Pediatric urolithiasis: causative factors, diagnosis and medical management

Abstract

Childhood urolithiasis is associated with considerable morbidity and recurrence. Many risk factors—including those metabolic, genetic, anatomic, dietary and environmental in nature—have been identified in children with urinary tract calculi. As pediatric urolithiasis with a metabolic etiology is the most common disease, evaluating the metabolic risk factors in patients is necessary to both effectively treat current stones and prevent recurrence. We discuss causative risk factors of pediatric urolithiasis, as well as the diagnostic and therapeutic approaches.

Key Points

  • Pediatric urolithiasis is a common health problem worldwide with many causes, including environmental, dietary and genetic; the most common disease has a metabolic etiology

  • Metabolic risk factors include hypercalciuria, hyperuricosuria, hyperoxaluria and cystinuria

  • Diagnostic evaluation should aim to rule out anatomic obstruction, determine the history of the patient (including familial risk factors) and involve urine analysis

  • Therapy should be targeted at the risk factors causing urolithiasis, although therapy should include increasing daily fluid intake

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Figure 1: Diagnostic approach for pediatric urolithiasis.

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F. Baştuğ conducted the research for the article, wrote the article and contributed to the discussion of content. R. Düşünsel contributed to the discussion of content and reviewed the manuscript before submission.

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Correspondence to Funda Baştuğ.

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Baştuğ, F., Düşünsel, R. Pediatric urolithiasis: causative factors, diagnosis and medical management. Nat Rev Urol 9, 138–146 (2012). https://doi.org/10.1038/nrurol.2012.4

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