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

Targeted Pharmacological Therapies

Usually, the major problem is long-term compliance of children to the following therapies.[1,2,13,29,34] Long-term monitoring and family education in this case are essential.

Potassium citrate supplementation is useful for idiopathic hypercalciuria, 0.25–1 mEq/kg/die divided into three doses (it increases solubility of urinary calcium), hypocitraturia and hyperuricuria (it increases urinary pH and solubility of uric acid).

Thiazide diuretics for hypercalciuria (they reduce urinary calcium excretion by increasing calcium absorption in the proximal tubule) are indicated in case of previous therapy failure and stone recurrences).

Potassium-sparing diuretics (for instance amiloride) enhance calcium reabsorption.

Empirical administration of pyridoxine can be prescribed if primary hyperoxaluria is suspected.

Both tiopronine and penicillamine increase cystine solubility.

Allopurinol is useful to reduce uric acid levels in case of defect in purine metabolism.

A possible treatment with O. formigenes will be available soon, but data demonstrating clinical utility are lacking.[21,22]

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