71% and 46% p <0.001). When the age, gender, family stone history, stone size, number and underlying metabolic abnormality of the factors that may affect stone disappearance in the follow-up were evaluated with multiple logistic regression analysis; only small stone size was found to affect prognosis (p: 0.009, odds ratio: 2.39, 95% confidence interval 1.2- 4.6).

Conclusion:

Kidney stones may present with nonspecific symptoms in childhood, so care should be taken in terms of stone in such patients with a family history of stones. The most common cause of stone is hypocitraturia and hypercalciuria, especially hypocraturia is thought to be underdiagnose in clinical practice. The most important factor in resolution od stones during follow-up has been shown to be the size of the stone.

Keywords:
Kidney stones, nephrolithiasis, hypocitraturia, hypercalciuria, child