Demographic and Clinic Features of Children with Nephrolithiasis in Izmir

Yıl 2012, Cilt: 2 Sayı: 2, 77 - 81, 01.06.2012

Nida Dinçel Kadriye Özdemir Sevgi Mir

Öz

Introduction. The aim of this study was to evaluate demographic data and clinical features of nephrolithiasis in children. Materials and Methods. We retrospectively collected the clinical finding and metabolic risk factors of 132 children (52 girls and 80 boys) with nephrolithiasis, between 2009 and 2012. Clinical presentation, urinary tract infection, calculus localization, family history and metabolic risk factors were noted. Results. The mean age of children were 6.8 ± 3.9 years.In 69 % of the cases, the calculus was located only in the kidneys (unilaterally) and 20.4 % was bilaterally. The most common presentations were macroscopic hematuria,abdominal pain and restlessness.A positive family history of urinary calculi was detected in 40.9 %; urinary tract infection, in 43 cases and recurrent calculus in 14.3% of patients. Metabolic evaluation was as follows: hypercalciuria in 76 cases, cystinuria in 11, hyperoxaluria in 18 .Three of the 11 patients with cystinuria were then diagnosed as cystinosis. Conclusions. We think that nephrolithiasis remains a serious and increasing problem in children in our country. Family history, metabolic disorders and urinary tract infections tend to be associated with childhood nephrolithiasis.

Anahtar Kelimeler

nephrolitiasis, children, hematuria, cystinuria

İzmir Bölgesinde Nefrolitiazis İle İzlenen Çocukların Demografik ve Klinik Özellikleri

Öz

Giriş: çalışmanın amacı nefrolitiazisli çocukların demografik ve klinik özelliklerini incelemektir. Materyal-Metod.2009-2012 arası nefrolitiazis nedeni ile izlenen 132 çocuğun (52 kız,80 erkek)klinik bulgularını ve metabolik risk faktörlerini özetledik.Klinik geliş,idrar yolu enfeksiyonu,kalkül yerleşimi,aile öyküsü ve metabolik risk faktörleri not edildi. Sonuçlar.çocukların yaş ortalaması 6.8 ± 3.9yıl idi. %69 olguda kalkül iki taraflı, %20.4 'ünde ise tek taraflı saptandı.En sık başvuru nedenleri,makroskopik hematüri,karın ağrısı ve huzursuzluktu.%40.9 olguda pozitif aile öyküsü, 43 olguda idrar yolu enfeksiyonu ve %14.3 hastada rekürren taş oluşumu gözlendi.Metabolik inceleme sonuçları: 76 olguda hiperkalsiüri,11'inde sistinüri,18 'inde hiperokzalüri şeklinde idi. 11 sistinürili olgunun 3'ü sistinozis tanısı aldı. Sonuçlar.Ülkemizde nefrolitiazisin hala ciddi ve artmakta olan bir problem olduğu düşünüyoruz.Aile öyküsü,metabolik hastalıklar ve idrar yolu enfeksiyonu çocukluk yaş grubu taş hastalığı ile ilişkili faktörlerdir.

Anahtar Kelimeler

nefrolitiazis, çocuk, hematüri, sistinüri

Kaynakça

• Edvardsson V, Elidottir H, Indridason OS, Palsson R. High incidence of kidney stones in Icelandic 2005;20:940-4. Pediatr
• Nephrol. 2. VanDervoort K, Wiesen J, Frank R, et al. Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol. 2007;177:2300-5.
• Lopez M, Hoppe B. History, epidemology and regional diversities of urolithiasis. Pediatr Nephrol. 2010;25:49-59.
• Spivacow FR, Negri AL, del Valle EE, Calvino I, Fradinger E, Zanchetta JR. Metabolic risk factors in children with kidney stone disease. Pediatr Nephrol. 2008;23:1129-33.
• Elder JS. Urinary lithiasis. In: Behrman RE, Kliegman RM, Jenson HB, Stanton BF, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: Saunders; 2008;p.2267-72.
• Milliner DS. Urolithiasis. In: Avner ED, Harmon WE, Niaudet P. Pediatric nephrology. 5th ed. Philadelphia: Springer; 2009;p. 1405-31. 7. Gillespie RS, Stapleton FB. Nephrolithiasis in Children. Pediatr Rev 2004;25:131–9.
• Tiselius HG, Ackermann D, Alken P, Working Party on Lithiasis, European Association of Urology Guidelines on urolithiasis. Eur Urol 2001;40:362–71.
• Sternberg K, Greenfield SP, Williot P et al. Pediatric stone disease: an evolving experience. J Urol 2005;174:1711–4.
• Afshin Safaei Asl, Shohreh Maleknejad, Pediatric Urolithiasis An Experience of a Single Center. Iranian Journal of Kidney Diseases; 2011;5:309-13.
• Bozkurt Y, Ece A, Yolbaş İ, Sancaktutar A.A, Kelekçi S, Güneş A, Yel S. Pediatrik ürolitiyazis:
• değerlendirilmesi. Düzce Tıp Fakültesi Dergisi 2009;11:21-5. hastaya ait
• verilerin Evaluation of children with urolithiasis. Indian J Urol. 2007;23:420-7.