Dr Abelardo Buch López Nephrology Institute (INEF), Havana,Cuba.
MEDICC Rev. 2021 Jan;23(1):43-48. doi: 10.37757/MR2021.V23.N1.9. Epub 2021 Jan 30.
Pediatric urinary lithiasis (urolithiasis) is an important health issue linked to urinary metabolic disorders. In the United States alone, annual costs associated with urolithiasis are $229 million for hospital admissions and $146 million for emergency care.
Identify urinary metabolic disorders in Cuban pediatric patients with urolithiasis and better understand the relationship of age, demographic and anthropometric variables to urinary metabolic disorders strongly associated with urolithiasis.
We carried out a descriptive, cross-sectional study. The study universe was comprised of Cuban patients aged 2 to 19 years with urinary lithiasis who underwent renal metabolic studies at the Dr Abelardo Buch López Nephrology Institute in Havana, Cuba, from 2008 through 2019. All data were obtained from reports of the aforementioned metabolic studies. We collected the following variables: age, sex, nutritional status, urinary volume, plasma and urinary creatine concentrations; and calcium, uric acid, oxalate and citrate urinary excretions collected during a 24-hour period. We included results of urinary cystine tests and urine mini-cultures. We obtained frequency distributions for categorical and qualitative variables and calculated means and standard deviations for quantitative variables. We also evaluated homogeneity of metabolic disorders between children and adolescents.
We studied 1592 pediatric patients, of whom 67.7% (1078/1592) were adolescents. The main metabolic disorders included hypercalciuria (39.1%; 622/1592), decreased urinary flow (22.4%; 357/1592) and hypocitraturia (18.2%; 289/1592). Hypercalciuria, hypocitraturia and hyperoxaluria were more common in children, while decreased urinary flow and hyperuricosuria were more common in adolescents. Hyperuricosuria was more frequent in male patients (6.3%; 40/639 vs. 1.8%; 8/439) and had the greatest impact on lithogenesis. Hypercalciuria was more frequent in undernourished children (62.5%; 30/48) than in overweight children (21.7%; 10/46), or those with obesity (33.3%; 15/45).
The main metabolic disorders among Cuban pediatric patients with urinary lithiasis are: hypercalciuria, decreased urinary flow and hypocitraturia. Hypercalciuria, hypocitraturia and hyperoxaluria are more common in children, and decreased urinary flow and hyperuricosuria are more common in adolescents. Identifying urinary metabolic disorders facilitates formulation of treatment plans tailored to decreasing the likelihood of urolithiasis.
小儿尿石症（尿石症）是与尿路代谢紊乱相关的重要健康问题。仅在美国，与尿石症相关的住院治疗费用就高达 2.29 亿美元，急诊治疗费用为 1.46 亿美元。
确定古巴小儿尿石症患者的尿路代谢紊乱情况，并更好地了解与尿路代谢紊乱强烈相关的年龄、人口统计学和人体测量学变量与尿石症之间的关系。
我们进行了一项描述性、横断面研究。研究对象为 2008 年至 2019 年在古巴哈瓦那 Abelardo Buch López 肾病研究所接受肾脏代谢研究的年龄在 2 至 19 岁之间的患有尿路结石的古巴患者。所有数据均来自上述代谢研究报告。我们收集了以下变量：年龄、性别、营养状况、尿量、血浆和尿肌酐浓度；以及 24 小时内排泄的钙、尿酸、草酸盐和柠檬酸盐。我们还进行了胱氨酸尿试验和尿微量培养的结果。我们对分类和定性变量进行了频率分布，并对定量变量计算了均值和标准差。我们还评估了儿童和青少年代谢紊乱的同质性。
我们研究了 1592 名儿科患者，其中 67.7%（1078/1592）为青少年。主要代谢紊乱包括高钙尿症（39.1%，622/1592）、尿流量减少（22.4%，357/1592）和低柠檬酸尿症（18.2%，289/1592）。高钙尿症、低柠檬酸尿症和高草酸尿症在儿童中更为常见，而尿流量减少和高尿酸尿症在青少年中更为常见。高尿酸尿症在男性患者中更为常见（6.3%，40/639 比 1.8%，8/439），对结石形成的影响最大。在营养不良的儿童（62.5%，30/48）中高钙尿症比超重儿童（21.7%，10/46）或肥胖儿童（33.3%，15/45）更为常见。
古巴小儿尿石症患者的主要代谢紊乱为：高钙尿症、尿流量减少和低柠檬酸尿症。高钙尿症、低柠檬酸尿症和高草酸尿症在儿童中更为常见，而尿流量减少和高尿酸尿症在青少年中更为常见。确定尿路代谢紊乱有助于制定针对降低尿石症发生风险的治疗计划。
