Konya Bölgesi Pediatrik Üriner Sistem Taş Hastalığında Klinik Özellikler ve Metabolik Risk Faktörleri
Öz
Amaç: Üriner sistem taş hastalığı hem çocuk hem de erişkin yaş grubunda dünya genelinde artan bir insidansa sahiptir ve Türkiye gibi endemik ülkelerde önemli bir morbidite sebebidir. Bu çalışmada üriner sistem taş hastalığı tanısı ile takip edilen çocukların klinik özellikleri ve metabolik risk faktörleri incelenmiştir.Gereç ve Yöntem: Üriner sistem taş hastalığı tanısı almış hasta dosyaları geriye dönük incelendi. Hasta bilgileri, görüntüleme yöntemleri ve laboratuar sonuçları eksiksiz olan hastalar çalışmaya dâhil edildi. Ultrasonografi US ve varsa kontrassız BT sonuçlarından taş lokalizasyonu ve boyutları kaydedildi. Metabolik değerlendirme tuvalet eğitimi olmayan çocuklarda spot idrarda, daha büyük çocuklarda ise 24 saatlik idrarda okzalat, sitrat, sistin, kalsiyum, ürik asit, kreatinin düzeyleri ölçülerek yapıldı.Bulgular: Çalışmaya 107’si erkek, 100’ü kız olmak üzere toplam 207 hasta dâhil edildi. Erkek/kız oranı 1,1:1 iken, ortanca yaş 1,6 yıl 2 ay16,1 yıl olarak bulundu. En sık görülen başvuru şikâyeti İYE %25,1 olurken bunu sırasıyla, karın/yan ağrısı %18,4 , huzursuzluk %17,4 ile mikroskobik ve/veya makroskobik hematüri %15,5 takip etti. Metabolik anormallik 150 hastada %72,5 saptanırken, en sık görülen anormallikler hipositratüri 51 hasta, %24,6 ve hiperkalsiüri 40 hasta, %19,3 idi.Sonuç: Konya bölgesinde pediatrik üriner sistem taş hastalığı olgularında altta yatan en sık metabolik anormallik hipositratüridir. Metabolik anormallikleri tespit edebilmek için her hastada gerekli inceleme yapılmalı ve erken dönemde uygun tedavi ile renal hasar riski en aza indirilmelidir
Kaynakça
- Sas DJ. An update on the changing epidemiology and me- tabolic risk factors in pediatric kidney stone disease. Clin J Am Soc Nephrol 2011; 6: 2062-8.
- Elmaci AM, Ece A, Akin F. Pediatric urolithiasis: metabolic risk factors and follow-up results in a Turkish region with endemic stone disease. Urolithiasis 2014; 42: 421-6.
- Lopez M, Hoppe B. History, epidemiology and regional di- versities of urolithiasis. Pediatr Nephrol 2010; 25: 49-9.
- Tekin A, Tekgul S, Atsu N, Sahin A, Ozen H, Bakkaloglu M. A study of the etiology of idiopathic calcium urolithiasis in children: hypocitruria is the most important risk factor. J Urol 2000; 164: 162-5.
- Sirin A, Emre S, Alpay H, Nayir A, Bilge I, Tanman F. Eti- ology of chronic renal failure in Turkish children. Pediatr Nephrol 1995; 9: 549-52.
- Habbig S, Beck BB, Hoppe B. Nephrocalcinosis and urolit- hiasis in children. Kidney Int 2011; 80: 1278-91.
- Acar B, Inci Arikan F, Emeksiz S, Dallar Y. Risk factors for nephrolithiasis in children. World J Urol 2008; 26: 627-30.
- Biyikli NK, Alpay H, Guran T. Hypercalciuria and recurrent urinary tract infections: incidence and symptoms in child- ren over 5 years of age. Pediatr Nephrol 2005; 20: 1435-8.
- Soucie JM, Coates RJ, McClellan W, Austin H, Thun M. Re- lation between geographic variability in kidney stones pre- valence and risk factors for stones. Am J Epidemiol 1996; 143: 487-95.
- Kalorin CM, Zabinski A, Okpareke I, White M, Kogan BA. Pediatric urinary stone disease--does age matter? J Urol 2009; 181: 2267-71.
- Gurgoze MK, Sari MY. Results of medical treatment and metabolic risk factors in children with urolithiasis. Pediatr Nephrol 2011; 26: 933-7.
