Safaei Asl Afshin, Maleknejad Shohreh
Division of Nephrology, Department of Pediatrics, Guilan University of Medical Sciences, Rasht, Iran.
Iran J Kidney Dis. 2011 Sep;5(5):309-13.
The aim of this study was to evaluate the clinical features and metabolic and anatomic risk factors of urolithiasis in children.
Between 2004 and 2009, a total of 84 children (35 girls and 49 boys) had been treated because of urolithiasis. Clinical presentation, urinary tract infection, calculus localization, family history, presence of anatomic abnormalities, and urinary metabolic risk factors were evaluated, retrospectively.
The children were between 6 months and 16 years of age (mean age, 5.25 ± 3.61 years). The calculus diameter was 3.2 mm to 31 mm (mean, 7.31 ± 4.64 mm). In 90.6% of the cases, the calculus was located only in the kidneys and in 2.4% it was only in the bladder. The most common presentations were urinary tract infection, restlessness, and abdominal pain. A positive family history of urinary calculi was detected in 27.3%; urinary tract infection, in 23.8%; and anatomic abnormality, in 10.7% of the patients. Metabolic evaluation, which was carried out in 78 patients, revealed that 52.6% of them had a metabolic risk factor including normocalcemic hypercalciuria (21.7%), hyperuricosuria (11.5%), cystinuria (3.8%), and hyperoxaluria (5.1%).
We think that urolithiasis remains a serious problem in children in our country. Family history of urolithiasis, urologic abnormalities, especially under the age of 5 years, metabolic disorders, and urinary tract infections tend to be associated with childhood urolithiasis.
本研究旨在评估儿童尿路结石的临床特征、代谢及解剖学危险因素。
2004年至2009年间,共有84例儿童(35名女孩和49名男孩)因尿路结石接受治疗。回顾性评估临床表现、尿路感染、结石部位、家族史、解剖学异常的存在情况以及尿液代谢危险因素。
患儿年龄在6个月至16岁之间(平均年龄5.25±3.61岁)。结石直径为3.2毫米至31毫米(平均7.31±4.64毫米)。90.6%的病例中,结石仅位于肾脏,2.4%仅位于膀胱。最常见的表现为尿路感染、烦躁不安和腹痛。27.3%的患者检测到尿路结石家族史阳性;23.8%有尿路感染;10.7%有解剖学异常。对78例患者进行的代谢评估显示,其中52.6%有代谢危险因素,包括正常血钙性高钙尿症(21.7%)、高尿酸尿症(11.5%)、胱氨酸尿症(3.8%)和高草酸尿症(5.1%)。
我们认为尿路结石在我国儿童中仍然是一个严重问题。尿路结石家族史、泌尿系统异常,尤其是5岁以下儿童、代谢紊乱和尿路感染往往与儿童尿路结石有关。