Instituto de Investigaciones Metabólicas (IDIM), Libertad 836, 1er piso (1012), Buenos Aires, Argentina.
Universidad del Salvador (USAL), Buenos Aires, Argentina.
Pediatr Nephrol. 2020 Nov;35(11):2107-2112. doi: 10.1007/s00467-020-04660-x. Epub 2020 Jun 20.
The prevalence of kidney stones in children has significantly increased in the past few decades, with concomitant increased morbidity and healthcare costs worldwide. Assessing metabolic risk factors is essential for diagnosis and specific treatment. The objective of this retrospective study is to identify the epidemiological and clinical characteristics of children under 17 years of age, as well as the metabolic risk factors of nephrolithiasis.
A total of 300 children with kidney stone disease were included to undergo several clinical tests using a standardized protocol.
The mean age was 11.2 years, and the male:female ratio was 1.15:1.0. Biochemical abnormalities were found in 89.3% of all cases. A single urine metabolic risk factor was present in 52.6% (n = 141) of the patients, and multiple risk factors were present in 36.7% (n = 106). Idiopathic hypercalciuria (alone or in combination) and hypocitraturia (alone or in combination) were the most frequent risk factors identified in 47.0% and 39.6% of these patients, respectively. Renal colic and/or unspecified abdominal pain were the most frequent forms of presentation (76.9%), followed by hematuria in 64.4% with 97.5% of stones located in the upper urinary tract. A positive family history in first-degree and second-degree relatives was found in 64.8% of boys and 61.8% of girls.
We conclude that specific urinary metabolic risk factors can be found in most children with kidney stones, with hypercalciuria and hypocitraturia being the most common diagnoses. Graphical abstract .
在过去几十年中，儿童肾结石的患病率显著增加，全球范围内发病率和医疗保健费用也随之增加。评估代谢危险因素对于诊断和特定治疗至关重要。本回顾性研究的目的是确定 17 岁以下儿童的流行病学和临床特征，以及肾结石的代谢危险因素。
共纳入 300 例肾结石患儿，采用标准化方案进行多项临床检查。
平均年龄为 11.2 岁，男女比例为 1.15:1.0。所有病例中均存在生化异常。52.6%（n=141）的患者存在单一尿代谢危险因素，36.7%（n=106）的患者存在多种危险因素。特发性高钙尿症（单独或联合存在）和低枸橼酸尿症（单独或联合存在）分别是这部分患者中最常见的危险因素，占 47.0%和 39.6%。肾绞痛和/或未特指的腹痛是最常见的表现形式（76.9%），其次是血尿，占 64.4%，97.5%的结石位于上尿路。一级和二级亲属中有阳性家族史的男孩占 64.8%，女孩占 61.8%。
我们得出结论，大多数肾结石患儿都可以发现特定的尿代谢危险因素，高钙尿症和低枸橼酸尿症最常见。