- Alpay H, Ozen A, Gokce I, Biyikli N. Clinical and metabolic features of urolithiasis and microlithiasis in children. Pedi- atr Nephrol 2009; 24: 2203-9.
- Bastug F, Gunduz Z, Tulpar S, Poyrazoglu H, Dusunsel R. Urolithiasis in infants: evaluation of risk factors. World J Urol 2013; 31: 1117-22.
Öz
Objective: Urinary stone disease is a growing entity in both children and adults. It is an important cause of morbidity in endemic countries such as Turkey. The aim of this study was to identify clinical features and metabolic disturbance of pediatric urinary stone disease in Konya province.Material and Methods: Retrospective analysis of patients with diagnosis of urinary stone disease was conducted. Those with complete demographics, imaging and laboratory results were included. Ultrasonography and computed tomography without contrast was used to obtain stone location and size. Metabolic analysis were based on spot urinary excretions in children without potty training where 24-hour urine samples were used to identify urinary oxalate, citrate, cystine, calcium, uric acid and creatinine levels.Results: A total of 107 males and 100 females were included in the study. Male/female ratio was 1.1 whereas median age was 1.6 years range 2 months - 16.1 years . Most common complaint of admission was urinary tract infection 25.1% followed by abdominal/side pain 18.4% , discomfort 17.4% and microscopic/macroscopic hematuria 15.5% . Metabolic disturbances were found in 150 patients. Most common metabolic abnormalities were hypocitraturia 51 patients, 24.6% and hypercalciuria 40 patients, 19.3% , respectively.Conclusion: Results of our study indicate most common metabolic abnormality in children with urinary stone disease in Konya province is hypocitraturia. Necessary test in order to evaluate metabolic disturbance should be obtained in every pediatric urolithiasis patient, thus the risk of renal morbidity should be decreased
Anahtar Kelimeler
Kaynakça
- Sas DJ. An update on the changing epidemiology and me- tabolic risk factors in pediatric kidney stone disease. Clin J Am Soc Nephrol 2011; 6: 2062-8.
- Elmaci AM, Ece A, Akin F. Pediatric urolithiasis: metabolic risk factors and follow-up results in a Turkish region with endemic stone disease. Urolithiasis 2014; 42: 421-6.
- Lopez M, Hoppe B. History, epidemiology and regional di- versities of urolithiasis. Pediatr Nephrol 2010; 25: 49-9.
- Tekin A, Tekgul S, Atsu N, Sahin A, Ozen H, Bakkaloglu M. A study of the etiology of idiopathic calcium urolithiasis in children: hypocitruria is the most important risk factor. J Urol 2000; 164: 162-5.
- Sirin A, Emre S, Alpay H, Nayir A, Bilge I, Tanman F. Eti- ology of chronic renal failure in Turkish children. Pediatr Nephrol 1995; 9: 549-52.
- Habbig S, Beck BB, Hoppe B. Nephrocalcinosis and urolit- hiasis in children. Kidney Int 2011; 80: 1278-91.
- Acar B, Inci Arikan F, Emeksiz S, Dallar Y. Risk factors for nephrolithiasis in children. World J Urol 2008; 26: 627-30.
- Biyikli NK, Alpay H, Guran T. Hypercalciuria and recurrent urinary tract infections: incidence and symptoms in child- ren over 5 years of age. Pediatr Nephrol 2005; 20: 1435-8.
- Soucie JM, Coates RJ, McClellan W, Austin H, Thun M. Re- lation between geographic variability in kidney stones pre- valence and risk factors for stones. Am J Epidemiol 1996; 143: 487-95.
- Kalorin CM, Zabinski A, Okpareke I, White M, Kogan BA. Pediatric urinary stone disease--does age matter? J Urol 2009; 181: 2267-71.
- Gurgoze MK, Sari MY. Results of medical treatment and metabolic risk factors in children with urolithiasis. Pediatr Nephrol 2011; 26: 933-7.
- Alpay H, Ozen A, Gokce I, Biyikli N. Clinical and metabolic features of urolithiasis and microlithiasis in children. Pedi- atr Nephrol 2009; 24: 2203-9.
- Bastug F, Gunduz Z, Tulpar S, Poyrazoglu H, Dusunsel R. Urolithiasis in infants: evaluation of risk factors. World J Urol 2013; 31: 1117-22.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Original Article |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Eylül 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 29 Sayı: 3 |
Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.