Bastug Funda, Celık Binnaz
Department of Pediatric Nephrology, Kayseri City Education and Research Hospital, Kocasinan/Kayseri, Turkey.
Department of Pediatrics, Kayseri City Education and Research Hospital, Kocasinan/Kayseri, 38080, Turkey.
Urolithiasis. 2021 Oct;49(5):457-462. doi: 10.1007/s00240-021-01248-4. Epub 2021 Feb 8.
Urinary stone disease is a common condition. We investigated the usefulness of medical treatment for infants with urinary stones 5 mm or smaller. The study included 197 infants (86 girls and 111 boys) with urolithiasis ≤ 5 mm who were referred to our Department of Nephrology between 2014 and 2016. Infants with metabolic or anatomical risk factors requiring medical treatment were excluded from the study. We retrospectively reviewed urine and serum metabolic profiles and compared stone resolution rates in patients who did and did not receive treatment. The mean age at diagnosis was 5.2 months (range, 14 days to 12 months). The most common complaint was restlessness (n = 92, 46.7%), and 49 infants (24.9%) were asymptomatic. Multiple stones were detected in 166 infants (84.3%). Hypomagnesuria, hypocitraturia, and hypercalciuria were present in 25.3, 19.7, and 18.7% of patients, respectively. Stones < 3 mm (microlithiasis) were detected in 97 infants (49.2%), and 100 (50.8%) patients had 3-5 mm stones. In total, 130 infants (66.5%) received regular treatment and 67 (33.5%) were not treated. Stone resolution was significantly higher in the group receiving K-citrate treatment at the 6th month follow-up, while there were no significantly difference between the two groups at the 12th month control. No previous studies have investigated treatment outcomes in infants with 3-5 mm urinary stones. According to our results, K-citrate treatment may accelerate the resolution of the stone in infants with stones smaller than 5 mm.
尿石症是一种常见病症。我们研究了药物治疗对5毫米及以下尿路结石婴儿的有效性。该研究纳入了2014年至2016年间转诊至我们肾脏病科的197例尿路结石≤5毫米的婴儿（86例女孩和111例男孩）。有需要药物治疗的代谢或解剖危险因素的婴儿被排除在研究之外。我们回顾性分析了尿液和血清代谢谱，并比较了接受治疗和未接受治疗患者的结石溶解率。诊断时的平均年龄为5.2个月（范围为14天至12个月）。最常见的症状是烦躁不安（n = 92，46.7%），49例婴儿（24.9%）无症状。166例婴儿（84.3%）检测到多发结石。分别有25.3%、19.7%和18.7%的患者存在低镁尿症、低枸橼酸尿症和高钙尿症。97例婴儿（49.2%）检测到<3毫米的结石（微结石症），100例（50.8%）患者有3 - 5毫米的结石。总共130例婴儿（66.5%）接受了常规治疗，67例（33.5%）未接受治疗。在第6个月随访时，接受柠檬酸钾治疗组的结石溶解率显著更高，而在第12个月复查时两组之间无显著差异。此前尚无研究调查3 - 5毫米尿路结石婴儿的治疗结果。根据我们的结果，柠檬酸钾治疗可能会加速5毫米以下结石婴儿的结石溶解。
