Clinical and biochemical characterization of childhood urolithiasis,Caractéristiques cliniques et biochimiques des lithiases urinaires de l’enfant
Archives de Pédiatrie. 2014-12-01; 21(12): 1322-1329
DOI: 10.1016/j.arcped.2014.08.027
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1. Arch Pediatr. 2014 Dec;21(12):1322-9. doi: 10.1016/j.arcped.2014.08.027. Epub
2014 Oct 5.
[Clinical and biochemical characterization of childhood urolithiasis].
[Article in French]
Giraudon A(1), Richard E(2), Godron A(3), Bouty A(4), Dobremez E(4), Barat P(3),
Blouin JM(2), Llanas B(3), Harambat J(5).
Author information:
(1)Unité de néphrologie-endocrinologie, service de pédiatrie, hôpital
Pellegrin-Enfants, CHU de Bordeaux, 33076 Bordeaux, France; Service de pédiatrie,
centre hospitalier de Pau, 64000 Pau, France.
(2)Laboratoire de biochimie, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux,
France; Biothérapies des maladies génétiques et cancers, U1035, université de
Bordeaux, 33000 Bordeaux, France.
(3)Unité de néphrologie-endocrinologie, service de pédiatrie, hôpital
Pellegrin-Enfants, CHU de Bordeaux, 33076 Bordeaux, France.
(4)Service de chirurgie pédiatrique, hôpital Pellegrin-Enfants, CHU de Bordeaux,
33076 Bordeaux, France.
(5)Unité de néphrologie-endocrinologie, service de pédiatrie, hôpital
Pellegrin-Enfants, CHU de Bordeaux, 33076 Bordeaux, France. Electronic address:
.
OBJECTIVES: Urolithiasis is rare in children, but the incidence has increased
over the past few decades. This study aims at describing the clinical and
biochemical characteristics, etiology, and treatment of urolithiasis in children.
METHODS: This was a retrospective study of all children under 16 years of age
seen at the Bordeaux University Children’s Hospital with a diagnosis of
urolithiasis. The diagnosis was confirmed either radiologically or clinically by
the expulsion of the stone.
RESULTS: A total of 186 children with a diagnosis of urolithiasis between 1994
and 2012 were included. The median age at diagnosis was 7.4 years. The
male-to-female ratio was 1.9. The estimated annual incidence was around
5.5/100,000 children under 15 years of age in the past 5 years. The main
presenting feature was nonspecific abdominal pain (71%). Metabolic calculi
accounted for 48% of the patients with idiopathic hypercalciuria as the main
cause. Genetic diseases accounted for 15% of cases. The proportion of infectious
calculi was estimated at 33% and decreased in the past two decades. Stone
fragments were sent for analysis in 86 children, and calcium oxalate was the
major component (37%), followed by calcium phosphate (33%), purine (9%), and
struvite (8%). At least 26% of patients experienced recurrence of stone passage.
CONCLUSION: This retrospective study highlighted changes in characteristics of
pediatric urolithiasis over time. Childhood-onset urolithiasis requires complete
etiological work-up so that a metabolic cause with a high risk of recurrence does
not go unrecognized.
Copyright © 2014 Elsevier Masson SAS. All rights reserved.
DOI: 10.1016/j.arcped.2014.08.027
PMID: 25287140 [Indexed for MEDLINE]