Diagnostic examination of the child with urolithiasis or nephrocalcinosis
Open Access
- 23 December 2008
- journal article
- review article
- Published by Springer Science and Business Media LLC in Pediatric Nephrology
- Vol. 25 (3), 403-413
- https://doi.org/10.1007/s00467-008-1073-x
Abstract
Urolithiasis and nephrocalcinosis are more frequent in children then currently anticipated, but still remain under- or misdiagnosed in a significant proportion of patients, since symptoms and signs may be subtle or misleading. All children with colicky abdominal pain or macroscopic hematuria should be examined thoroughly for urolithiasis. Also, other, more general, abdominal manifestations can be the first symptoms of renal stones. The patients and their family histories, as well as physical examination, are important initial steps for diagnostic evaluation. Thereafter, diagnostic imaging should be aimed at the location of calculi but also at identification of urinary tract anomalies or acute obstruction due to stone disease. This can often be accomplished by ultrasound examination alone, but sometimes radiological methods such as plain abdominal films or more sensitive non-enhanced computed tomography are necessary. Since metabolic causes are frequent in children, diagnostic evaluation should be meticulous so that metabolic disorders that cause recurrent urolithiasis or even renal failure, such as the primary hyperoxalurias and others, can be ruled out. The stone is not the disease itself; it is only one serious sign! Therefore, thorough and early diagnostic examination is mandatory for every infant and child with the first stone event, or with nephrocalcinosis.Keywords
This publication has 41 references indexed in Scilit:
- History, epidemiology and regional diversities of urolithiasisPediatric Nephrology, 2010
- A new approach to the diagnosis of children’s urolithiasis based on the Bonn Risk IndexPediatric Nephrology, 2008
- Oxalobacter formigenes May Reduce the Risk of Calcium Oxalate Kidney StonesJournal of the American Society of Nephrology, 2008
- The Roles and Mechanisms of Intestinal Oxalate Transport in Oxalate HomeostasisSeminars in Nephrology, 2008
- Ceftriaxone associated nephrolithiasis: a prospective study in 284 childrenPediatric Nephrology, 2007
- Nephrolithiasis in childrenPediatric Nephrology, 2005
- High incidence of kidney stones in Icelandic childrenPediatric Nephrology, 2005
- Sulfadiazine-induced nephrolithiasis in childrenPediatric Nephrology, 2004
- Urinary Calcium Oxalate Saturation in Healthy Infants and ChildrenJournal of Urology, 1997
- A screening test for hyperuricosuriaThe Journal of Pediatrics, 1983