ÇOCUKLARDA ÜRİNER SİSTEM TAŞ HASTALIĞI: TANI VE TEDAVİ / URINARY SYSTEM STONE DISEASE IN CHILDREN: DIAGNOSIS AND TREATMENT

Yıl 2015, Cilt: 37 Sayı: 1, 1 - 13, 03.11.2015

Nuran Çetin , Nadide Sav Bilal Yildiz

https://doi.org/10.20515/otd.217962

Öz

Özet: Üriner sistem taş hastalığı son yıllarda prevelansı artış gösteren önemli bir hastalıktır. Çocuklarda yüksek tekrarlama oranı nedeni ile son dönem böbrek hastalığına sebep olduğundan önemli bir morbidite nedenidir. Üriner sistem taş hastalığı Türk çocuklarında kronik böbrek hastalığının altında yatan sebeplerin %8'ini oluşturmaktadır. Metabolik ve genitoüriner sisteme ait anormallikler çocuklarda üriner sistem taşlarının oluşmasına yatkınlık yaratabilir. Metabolik bir risk faktörü saptama oranı, çocuklarda üriner sistem taşı olan yetişkinlerden daha yüksektir. Diyet, çevresel faktörler ve idrar yolu enfeksiyonları üriner sistem taşlarının oluşmasında rol oynayabilir. Tekrarlama özelliği nedeni ile metabolik faktörlerin taşı olan bütün çocuklarda araştırılması gereklidir. Erken tedavi ve risk faktörlerinin saptanması morbiditeyi azaltmada oldukça önemlidir. Böbrek taşı olan çocuklarda üriner sistem taş hastalığının tedavi amacı, böbrek fonksiyonlarını korumak için  taşın ortadan kaldırılmasını, nükslerin engellenmesini ve metabolik problemlerin düzeltilmesini kapsamaktadır.Uygun tedavi taşın boyutuna, yerleşimine ve tipine, anatomik anormalliklerin varlığına göre seçilir. Medikal tedavi, yeni taşların oluşumunu ve mevcut taşların büyümesini önleyerek morbiditeyi azaltmaktadır.

Anahtar kelimeler: Üriner sistem taşı, çocukluk çağı, tanı, tedavi.

URINARY SYSTEM STONE DISEASE IN CHILDREN: DIAGNOSIS AND TREATMENT

Abstract: Urinary system stone disease is a disease that there is a increase in the prevalence of the disease in recent years. This disease is an important cause of morbidity because it causes end stage renal disease due to high recurrence rate. Urinary system stone disease is the cause of  8% of the underlying etiological factors for development of chronic kidney disease in Turkish children. Metabolic and genitourinary anomalies can predispose to develop urinary system stones in children. The detection rate of metabolic risk factor is higher in children than adults with urinary system stone. Diet, environmental factors and urinary tract infections may play a role in the formation of urinary system stones. Because of its recurrent nature, the metabolic abnormalities should be investigated in all of the children with urinary system stone. Early treatment and determination of the risk factors are very important to reduce morbidity. The aim of treatment of pediatric uri­nary system stone disease includes eliminating the stone and preventing recurrence and the correction of metabolic problems for protection kidney functions. The appropriate treatment depends on the size, location and type of stone; the presence of anatomical abnormalities. Medical therapy reduces morbidity by preventing the growth of stone and the formation of new stones.

Key words: Uri­nary system stone, childhood, diagnosis, treatment.

 

