Celiksoy Mehmet Halil, Yilmaz Alev, Aydogan Gonul, Kiyak Aysel, Topal Erdem, Sander Serdar
Department of Pediatrics, İstanbul Bakırköy Maternity and Children's Diseases Training and Research Hospital, Istanbul, Turkey.
Division of Pediatric Nephrology, Department of Pediatrics, İstanbul Bakırköy Maternity and Children's Diseases Training and Research Hospital, Istanbul, Turkey.
Urology. 2015 Apr;85(4):909-13. doi: 10.1016/j.urology.2014.12.032.
To review metabolic disorders in Turkish children with urinary tract stone disease.
The medical records of 308 pediatric patients with the diagnosis of urolithiasis between 1996 and 2008, whose disease progression was followed in a single tertiary-care center, were reviewed retrospectively. Two hundred forty-eight patients whose metabolic analyses were performed were included in the study.
Of the 248 patients participating in the study, 142 (57%) were men and 106 (43%) were women. The median age of the patients was 48 months (minimum-maximum, 2-180 months). Seventy-six percent of the patients had metabolic disorders. Of all patients, 44% had 1, 23% had 2, and 7% had 3 metabolic disorders. Hypercalciuria, hypocitraturia, hyperoxaluria, hyperuricosuria, and cystinuria were detected in 41%, 39%, 22%, 9%, and 4% of the patients, respectively. The rate of multiple stone formation, infection, and recurrence was significantly higher in the 0-2 years age group (P = .030, P = .001, P = .019, respectively). The median age of patients was greater (P = .001) in patients with hyperoxaluria in comparison with other metabolic disorders. Compared with other metabolic disorders, multiple stones and recurrence were more frequent in patients with cystinuria (P = .022 and P = .008, respectively). The size of the stones was greater in patients with hyperuricosuria in comparison with other metabolic disorders (P = .009).
The majority of children with urinary tract stone disease exhibited ≥1 metabolic risk factors. Metabolic risk factors should be evaluated in all children with urinary stone disease to provide appropriate treatment.
回顾土耳其患尿路结石病儿童的代谢紊乱情况。
回顾性分析1996年至2008年间在单一三级医疗中心接受随访的308例诊断为尿石症的儿科患者的病历。本研究纳入了248例进行了代谢分析的患者。
参与研究的248例患者中，142例（57%）为男性，106例（43%）为女性。患者的中位年龄为48个月（最小-最大，2-180个月）。76%的患者存在代谢紊乱。在所有患者中，44%有1种、23%有2种、7%有3种代谢紊乱。高钙尿症、低枸橼酸尿症、高草酸尿症、高尿酸尿症和胱氨酸尿症分别在41%、39%、22%、9%和4%的患者中被检测到。0-2岁年龄组的多发结石形成、感染和复发率显著更高（分别为P = .030、P = .001、P = .019）。与其他代谢紊乱患者相比，高草酸尿症患者的中位年龄更大（P = .001）。与其他代谢紊乱相比，胱氨酸尿症患者的多发结石和复发更为频繁（分别为P = . .022和P = .008）。与其他代谢紊乱患者相比，高尿酸尿症患者的结石尺寸更大（P = .009）。
大多数患尿路结石病的儿童表现出≥1种代谢风险因素。应对所有患尿路结石病的儿童评估代谢风险因素，以提供适当治疗。
