Department of Pediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, N6A 5W9, Canada.
Instituto Nacional de Pediatría, 04530, Ciudad de México, Mexico.
Pediatr Nephrol. 2020 Mar;35(3):383-397. doi: 10.1007/s00467-018-4179-9. Epub 2019 Jan 4.
The incidence of nephrolithiasis in children and adolescents is increasing and appears to double every 10 years. The most important role of the pediatric nephrologist is to diagnose and modify various metabolic and non-metabolic risk factors, as well as prevent long-term complications especially in the case of recurrent nephrolithiasis.
The purpose of this review is to summarize the existing literature on the etiology and management of pediatric nephrolithiasis.
The incidence of kidney stones is increasing; dietary and environmental factors are probably the main causes for this increased incidence. In most pediatric patients, the etiology for the kidney stones can be identified. Metabolic factors, such as hypercalciuria and hypocitraturia, urinary tract infection, and urinary stasis, constitute leading causes. Herein, we review the etiologies, diagnostic work-up, and treatment options for the most prevalent causes of kidney stones. The detrimental effects of excessive dietary sodium, reduced fluid intake, and the benefits of plant-based over animal-based protein consumption on urinary crystal formation are discussed. We also review the long-term complications.
Pediatric nephrologists have an important role in the diagnostic work-up and prevention of recurring nephrolithiasis.
儿童和青少年肾结石的发病率正在增加，似乎每 10 年翻一番。儿科肾脏病学家的最重要作用是诊断和改变各种代谢和非代谢危险因素，并预防长期并发症，特别是在复发性肾结石的情况下。
本文旨在总结有关儿童肾结石病因和治疗的现有文献。
肾结石的发病率正在增加；饮食和环境因素可能是发病率增加的主要原因。在大多数儿科患者中，可以确定肾结石的病因。代谢因素，如高钙尿症和低柠檬酸尿症、尿路感染和尿潴留，构成主要原因。在此，我们回顾了最常见肾结石病因的病因、诊断方法和治疗选择。讨论了过量膳食钠、液体摄入减少以及植物性蛋白质摄入优于动物性蛋白质摄入对尿晶体形成的有害影响。我们还回顾了长期并发症。
儿科肾脏病学家在复发性肾结石的诊断和预防中发挥着重要作用。
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