Anahtar Kelimeler

çocukluk çağı, tanı, tedavi, üriner sistem taşı

Kaynakça

• Xu, H. Zisman, A.L. Coe, F.L. Worcester, E.M. (2013). Kidney stones: an update on current pharmacological management and future directions. Expert Opin Pharmacother. 14:435-47.
• Tasian, G.E. Copelovitch, L. (2014). Evaluation and medical management of kidney stones in children. J Urol. 192:1329-36. Sirin, A. Emre, S. Alpay, H. Nayir, A. Bilge, I. Tanman, F. (1995). Etiology of chronic renal failure in Turkish children. Pediatr Nephrol. 9:549– 552. López, epidemiology urolithiasis. Pediatr Nephrol. 25:49–59. History, diversities of
• Z. Gurgoze, M.K. Demirci, D, Kucukaydın, M. (2008). Pediatric urolithiasis: an 8-year experience of single centre. Int Urol Nephrol. 40:3–9.
• Bak, M. Ural, R. Agin, H. Serdaroglu, E. Calkavur, S. (2009). The metabolic etiology of urolithiasis in Turkish children. Int Urol Nephrol. 41:453–460.
• Tabel, Y. Akin, I.M. Tekin, S. (2009). Clinical and demographic ,characteristics of children with urolithiasis. Single-centre experience from eastern Turkey. Urol Int. 83:217–221.
• Dursun, I. Poyrazoglu, H.M. Dusunsel, R. et al. (2008). Pediatric urolithiasis: an 8-year experience of single centre. Int Urol Nephrol. 40:3-9.
• Ertan, P. Tekin, G. Oger, N. et al. (2011). Metabolic and demographic characteristics of children with urolithiasis in Western Turkey. Urol Res. 39:105-10. 13. Carter, M.R. Green, B.R. (2011). Renal calculi: emergency diagnosis and treatment. Emerg Med Pract. 13:1- 17. department
• Dawson,C.H.Tomson,C.R.(2012).Kidneystone dise ase: pathophysiology, investigation and medical tre atment. Clin Med. 12:467-71.
• Spivacow, F. Negri, A. Del Valle, E. Calviño, I. Fradinger, E. Zanchetta, J.R. (2008). Metabolic risk factors in children with kidney stone disease. Pediatr Nephrol. 32:1129-33.
• Grases, F. Costa-Bauzá, A. Prieto, R. (2006). Renal lithiasis and nutrition. Nutr J. 5:1–7.
• Grases, F. Ramis, M. Villacampa, A.I. Costa- Bauzá, A. (1999).Uric acid urolithiasis and crystallization inhibitors. Urol Int. 62:201-204.
• Moe, O.W. (2006). Kidney stones: pathophysiology and medical management. Lancet. 367:333–344.
• Sáez-Torres, C. Grases, F. Rodrigo, D. García- Raja, A.M. Gómez, C. Frontera, G. (2013). Risk factors for urinary stones in healthy schoolchildren with and without a family history of nephrolithiasis. Pediatr Nephrol. 28:639–645.
• Battino, B. De Foor, W. Coe, F. Tackett, L. Erhard, M. E.(2002).Metabolic evaluation of children with urolitiasis: are adult references for supersaturation appropriate? J Urol.168:2568–2571. Minevich,
• Capolongo, G. Sakhaee, K. Pak, C.Y. Maalouf, N.M. (2011). idrar ph. Fasting versus 24-h urine pH in the evaluation of nephrolithiasis Urol Res. 39:367-372.
• Önen, A. (2013).Çocuklarda üriner sistem taş hastalığı. Çocuk Cerrahisi Dergisi.27:8-32. 23. Butani, L. Kalia, A. hypercalciuria in children–how validare the existing Nephrol.19:577–582. (2004). Idiopathic diagnostic criteria? Pediatr
• Polito, C. Signoriello, G. Andreoli, S. La Manna, A. (2006). Urinary urea excretion in idiopathic hypercalciuria of children. J Pediatr. 2:419–423.
• Frick, K.K. Bushinsky, D.A. (2003). Molecular mechanisms of primary hypercalciuria. J Am Soc Nephrol.14:1082–1095.
• Rendina, D. Esposito, T. Mossetti, G. et al. (2012). A functional allelic variant of the FGF23 gene is associated with renal phosphate leak in calcium nephrolithiasis. J Clin Endocrinol Metab.97:840–4. Stapleton, Endocrinol Metab Clin North Am.31:1001-1015. Childhood stones. Valle,
