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Metabolic risk factors in children with kidney stone disease: an update

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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.

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Authors and Affiliations

  1. Instituto de Investigaciones Metabólicas (IDIM), Libertad 836, 1er piso (1012), Buenos Aires, Argentina

    Francisco R. Spivacow, Elisa E. del Valle, Juan A. Boailchuk, Gaudencio Sandoval Díaz, Viridiana Rodríguez Ugarte & Zila Arreaga Álvarez

  2. Universidad del Salvador (USAL), Buenos Aires, Argentina

    Francisco R. Spivacow & Elisa E. del Valle

Authors
  1. Francisco R. Spivacow
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  2. Elisa E. del Valle
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  3. Juan A. Boailchuk
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  4. Gaudencio Sandoval Díaz
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  5. Viridiana Rodríguez Ugarte
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  6. Zila Arreaga Álvarez
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Corresponding author

Correspondence to Francisco R. Spivacow.

Ethics declarations

Following approval by the local institutional review board (IRB), written informed consent was obtained from the legal guardians of all participants for the use of their clinical and laboratory data for scientific purposes. Following the evaluation of all metabolic risk factors, the treatment and follow-up of patients were carried out by their referring physicians. Urologic treatments, types of dietary measures in children, and acidification defect assessments were not part of the objectives of this study.

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The authors declare that they have no conflicts of interest.

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Spivacow, F.R., del Valle, E.E., Boailchuk, J.A. et al. Metabolic risk factors in children with kidney stone disease: an update. Pediatr Nephrol 35, 2107–2112 (2020). https://doi.org/10.1007/s00467-020-04660-x

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  • DOI: https://doi.org/10.1007/s00467-020-04660-x

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