Alemzadeh-Ansari Mohammad Hasan, Valavi Ehsan, Ahmadzadeh Ali
Department of Pediatric Nephrology, Abuzar Children's Hospital, Jundishapour University of Medical Sciences, Ahvaz, Iran.
Iran J Kidney Dis. 2014 Jan;8(1):53-7.
Urinary calculi in infants are relatively infrequent, but their incidence has increased in the recent decades. The aim of this study was to investigate the clinical presentation, metabolic risk factors, and urinary tract abnormalities in infants suffering from kidney calculus.
A total of 152 infants were admitted between 2009 and 2012 with ultrasonography-proven urolithiasis. A Foley catheter was fixed and 24-hour urine samples were analyzed for calcium, citrate, oxalate, uric acid, and magnesium. For detecting cystinuria, qualitative measurement of urinary cystine was done by nitroprusside test. Urinary tract structural abnormalities were also evaluated.
The mean age at the diagnosis of kidney calculus was 5.46 months (range, 15 days to 12 months). The most common clinical findings were restlessness and urinary tract infection. A family history of calculi was found in 67.1% of the patients and 68.4% were born to consanguineous marriages. Metabolic abnormalities and urinary tract abnormalities were found in 96.1% and 15.1% of children, respectively. Urinary tract abnormalities were more common in girls. The most common metabolic risk factors were hypercalciuria (79.6%) and hypocitraturia (40.9%). Hyperoxaluria and hypomagnesuria were found in about 28% of patients, both of which were associated with bilateral urolithiasis.
These findings show that urinary metabolic abnormalities are very common in infants with urolithiasis. Appropriate evaluation of urinary metabolic parameters can lead us to proper diagnosis and treatment.
婴儿尿路结石相对少见，但近几十年来其发病率有所上升。本研究旨在调查患肾结石婴儿的临床表现、代谢危险因素及尿路异常情况。
2009年至2012年间，共有152例经超声证实患有尿路结石的婴儿入院。留置Foley导尿管，分析24小时尿液样本中的钙、枸橼酸盐、草酸盐、尿酸和镁。通过硝普钠试验对尿胱氨酸进行定性检测以检测胱氨酸尿症。同时评估尿路结构异常情况。
诊断肾结石时的平均年龄为5.46个月（范围为15天至12个月）。最常见的临床表现为烦躁不安和尿路感染。67.1%的患者有结石家族史，68.4%为近亲结婚所生。分别有96.1%和15.1%的儿童存在代谢异常和尿路异常。尿路异常在女孩中更为常见。最常见的代谢危险因素是高钙尿症（79.6%）和低枸橼酸尿症（40.9%）。约28%的患者存在高草酸尿症和低镁尿症，两者均与双侧尿路结石有关。
这些发现表明，尿路代谢异常在患尿路结石的婴儿中非常常见。对尿路代谢参数进行适当评估可引导我们做出正确的诊断和治疗。
