Pediatric Calculi: Cause, Prevention and Medical Management

Cesare M. Scoffone; Cecilia M. Cracco

Disclosures

Curr Opin Urol. 2018;28(5):428-432. 

In This Article

Abstract and Introduction

Abstract

Purpose of review: The incidence of pediatric nephrolithiasis is on the rise, with a significant related morbidity and a concomitant relevant increase in healthcare costs. The purpose of this review is to portray the current epidemiology and cause of renal stones in children, to provide a framework for appropriate clinical evaluation on an individual basis, and a guidance regarding treatment and prevention for the significant risk of lifelong recurrence and deriving complications.

Recent findings: The early identification of modifiable risk factors and other abnormalities is essential, to prevent related morbidity, the onset of chronic kidney disease, and the associated increased risk of developing other diseases. The implementation of risk reduction strategies, including dietary modifications and targeted pharmacological therapies, will significantly influence stone recurrences and preserve renal function.

Summary: Future research is desirable, with the aim to strengthen personalized conservative management of pediatric nephrolithiasis as first-line treatment.

Introduction

Nephrolithiasis, once considered an adult disease, has become increasingly prevalent in children,[1–5] with a significant related morbidity (episodes of colicky pain, necessity for surgical interventions, progression to chronic kidney disease) and a concomitant relevant increase in healthcare costs (including outpatient visits, urgent hospitalizations, the option of active surveillance for asymptomatic small renal calculi, a variety of medical therapies, laboratory exams and imaging studies, the burden of missed work/lost wages by caregivers).[6–8]

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