Urolithiasis in pediatric patients: A single center study of incidence, clinical presentation and outcome
Urolithiasis in pediatric patients: A single center study of incidence, clinical presentation and outcome
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DOI：
10.1016/j.juro.2007.02.002
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发表时间：
2007-06-01
影响因子：
6.6
通讯作者：
Trachtman, Howard
中科院分区：
文献类型：
--
作者：
VanDervoort, Kristy;Wiesen, Jonathan;Trachtman, Howard
目的：在过去的30年中，成人肾结石的发病率有所增加。这项回顾性的单中心研究旨在检验以下假设：1994年至2005年儿童患者尿石症的发病率增加，在研究期的最后3年，代谢异常在肾结石患者中更常见。材料和方法：审查了1994年至1996年（第一阶段）和2003年至2005年（第二阶段）两个时期的图表。临床和实验室数据，包括人口统计学，提出投诉，实验室评估，治疗和结果，制成表格，在患者确诊urolithies.Results：尿石症患者的数量增加，从7在第一阶段到61在第2阶段。当表示为每100例新患者的病例数时，发生率增加了4.6倍（p = 0.014）。关注第2阶段，28%的患者年龄小于10岁。虽然血液检查通常正常，但76%的患者在24小时尿液采集中至少有1次异常。低柠檬酸尿是最常见的代谢异常，在52%的患者中观察到。第1阶段的患者数量较少，无法确定第2阶段的代谢异常是否更常见。12名儿童需要手术和/或碎石术。结石病复发的patients.Conclusions的39%：在过去的十年中，在我们的机构在儿科人群中的尿石症的发病率增加了近5倍。我们建议主要的诊断测试是24小时尿液收集。最常见的代谢异常是低柠檬酸尿，其次是高钙尿。结石复发很常见（约40%），建议进行随访。
Purpose: The incidence of kidney stones in adults has increased in the last 30 years. This retrospective, single site review was done to test the hypotheses that the incidence of urolithiasis in pediatric patients increased from 1994 to 2005, and that metabolic abnormalities were more common in patients with renal stones in the final 3 years of the study period.Materials and Methods: Charts from 2 time periods were reviewed, 1994 to 1996 (period 1) and 2003 to 2005 (period 2). Clinical and laboratory data, including demographics, presenting complaints, laboratory assessment, treatment and outcome, were tabulated in patients with confirmed urolithiasis.Results: The number of patients with urolithiasis increased from 7 in period I to 61 in period 2. When expressed as cases per 100 new patients the incidence increased 4.6 times (p = 0.014). Focusing on period 2, 28% of patients were younger than 10 years. While blood tests were generally normal, 76% of patients had at least 1 abnormality in the 24-hour urine collection. Hypocitraturia, which was the most common metabolic abnormality, was noted in 52% of patients. The small number of patients in period 1 precluded determination as to whether metabolic abnormalities were more common in period 2. Surgery and/or lithotripsy was required in 12 children. Stone disease recurred in 39% of the patients.Conclusions: The incidence of urolithiasis in the pediatric population increased nearly 5-fold at our institution during the last decade. We recommend that the primary diagnostic test be a 24-hour urine collection. The most common metabolic abnormality was hypocitraturia, followed by hypercalciuria. Recurrence of stones is common (approximately 40% rate) and followup is advised.