Metabolic risk factors in children with kidney stone disease: an update
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ORIGINAL ARTICLE
Metabolic risk factors in children with kidney stone disease: an update Francisco R. Spivacow 1,2 & Elisa E. del Valle 1,2 & Juan A. Boailchuk 1 & Gaudencio Sandoval Díaz 1 & Viridiana Rodríguez Ugarte 1 & Zila Arreaga Álvarez 1 Received: 5 December 2019 / Revised: 2 June 2020 / Accepted: 9 June 2020 # IPNA 2020
Abstract Background 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. Methods A total of 300 children with kidney stone disease were included to undergo several clinical tests using a standardized protocol. Results 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. Conclusions 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.
Keywords Children . Kidney stones . Family history . Metabolic risk factors . Hypercalciuria . Hypocitraturia . Urolithiasis
Introduction In the past two decades, a significant increase in the prevalence of kidney stones has been observed. Stamatelou et al. [1] reported a 37% increase in adults between 1980 and 1994 in the USA, while Trinchieri et al. [2] and Serio et al. [3] have also reported this occurrence in Europe. Despite the scarce Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00467-020-04660-x) contains supplementary material, which is available to authorized users. * Francisco R. Spivacow [email protected] 1
Instituto de Investigaciones Metabólicas (IDIM), Libertad 836, 1er piso (1012), Buenos Aires, Argentina
2
Universidad del Salvador (USAL), Buenos Aires, Argentina
data in childhood urolithiasis, recent reports have indicated an increasing incidence [4, 5]. An epidemiologic study conducted from 1997 to 2003 showed a significant increase in treated stone disease for both genders, with a rate of increase of 365% in females and 274% in males [6]. This study also demonstrated m
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