Pediatric Calculi: Cause, Prevention and Medical Management

Cesare M. Scoffone; Cecilia M. Cracco


Curr Opin Urol. 2018;28(5):428-432. 

In This Article

Fluid Intake

High fluid intake (1.5–2 l/m2/day), better if evenly distributed to the whole day, has been universally recommended for kidney stone prophylaxis. Urine volumes should be more than 750 ml/day in infants, more than 1000 ml/day in children, and more than 2000 ml/day more than 10 years.[1,2,10,13]

Evaluation of 24-h urine osmolality is regarded as the best biomarker of the current hydration status, and upper metastable limit osmolality after the water evaporation test from urine samples to the onset of spontaneous crystallization is a new risk index that would describe an individual lithogenic potential, depending upon urine composition. In fact, pediatric stone formers present with higher urine volumes and lower urine osmolality than healthy controls. Despite that, their urine samples require much lower volume reduction to induce spontaneous crystallization than that of controls, being at risk to stone formation when exposed to dehydration.[33]