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Pediatric urolithiasis: metabolic risk factors and follow-up results in a Turkish region with endemic stone disease.
[cystinuria]
The
goal
of
this
study
was
to
investigate
the
metabolic
etiology
,
clinical
findings
and
medical
treatment
of
children
with
urolithiasis
in
an
endemic
region
of
Turkey
.
We
retrospectively
analyzed
the
medical
records
of
742
(
437
males
,
305
females
)
children
with
urolithiasis
.
Physical
examination
results
,
serum
biochemistry
and
urine
metabolic
evaluation
,
including
urinary
citrate
,
oxalate
,
calcium
,
uric
acid
,
cystine
and
magnesium
levels
were
recorded
.
We
obtained
follow-up
records
in
316
patients
to
evaluate
the
association
between
stone
recurrence
and
metabolic
risk
factors
.
The
mean
age
at
diagnosis
was
2
.
6
±
3
.
4
(
0
.
1
-
17
.
0
)
years
.
Male
-
to
-
female
ratio
was
1
.
4
:
1
.
A
family
history
of
stone
disease
was
found
in
76
.
5
%
of
patients
and
41
%
of
parents
had
consanguineous
marriage
.
The
most
common
presenting
symptoms
were
urinary
tract
infection
(
UTI
,
23
.
9
%
)
and
hematuria
(
23
.
6
%
)
.
Metabolic
abnormalities
were
found
in
588
(
79
.
2
%
)
patients
,
including
hypercalciuria
in
31
.
5
%
,
hypocitraturia
in
24
.
2
%
,
hyperoxaluria
in
11
.
4
%
,
hyperuricosuria
in
9
.
1
%
,
hypomagnesuria
in
3
.
9
%
,
and
cystinuria
in
3
.
1
%
of
patients
.
The
frequency
of
hyperoxaluria
and
hypocitraturia
were
significantly
higher
in
patients
with
new
stone
formation
.
Follow-up
records
of
316
(
42
.
6
%
)
patients
(
192
males
,
124
females
)
were
available
.
Urolithiasis
was
shown
in
135
(
42
.
7
%
)
of
the
patients
on
control
ultrasonography
,
and
61
.
5
%
of
these
patients
had
a
stone
size
≤
3
mm
.
Hyperoxaluria
and
cystinuria
were
significantly
higher
in
patients
with
stone
persistence
.
The
main
goal
of
management
for
children
with
urolithiasis
should
be
identification
of
risk
factors
.
Diseases
Validation
Diseases presenting
"hyperoxaluria"
symptom
cystinuria
neonatal adrenoleukodystrophy
primary hyperoxaluria type 1
This symptom has already been validated