2006, Number 6
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Bol Med Hosp Infant Mex 2006; 63 (6)
Renal failure related to urolithiasis in children
Medina-Escobedo M, León-Burgos V, Duarte AA, Villanueva-Jorge S
Language: Spanish
References: 23
Page: 395-401
PDF size: 164.40 Kb.
ABSTRACT
Introduction. Because urolithiasis (UL) in an endemic disease in the Yucatan peninsula, we carried out a prospective to study over a 5 year period to determine the prevalence, clinical course and metabolic disturbances of renal failure (RF) secondary to UL in children admitted to our institution.
Material and methods. Patients 15 years old and younger, diagnosed with RF, and hospitalized from March 2001 to February 2006, were prospectively examined. Cases associated to UL were selected. Age, sex, hospitalization conditions, litho locus, medical and surgical treatment, complications, and evolution, were registered. Metabolic tests were performed in those in whom RF reverted, posterior to the recovery of renal function.
Results. One hundred four patients with RF were detected; 13 cases (8 females and 5 males) had RF and UL. Age was between 8 months and 12 years old and 10 patients were registered to be less than 3 years old. Anuria was the principal clinical data. Every case had multiple stones. Some undernourishment degree was diagnosed in 10 patients. Hypouricemia and hypouricosuria were present in one case whereas hyperuricosuria and hypercalciuria were present in another; hyperuricosuria was found in 8 cases and the metabolic cause for UL in 3 cases could not be identified. Dialysis was required in 2 cases and nephrostomy probes were used in 2 more cases. All cases needed lithotomy. A satisfactory evolution was achieved in 10 patients and chronic RF developed in 2; one patient died due to urosepsis after few hours of been hospitalized in the emergency room.
Conclusions. RF in children can be caused by UL and in some cases irreversible damage and even death can occur. Hyperuricosuria was the predominant metabolic alteration.
REFERENCES
Gordillo-Paniagua G, Gómez-Chico R. Insuficiencia renal aguda. En: Gordillo G, Exeni R, de la Cruz J, editores. Nefrología pediátrica. 3ª ed. España: Elsevier Science; 2003. p. 439-51.
Gordillo-Paniagua G. Insuficiencia renal crónica. En: Gordillo G, editor. Nefrología pediátrica. España: Mosby-Doyma; 1996. p. 374-400.
Strazdins V, Watson AR, Harvey B. Renal replacement therapy for acute renal failure in children: European guidelines. Pediatr Nephrol. 2003; 19: 199-207.
Williams DM, Sreedhar SS, Mickell JJ, Chan JC. Acute kidney failure: a pediatric experience over 20 years. Arch Pediatr Adolesc Med. 2002; 156: 893-900.
Medina-Escobedo M, Medina-Escobedo C, Martín-Soberanis G. Frecuencia de las enfermedades del sistema urinario en niños atendidos en un Hospital General en Yucatán, México. Bol Med Hosp Infant Mex. 2004; 61: 482-8.
Florentín L. Prevalencia de la insuficiencia renal aguda y de sus etiologías más frecuentes en pacientes nefrológicos pediátricos. Arch Argent Pediatr. 2001; 99: 219-27.
Díaz Y, Cazorla N, Levis O, Saura M, Durán D, Florin J, et al. Insuficiencia renal aguda con tratamiento dialítico. Rev Cubana Pediatr. [online]. 2004; 76: [citado 11 Agosto 2006]. Disponible en la World Wide Web: . ISSN 0034-7531.
Subsecretaría de Prevención y Control de Enfermedades. Insuficiencia Renal Crónica. Práctica Médica Efectiva. [online] 2000; 2: http://bvs.insp.mx/articulos/1/13/v2n6.pdf 11/Agosto/2006: 10:30 hs.
Polinsky M, Kaiser B, Baluarte J. Urolitiasis en la infancia. Clin Pediatr Norteam. 1987; 3: 731-58.
Villegas J, Villatoro C, Moussali L. Litiasis urinaria en niños. Rev Mex Pediatr. 1980; 9: 489-97.
Medina-Escobedo M, Zaidi M, Orozco-Rivadeneyra S, Real-de-León E. Prevalencia y factores de riesgo en Yucatán, México, para litiasis urinaria. Salud Publica Mex. 2002; 44: 541-5.
Sánchez EL. Epidemiología de la Insuficiencia renal crónica en la delegación Yucatán del Instituto Mexicano del Seguro Social. Tesis. Universidad Autónoma de Yucatán, Mérida, Yucatán, México, 2001.
Ece A, Ozdemir E, Gurkan F, Dokucu AI, Akdeniz O. Characteristics of pediatric urolithiasis in South-East Anatolia. Int J Urol. 2000; 7: 330-4.
Rizvi SA, Naqvi SA, Hussain Z, Hashmi A, Hussain M, Zafar MN, et al. Pediatric urolithiasis: developing nation perspectives. J Urol. 2002; 168: 1522-5.
Santos M, Hidalgo-Barquero E, García J. Urolitiasis en la infancia: revisión clínica y epidemiológica de los últimos años en nuestro medio. Vox Paediatr. 2004; 12: 13-9.
Al-Nono I. Infantile obstructive anuria. BJU Int. 2004; 94 Supl 2: 63.
Oner A, Demircin G, Ipekcioglu H, Bulbul M, Ecin N. Etiological and clinical patterns of urolithiasis in Turkish children. 1997; 31: 453-8.
Gambaro G, Favaro S, D’Angelo A. Risk for renal failure in nephrolithiasis. Am J Kidney Dis. 2001; 37: 233-43.
Al-Busaidy S, Prem A, Medhat M, Al-Bulushi Y. Ureteric calculi in children: preliminary experience with holmium: YAG laser lithotripsy. BJU Int. 2004; 93: 1318-23.
Van Savage J, Palanca L, Andersen R, Rao G, Slaughenhoupt B. Treatment of distal ureteral stones in children: similarities to the American Urological Association Guidelines in adults. J Urol. 2000; 164: 1089-93.
Medina-Escobedo M, Villanueva-Jorge S, Cisneros-Martínez E, Medina-Escobedo C, Gala-Trujano E. Cristaluria por ácido úrico en recién nacidos, su relación con la uricosuria y el pH. Bol Med Hosp Infant Mex. 2003; 60: 591-6.
Kamel K, Cheema D, Halperin M. Studies on the pathophysiology of the low urine pH in patients with uric acid stones. Kidney Int. 2002; 61: 988-94.
Danpure Ch. Genetic disorders and urolithiasis. Ur Clin North Am. 2000; 27: 431-45.