Pediatric calculi: cause, prevention and medical management

Curr Opin Urol. 2018 Sep;28(5):428-432. doi: 10.1097/MOU.0000000000000520.

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.

Publication types

  • Review

MeSH terms

  • Allopurinol / therapeutic use
  • Chelating Agents / therapeutic use
  • Child
  • Conservative Treatment
  • Diet Therapy
  • Diet*
  • Diuretics / therapeutic use
  • Diuretics, Potassium Sparing / therapeutic use
  • Environment*
  • Enzyme Inhibitors / therapeutic use
  • Humans
  • Nephrolithiasis / epidemiology*
  • Nephrolithiasis / prevention & control
  • Nephrolithiasis / therapy
  • Penicillamine / therapeutic use
  • Potassium Citrate / therapeutic use
  • Risk Factors
  • Sodium Chloride Symporter Inhibitors / therapeutic use
  • Tiopronin / therapeutic use

Substances

  • Chelating Agents
  • Diuretics
  • Diuretics, Potassium Sparing
  • Enzyme Inhibitors
  • Sodium Chloride Symporter Inhibitors
  • Allopurinol
  • Tiopronin
  • Potassium Citrate
  • Penicillamine