Scoffone Cesare M, Cracco Cecilia M
Department of Urology, Cottolengo Hospital, Torino, Italy.
Curr Opin Urol. 2018 Sep;28(5):428-432. doi: 10.1097/MOU.0000000000000520.
The incidence of pediatric nephrolithiasis is on the rise, with a significant related morbidity and a concomitant relevant increase in healthcare costs. The purpose of this review is to portray the current epidemiology and cause of renal stones in children, to provide a framework for appropriate clinical evaluation on an individual basis, and a guidance regarding treatment and prevention for the significant risk of lifelong recurrence and deriving complications.
The early identification of modifiable risk factors and other abnormalities is essential, to prevent related morbidity, the onset of chronic kidney disease, and the associated increased risk of developing other diseases. The implementation of risk reduction strategies, including dietary modifications and targeted pharmacological therapies, will significantly influence stone recurrences and preserve renal function.
Future research is desirable, with the aim to strengthen personalized conservative management of pediatric nephrolithiasis as first-line treatment.
儿童肾结石的发病率呈上升趋势,伴有显著的相关发病率以及医疗费用的相应增加。本综述的目的是描述儿童肾结石的当前流行病学和病因,为基于个体的适当临床评估提供框架,并就终身复发和引发并发症的重大风险提供治疗和预防指导。
早期识别可改变的风险因素和其他异常情况至关重要,以预防相关发病率、慢性肾脏病的发生以及发展其他疾病的相关风险增加。实施降低风险策略,包括饮食调整和靶向药物治疗,将显著影响结石复发并保护肾功能。
未来需要开展研究,以加强对儿童肾结石的个性化保守治疗作为一线治疗。