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8 - Metabolic abnormalities in children with urinary stone disease and the influence of gender
Objective: Urinary stone disease is associated with age, gender, diet, climate, and genetic causes. Infections, anatomic and metabolic abnormalities can lead to stone formation. We aimed to evaluate epidemiologic and metabolic factors in children with urolithiasis.
Material and Methods: A total of 89 patients (46 girls), aged between 0 and 18 years with diagnosis of urolithiasis, microlithiasis and a history of urolithiasis were recruited in this retrospective study. Medical records were assessed for current age, gender, age at diagnosis, presenting symptoms, family history, physical findings, medications, results of laboratory tests (including blood urea nitrogen, serum creatinine, electrolytes, blood gases, urinalysis:urinary calcium, uric acid, oxalate, cystine, citrate, magnesium and creatinine levels) and radiological findings.
Results: The mean age was 6.20±5.27 (range, 0.2-18.2 years). Stones were mostly located in the kidneys (n=52, 58.4%). Microlithiasis, urolithiasis and urolithiasis history were defined in 22 (24.7%), 64 (71.9%), and 3 (3.4%) patients, respectively. Anatomic abnormalities were determined in 17.9% of the patients. Of all patients, 31 (34.8%) had metabolic abnormalities in their urinary analyses. While 26 patients (29.2%) had one metabolic abnormality, five (5.6%) patients had more than one. Metabolic abnormalities were two times more in girls than in boys (p=0.027). The most common metabolic disorder detected was hypocitraturia (n=16, 17.9%), followed by hyperoxaluria (n=8, 8.9%), hypercalciuria (n=6, 6.7%), and hyperuricosuria (n=6, 6.7%).
Conclusions: Metabolic abnormalities were detected frequently in children with urinary stone disease. Hypocitraturia was the most common metabolic abnormality. Detailed evaluation is needed to manage patients with urolithiasis. Female gender may be accepted as a predisposing factor for metabolic abnormality.
Keywords: Childhood, gender, hypercalciuria, hypocitraturia, urolithiasis
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