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Evaluation of children with urolithiasis
OBJECTIVES: To describe an evaluation protocol for pediatric stone formers for risk assessment and management strategies. MATERIALS AND METHODS: Between 2002-2006, 2618 children of age three months to 15 years were evaluated for stone disease. Evaluation included demographics, history, anthropometry...
Autores principales: | , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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Medknow Publications
2007
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721575/ https://www.ncbi.nlm.nih.gov/pubmed/19718299 http://dx.doi.org/10.4103/0970-1591.36717 |
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author | Rizvi, Syed A.H. Sultan, Sajid Zafar, Mirza N. Ahmed, Bashir Faiq, Syed M. Hossain, Kehkashan Z. Naqvi, Syed A.A. |
author_facet | Rizvi, Syed A.H. Sultan, Sajid Zafar, Mirza N. Ahmed, Bashir Faiq, Syed M. Hossain, Kehkashan Z. Naqvi, Syed A.A. |
author_sort | Rizvi, Syed A.H. |
collection | PubMed |
description | OBJECTIVES: To describe an evaluation protocol for pediatric stone formers for risk assessment and management strategies. MATERIALS AND METHODS: Between 2002-2006, 2618 children of age three months to 15 years were evaluated for stone disease. Evaluation included demographics, history, anthropometry, diet, ultrasound, X-ray KUB, IVU, blood and 24h urine chemistry and cultures. Stones were analyzed by IR spectroscopy. RESULTS: The median age was seven years with a M:F ratio of 2.2:1. Of the 2618 patients, 2216 presented with normal renal function and 402 with renal failure. Main symptoms were abdominal pain (33%), flank pain (38%) and fever (38%). Renal failure patients also had shortness of breath (38%) and oligo-anuria (26%). Children were malnourished with height and weight deficits in 65% and 76% respectively. Diet was low in protein (74%), calcium (55%) and fluids in (55%), high in oxalate (55%), sodium (39%), purines (42%) and refined sugar (41%). Overall urine cultures were positive in 1208 (46%) with E. coli (38%) and Klebsiella (8%). Stone distribution was renal in 64%, ureter in 8%, bladder in 18%, bilateral in 40% and multiple sites in 18%. Median stone size was >1.5-2.0 cm. The frequency of compounds in stones was ammonium urate (58%), calcium oxalate (63%), uric acid (6%), calcium phosphate (12%) and struvite (8%). Metabolic abnormalities included hypovolumia (31%), hypocitraturia (87%), hyperoxaluria (43%) and hyperuricosuria (26%). Dietary and medical treatment corrected risk factors in two-thirds of patients with a recurrence rate of about 1.15%. CONCLUSION: An evaluation based on history, imaging, diet, metabolic analysis and stone type can help to tailor management strategies. |
format | Text |
id | pubmed-2721575 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2007 |
publisher | Medknow Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-27215752009-08-29 Evaluation of children with urolithiasis Rizvi, Syed A.H. Sultan, Sajid Zafar, Mirza N. Ahmed, Bashir Faiq, Syed M. Hossain, Kehkashan Z. Naqvi, Syed A.A. Indian J Urol Symposium OBJECTIVES: To describe an evaluation protocol for pediatric stone formers for risk assessment and management strategies. MATERIALS AND METHODS: Between 2002-2006, 2618 children of age three months to 15 years were evaluated for stone disease. Evaluation included demographics, history, anthropometry, diet, ultrasound, X-ray KUB, IVU, blood and 24h urine chemistry and cultures. Stones were analyzed by IR spectroscopy. RESULTS: The median age was seven years with a M:F ratio of 2.2:1. Of the 2618 patients, 2216 presented with normal renal function and 402 with renal failure. Main symptoms were abdominal pain (33%), flank pain (38%) and fever (38%). Renal failure patients also had shortness of breath (38%) and oligo-anuria (26%). Children were malnourished with height and weight deficits in 65% and 76% respectively. Diet was low in protein (74%), calcium (55%) and fluids in (55%), high in oxalate (55%), sodium (39%), purines (42%) and refined sugar (41%). Overall urine cultures were positive in 1208 (46%) with E. coli (38%) and Klebsiella (8%). Stone distribution was renal in 64%, ureter in 8%, bladder in 18%, bilateral in 40% and multiple sites in 18%. Median stone size was >1.5-2.0 cm. The frequency of compounds in stones was ammonium urate (58%), calcium oxalate (63%), uric acid (6%), calcium phosphate (12%) and struvite (8%). Metabolic abnormalities included hypovolumia (31%), hypocitraturia (87%), hyperoxaluria (43%) and hyperuricosuria (26%). Dietary and medical treatment corrected risk factors in two-thirds of patients with a recurrence rate of about 1.15%. CONCLUSION: An evaluation based on history, imaging, diet, metabolic analysis and stone type can help to tailor management strategies. Medknow Publications 2007 /pmc/articles/PMC2721575/ /pubmed/19718299 http://dx.doi.org/10.4103/0970-1591.36717 Text en © Indian Journal of Urology http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Symposium Rizvi, Syed A.H. Sultan, Sajid Zafar, Mirza N. Ahmed, Bashir Faiq, Syed M. Hossain, Kehkashan Z. Naqvi, Syed A.A. Evaluation of children with urolithiasis |
title | Evaluation of children with urolithiasis |
title_full | Evaluation of children with urolithiasis |
title_fullStr | Evaluation of children with urolithiasis |
title_full_unstemmed | Evaluation of children with urolithiasis |
title_short | Evaluation of children with urolithiasis |
title_sort | evaluation of children with urolithiasis |
topic | Symposium |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721575/ https://www.ncbi.nlm.nih.gov/pubmed/19718299 http://dx.doi.org/10.4103/0970-1591.36717 |
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