Urolithiasis in children: Current medical management

Joseph Laufer, Hayim Boichis

Research output: Contribution to journalArticlepeer-review

Abstract

The mechanism of stone formation in the urinary tract is reviewed. Diet, urinary tract infection and metabolic disorders account for the different epidemiological patterns of stone formation. The diagnosis and management of renal tract calculi are discussed. Calcium stones are associated with hypercalciuria, urine acidification defects, the use of furosemide in premature babies, hypercalcaemia, hyperoxaluria, hyperuricosuria, an alkaline urine and hypocitraturia. Uric acid stones occur in acid urine, from increased purine synthesis with lympho- or myeloproliferative disorders or from several inborn errors of purine metabolism which can also cause xanthine or dihydroxyadenine stones. Cystinuria, inherited as an autosomal recessive disorder is best treated with a low sodium diet, a fluid intake exceeding 40 ml/kg per day maintaining urine pH between 7.5 and 8 and, if necessary, with oral penicillamine. Oxalate stones occur in relation to diet, bowel disease and primary inherited defects in oxalate metabolism. Urinary tract infection causing struvite and carbonate apatite formation is the commonest cause of stones in Europe.

Original languageEnglish
Pages (from-to)317-331
Number of pages15
JournalPediatric Nephrology
Volume3
Issue number3
DOIs
StatePublished - Sep 1989

Keywords

  • Calcium
  • Calculi
  • Cystine
  • Infection
  • Oxalate
  • Purine
  • Urinary tract

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