• E.E.Spivacow,F.R.Negri,
• A.L.(2013).Citrate and renal stones. Medicina 73:363-8.
• Grases, F. Rodriguez, A. Costa-Bauza, A. (2014). Theobromine inhibits uric acid crystallization. A potential application in the treatment of uric acidnephrolithiasis. PLoS One. 9: 111184.
• Cameron, M.A. Sakhaee, K.(2007).Uric acid nephrolithiasis.Urol Clin North Am.34:335–46.
• Neuhaus, T.J. Belzer, T. Blau, N. et al. (2000). Urinary oxalate excretion in urolithiasis and nephrocalcinosis. Arch Dis Child.82:322-326.
• Monico, C.G. Persson, M. Ford, G.C. Rumsby, G. Milliner, D.S. (2002). Potential mechanisms of marked hyperoxaluria not due to primary hyperoxaluria I or II. Kidney Int. 62:392-400.
• Cochat, P. Pichault, V. Bacchetta, J. Dubourg, L. Sabot, J.F. Saban, C. Daudon, M. Liutkus, A. (2010). Nephrolithiasis related to inborn metabolic diseases.Pediatr Nephrol. 25:415-24.
• Urinary stone disease, in Kher K.K. Schnaper, H.W. Makker, S.P. (2007). Clinical Pediatric Nephrology, Informa UK Ltd. 539-551.
• Cochat, P. Pichault, V. Bacchetta, J. Dubourg, L. Sabot, J.F. Saban, C. Daudon, M. Liutkus, A. (2010). Nephrolithiasis related to inborn metabolic diseases. Pediatr Nephrol. 25:415-24.
• Edvardsson, V.O. Goldfarb, D.S. Lieske, J.C. Beara-Lasic, L. Anglani, F. Milliner, D.S. Palsson, R. stones and chronic kidney disease. Pediatr Nephrol. 28:1923-42.
• Fattah, H. Hambaroush, Y. Goldfarb, D.S. (2014). Cystine nephrolithiasis. Transl Androl Urol. 3:228- 233.
• Lippiat, J.D. Smith, A.J. (2012). The CLC-5 2Cl(- )/H(+) exchange transporter in endosomal function and Dent's disease. Front Physiol.Nov 30;3:449.
• Sugimoto, K. Nishi, H. Miyazawa, T. Fujita, S. Okada, A novel OCRL1 mutation in the mild phenotype of Lowe syndrome. Tohoku J Exp Med. 232:163-6. T. a patient with
• Devuyst, O. Thakker, R.V. (2010). Dent's disease. Orphanet J Rare Dis. 5:28.
• Al-Shibli, A. Konrad, M. Altay, W. Al Masri, O. Al-Gazali, Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC): report of three cases with a novel mutation in CLDN19 gene. Saudi J Kidney Dis Transpl. 24:338-44. I. (2013).
• Bhasin, B. Ürekli, H.M. Atta, M.G. (2015). Primary and Understanding the enigma.World J Nephrol. 4: 235-44.
• Santos, F. Ordóñez, F. A. Claramunt-Taberner, D. Gil-Peña, Clinical and laboratory approaches in the diagnosis of renal tubular acidosis. Nephrol.1-9. (2015). Pediatr
• Zhang, C. Ren, H. Shen, P. Xu, Y. Zhang, W. Wang, W. Li, X. Ma, Y. Chen, N. (2015). Clinical evaluation of Chinese patients with primary distal renal tubular acidosis. Intern Med.54:725-30.
• Gillespie, R.S. Stapleton, Nephrolithiasis in Children. Pediatr Rev. 25:131- 39. F.B. (2004).
• Sepahi, M.A. Heidari, A. Shajari, A. (2010). Clinical Manifestations and Etiology of Renal Stones in Children Less than 14 Years Age. Saudi J Kidney Dis Transpl.21:181-184.
• Biyikli, N.K. Alpay, H. Guran, T. (2005). Hypercalciuria infections: incidence and symptoms in children over 5 years of age. Pediatr Nephrol.20:1435-8.
• Stechman, M.J. Loh, N.Y. Thakker, R.V. (2009). Genetic causes of hypercalciuric nephrolithiasis. Pediatr Nephrol. 24:2321-32.
• Naseri, M. Varasteh, A.R. Alamdaran, S.A.(2010). Metabolic factors associated with urinary calculi in children. Iran J Kidney Dis .4:32-8.
• Mehmet, N.M. Ender, O. (2015). Effect of urinary stone disease and its treatment on renal function. World J Nephrol. 4:271-6.
