DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20211679

Analysis of renal calcular disease among children: our tertiary care experience

Anzeen Nazir Kanth, Suhail Masood Khan, Azhar Ajaz Khan, Aymen Masood Khan, Irtifa Nazir Kanth

Abstract


Background: Renal calcular disease is a common disorder that affects patients of all age groups. Paediatric age group is no exception and due to lack of timely intervention it can prove disastrous in the years to come. This study is aimed to assess and evaluate the clinical and metabolic profile of paediatric patients presenting with renal calculi. The research was conducted in a cross-sectional manner.

Methods: The research enrolled a total of 254 urolithiasis patients aged 14 or less who presented to G. B. Panth hospital Srinagar. Structured history and relevant investigations were collected from all the patients. The physical exam, blood chemistry, and metabolite excretion in the urine (urinary calcium, citrate, magnesium, and oxalate) were all recorded.

Results: There were 65 percent males and 35 percent females (2:1) among the 254 patients, with an average age of 8.15±5.04 years at presentation. In 54% of the patients, hypertension was discovered. Urea and creatinine levels were respectively 73.01, 59 mg/dl and 4.45, 4.01 mg/dl. The amount of PTH in the blood was 51.2931 pg/l. The calcium and phosphorus levels in the blood were 8.44±1.14 and 5.0234±0.895, respectively. Metabolic irregularities were discovered in 95 percent of the patients. Hypercalciuria was the most prevalent (54%), followed by hyperoxaluria (28%). In 21% of the patients, hypocitraturia was observed. In 7.8% of children, distal renal tubular acidosis was discovered. Just 4.7% of the children had a magnesium deficiency in their urine.

Conclusions: The majority of children with stone disease have a metabolic risk factor, with hypercalciuria being the most frequent in our environment.

 


Keywords


Paediatric, Urology, Stones, Hypercalciuria, Hypocitraturia, Metabolic workup, Urolithiasis

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References


Aki K, Ghawanmeh R. The trial spectrum of idiopathic hyperuricosuria in children: isolated and associated with hypercalciuria/hyperoxaluria. Saudi J Kidney Dis Transpl. 2012;23:979-84.

Copelvitch L. Urolithiasis in children. Pediatr Clin N Am. 2012;59:881-96.

Hoppe B, Kemper MJ. Diagnostic examination of child with urolithiasis or nephrocalcinosis. Pediatr Nephrol. 2010;25:403-13.

Johri N, Cooper B, Roberton W, Choong S, Richard D, Unwin R. An update and practical guide renal stone management. Nephron Clin Pract. 2010;116: c159-71.

Tilahun A, Beyene P. Kidney stone disease: an update on current concepts. Adv Urol. 2018;2018:1-12.

Tanthanuch N, Apiwatgaroon A, Pripatnanont C. Urinary tract calculi in southern Thailand. J Med Assoc Thai. 2005;88:80-5.

Malaki M. The comparison of ultrasound and non-contrast helical computerized tomography for children nephrolithiasis detection. Urol Ann. 2014;6:309-13.

Kokorowaski PJ, Hubert K, Nelson CP. Evaluation of pediatric nephrolithiasis. Indian J Urol. 2010;26:531-5.

Wang S, Zhang Y, Zhang X, Tang Y, Li J. Upper urinary tract stone compositions: the role of age and gender. Int Braz J Urol. 2020;46(1):70-80.

Sepahi MA, Hoseini R. Approarch and medical management of urinary tract stone in children. Caspian J Pedaitr. 2016;2:86-95.

Rellum DM, Feitz WF, Hewaarden AE, Schreuder MF. Pediatric urolithiasis in a non-endemic country. A single center experience from Netherlands. J Pediatr Urol. 2014;10:155-61.

Elmaci AM, Ece A, Akin F. Pediatric urolithiasis: metabolic risk factor and follow up results in a Turkish region with endemic stone disease. Urolithiasis. 2014;42:421-6.

Alpay H, Ozen A, Gokee I, Biyikli N. Clinical and metabolic features of urolithiasis and microlithiasis in children. Pediatr Nephrol. 2009;24:2203-9.

Joshi A, Gupta SK, Srivastava A. Metabolic evaluation in first time stone formers in north India: A single center study. Saudi J Kidney Dis Transpl. 2013;24:838-43.

Hulton SA. Evaluation of urinary tract calculi in children. Arch Dis Child. 2001;84:320-3.

Spivacow FR, Negri AL, Del Valle E, Calvino I, Fradinger E, Zanchetta JR. Metabolic risk factor in children with kidney disease. Pediatr Nephrol. 2008; 23:1129-33.

Sas DJ. An update on the changing epidemiology and metabolic risk factors in pediatric kidney stone disease. Clin J Am Soc Nephrol. 2011;6:2062-8.

Bangash K, Shigri F, Jamal A, Anwar K. Spectrum of renal stones composition; chemical analysis of renal stones. Int J Path. 2011;9:63-6.

Rizvi SAH, Naqvi SAA, Hussain Z, Hashmi A, Hussain M, Zafar MN, et al. The management of stone disease. BJU International. 2002;89:62-8.

Scales CD, Tasian GE, Schwaderer AL, Goldfarb DS, Star RA, Kirkali Z. Urinary stone disease: advancing knowledge, patient care, and population health. Clin J Am Soc Nephrol. 2016;11:1305-12.