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Boletín médico del Hospital Infantil de México
versão impressa ISSN 1665-1146
Resumo
VELASQUEZ-FORERO, Francisco et al. Risk factors evaluation for urolithiasis among children. Bol. Med. Hosp. Infant. Mex. [online]. 2016, vol.73, n.4, pp.228-236. ISSN 1665-1146. https://doi.org/10.1016/j.bmhimx.2016.05.006.
Background:
The prevalence of pediatric urolithiasis varies from 0.01-0.03%. Urolithiasis may be caused by anatomical, metabolic and environmental factors. Recurrence varies between 16 to 67%, and it is frequently associated with metabolic abnormalities. The objective of the present work was the identification of risk factors that promote urolithiasis in a child population.
Methods:
This study included 162 children with urolithiasis and normal renal function (mean age 7.5 years). Risk factors were investigated in two stages. In the first stage, 24-hour urine, and blood samples were analyzed to assess metabolic parameters and urinary tract infection. During the second stage, the effect of calcium restriction and a calcium load on renal Ca excretion were evaluated. Data were statistically analyzed.
Results:
Urolithiasis was observed in 0.02% of children, 50% of them with family history of urinary stones. There were multiple risk factors for urolithiasis including hypocitraturia (70%), hypomagnesuria (42%), hypercalciuria (37%; in 11/102 was by intestinal hyperabsorption, in 13/102 was unclassified. Ca resorption or renal Ca leak were not detected). We also detected alkaline urine (21%), systemic metabolic acidosis (20%), urinary infections (16%), nephrocalcinosis with urolithiasis (11%), oliguria (8%), urinary tract anomalies, hyperuricosemia and hypermagnesemia (7% each one), hypercalcemia (6%), hyperoxaluria (2%) and hypercystinuria (0.61%).
Conclusions:
Hypocitraturia and hypomagnesuria were the most frequent risk factors associated with urolithiasis, followed by hypercalciuria. High PTH values were excluded. Children presented two or more risk factors for urolithiasis.
Palavras-chave : Hypocitraturia; Hypomagnesuria; Hypercalciuria; Pediatric urolithiasis; Systemic metabolic acidosis; Urolithiasis risk factors.