• Coward, R.J.M. Peters, C.J. Duffy, P.G. et al. (2003). Epidemiology of pediatric renal stone disease in the UK. Arch Dis Child. 88:962-965.
• Baysal, Y.E. Koyun, M. Akman, S. Güven, A.G. Güntekin, E. (2004). Çocuklarda ürolitiyazis: Antalya yöresinde 10 yıllık deneyim. Çocuk Sağlığı ve Hastalıkları Dergisi.47: 254-259
• Stapleton, F.B. (2002). Endocrinol Metab Clin North Am. 31:1001-1015.
• Sas, D.J. (2011). An update on the changing epidemiology and metabolic risk factors in pediatric kidney stone disease. Clin J Am Soc Nephrol. 6:2062–2068.
• Kalorin, C.M. Zabinski, A. Okpareke, I. White, M. Kogan, B.A. (2009). Pediatric urinary stone disease-does age matter? J Urol.181:2267–2271.
• Pietrow, P.K. Pope, J.C. Adams, M.C. Shyr, Y.
• Brock, J.W. (2002). Clinical outcome of pediatric stone disease. J Urol.167:670–673.
• DeFoor,W. Asplin, J. Jackson, E. Jackson, C. Reddy, P. Sheldon, C. et al. (2006).Urinary metabolic evaluations in normal and stone forming children. J Urol. 176:1793–1796.
• DeFoor, W. Asplin, J. Jackson, E. Jackson, C. Reddy, P. Sheldon, C. et al. (2005). Results of a prospective trial to compare normal urine supersaturation in children and adults. J Urol. 174:1708–1710.
• Hoppe, B. Kemper, M.J. (2010). Diagnostic examination of the child with urolithiasis or nephrocalcinosis. Pediatr Nephrol.25:403-13.
• Habbig, S. Beck, B.B. Hoppe, B. (2011). Nephrocalcinosis and urolithiasis in children. Kidney Int. 80:1278-91.
• generation lithotripters. BJU Int. 86: 851-856.
• Özçakır, E. et al. (2010). Çocuklarda üriner sistem taş hastalığı tedavisinde ESWL deneyimlerimiz. Çocuk Cerrahisi Dergisi.24:12-17.
• Desai, M.R. Kukreja, R.A. Patel, S.H. Bapat, S.D. (2004). Percutaneous nephrolithotomy for complex pediatric renal calculus disease. J Endourol.18:23- 27.
• Schuster, T.G. Russell, K.Y. Bloom, D.A. Koo, H.P. Faerber, G.J. (2002). Ureteroscopy for the treatment Urol.167:1813-1816. in children. J
• Özgür Tan, M. Karaoğlan, U. Sen, I. Deniz, N. Bozkirli, I. (2003). The impact of radiological anatomy in clearance of lower calyceal stones after shock wave lithotripsy in paediatric patients. Eur Urol. 43:188-193.
• Shokeir, A.A. Sheir, K.Z. El-Nahas, A.R. El- Assmy, A.M. Eassa, W. El-Kappany, H.A. (2006). Treatment of renal stones in children: a comparison between percutaneous nephrolithotomy and shock wave lithotripsy. J Urol. 176:706-710.
• Tekgül, S. Riedmiller, H. Hoebeke, P. Kočvara, R. Nijman, R.J. Radmayr, C. Stein, R. Dogan, H.S. (2012). EAU guidelines on vesicoureteral reflux in children. Eur Urol. 62: 534-542.
• Straub, M. Gschwend, J. Zorn, C. (2010). Pediatric urolithiasis: the current surgical management. Pediatr Nephrol. 25:1239-1244.
• Smaldone, M.C. Corcoran, A.T. Docimo, S.G. Ost, M.C. (2009). Endourological management of pediatric stone disease: present status. J Urol. 181: 17-28.
• Kazan, E. Kezer, C. Akay, A. Örgen, S. Aslan, R. Zaman, M.C. (2014). Pediatrik Hastalarda Üreter Taşı Tedavisinde Üreterorenoskopi Sonuçlarımız. IJCR. 2:1-5.
• Ataç, F. Bostancı, Y. Germiyanoğlu, R.C. (2014). Pediatrik Endoskopik Üroloji’de Son Durum. Endoüroloji Bülteni. 7:57-61.
• Sancaktutar, A.A. Atar, M. Söylemez, H. Bozkurt, Y. Penbegül, N. Bodakçı, M.N. Gümüş, H. (2011). Effectiveness of 4.5 F semirigid ureteroscope (Mini-URS) in the management of ureteral stones in children younger than 3 years of age. Turkish Journal of Urology. 37:335-340.
• Paik, M.L. Resnick, M.I. (2000). Is there a role for open stone surgery? Urol Clin North Am. 27:323- 331.