Ertan Pelin, Tekin Gökhan, Oger Neşe, Alkan Senem, Horasan Gönül Dinç
Department of Pediatric Nephrology, Celal Bayar University, Manisa, Turkey.
Urol Res. 2011 Apr;39(2):105-10. doi: 10.1007/s00240-010-0306-1. Epub 2010 Jul 23.
Pediatric urolithiasis is an endemic disease in Turkey. We evaluated the clinical, radiological and metabolic features of children with urolithiasis in Western Turkey. We retrospectively reviewed the records of 85 children with urolithiasis who were followed-up between 2004 and 2010 in Pediatric Nephrology Department of Celal Bayar University, Manisa. The male/female ratio was 1.23/1. The mean age at diagnosis was 66.1 months (range 3-210 months). Family history of urolithiasis was found in 58 (68.2%) patients. 23 (27%) patients were born from consanguineous marriages. Stones were located in the upper urinary tract in 79 (92.9%) patients. In 66 (77.6%) patients, stones were single-sided and 41 (48.2%) patients had multiple stones. Calcium oxalate stones were the most common one among patients in whom stone analysis was performed (78.5%). Hypocitraturia was the most commonly detected urinary metabolic risk factor. In patients who were under 12 months of age at diagnosis, hypercalciuria was the most commonly seen urinary metabolic risk factor. At the end of follow-up period, 24 patients became free of stone disease and 4 patients had recurrence. In conclusion, metabolic abnormalities are common in pediatric stone patients and are strongly associated with recurrence. Considering that urolithiasis in children is an important risk factor for renal failure, early diagnosis, detailed metabolic evaluation and implementing appropriate treatment and follow-up protocols may prevent recurrence and renal damage.
小儿尿石症在土耳其是一种地方病。我们评估了土耳其西部小儿尿石症患儿的临床、放射学和代谢特征。我们回顾性分析了2004年至2010年期间在马尼萨市切拉尔·巴亚尔大学儿科肾脏病科接受随访的85例小儿尿石症患儿的病历。男女比例为1.23:1。诊断时的平均年龄为66.1个月(范围3 - 210个月)。58例(68.2%)患者有尿石症家族史。23例(27%)患者出生于近亲结婚家庭。79例(92.9%)患者结石位于上尿路。66例(77.6%)患者结石为单侧,41例(48.2%)患者有多发性结石。在进行结石成分分析的患者中,草酸钙结石最为常见(78.5%)。低枸橼酸尿是最常检测到的尿液代谢风险因素。在诊断时年龄小于12个月的患者中,高钙尿是最常见的尿液代谢风险因素。随访结束时,24例患者结石病痊愈,4例患者复发。总之,代谢异常在小儿结石患者中很常见,且与复发密切相关。鉴于小儿尿石症是肾衰竭的重要危险因素,早期诊断、详细的代谢评估以及实施适当的治疗和随访方案可能预防复发和肾脏损害。