Metabolic Abnormalities in Children Younger Than Two Years with Urolithiasis: A Single-Center Case–Control Study

Abstract

Purpose: Pediatric urolithiasis has become more prevalent in recent years; however, studies focusing on urolithiasis in infancy are limited and mostly retrospective. The aim of this study was to compare the clinical, nutritional, and metabolic characteristics of children younger than two years with urolithiasis and age- and sex-matched healthy controls. Material and Methods: This single-center, case-control study included 30 children under 2 years of age diagnosed with urolithiasis and 30 age- and sex-matched healthy controls. Demographic characteristics, family history, nutritional and medication history, and presenting symptoms were recorded. All subjects underwent urinary ultrasonography and laboratory evaluation. Results: There were no significant differences between the patients and controls in terms of age (11.1±5.35 vs. 11.3±5.33 months) or male-to-female ratio (1.7:1 vs. 1.3:1). A positive family history of urolithiasis was significantly more common in patients than in controls (47% vs. 10%, p=0.003), whereas feeding practices, early water intake, and prematurity did not differ between groups. Restlessness was the most common presenting symptom (40.0%), and 16.7% of patients were asymptomatic. A total of 59 stones were identified; 16 patients (53.3%) had multiple stones and eight (26.7%) had bilateral stones, and 22 stones (37.3%) measured <3 mm. At least one metabolic abnormality was detected in 21 patients (70.0%), and five (16.7%) had more than one abnormality. Hypercalciuria (36.7% vs. 10.0%, p=0.015) and hypocitraturia (30.0% vs. 6.7%, p=0.020) were more frequent among patients. Conclusion: Urolithiasis in children younger than two years is frequently accompanied by a positive family history and metabolic abnormalities. Hypercalciuria and hypocitraturia were more commonly detected in affected children than in healthy controls.

Keywords

• children
• urinary system stones
• urolithiasis
• infections

Supporting Institution

Turkish Pediatric Association.

İki Yaşından Küçük Ürolitiyazisli Çocuklarda Metabolik Anormallikler: Tek Merkezli Bir Olgu-Kontrol Çalışması

Abstract

Amaç: Pediatrik ürolitiyazis son yıllarda daha yaygın hale gelmiştir; ancak bebeklik dönemindeki ürolitiyazise odaklanan çalışmalar sınırlı sayıdadır ve çoğunlukla retrospektiftir. Bu çalışmanın amacı, iki yaşından küçük ürolitiyazisli çocukların klinik, beslenme ve metabolik özelliklerini yaş ve cinsiyet açısından eşleştirilmiş sağlıklı kontrollerle karşılaştırmaktır. Gereç ve Yöntem: Bu tek merkezli olgu-kontrol çalışmasına, ürolitiyazis tanısı alan iki yaşından küçük 30 çocuk ile yaş ve cinsiyet açısından eşleştirilmiş 30 sağlıklı kontrol dahil edildi. Demografik özellikler, aile öyküsü, beslenme ve ilaç kullanımı öyküsü ile başvuru semptomları kaydedildi. Tüm olgulara üriner ultrasonografi ve laboratuvar değerlendirmesi yapıldı. Bulgular: Hastalar ve kontroller arasında yaş (11,1±5,35 aya karşı 11,3±5,33 ay) veya erkek/kız oranı (1,7:1'e karşı 1,3:1) açısından anlamlı fark yoktu. Pozitif ürolitiyazis aile öyküsü, hastalarda kontrollere göre anlamlı derecede daha sık saptandı (%47'ye karşı %10, p=0,003); buna karşın beslenme şekli, erken su alımı ve prematürite açısından gruplar arasında fark bulunmadı. En sık başvuru semptomu huzursuzluktu (%40,0) ve hastaların %16,7'si asemptomatikti. Toplam 59 taş saptandı; 16 hastada (%53,3) birden fazla taş, 8 hastada (%26,7) bilateral taş vardı ve taşların 22'si (%37,3) 3 mm'den küçüktü. Hastaların 21'inde (%70,0) en az bir metabolik anormallik saptanırken, 5 hastada (%16,7) birden fazla metabolik anormallik mevcuttu. Hiperkalsiüri (%36,7'ye karşı %10,0; p=0,015) ve hipositratüri (%30,0'a karşı %6,7; p=0,020) hastalarda kontrollere göre daha sık görüldü. Sonuç: İki yaşından küçük çocuklarda ürolitiyazise sıklıkla pozitif aile öyküsü ve metabolik anormallikler eşlik etmektedir. Hiperkalsiüri ve hipositratüri, etkilenen çocuklarda sağlıklı kontrollere göre daha sık saptanmıştır.

Keywords

• çocuklar
• üriner sistem taşları
• ürolitiyazis
• enfeksiyonlar

Supporting Institution

Türk Pediatri Kurumu

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