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Pediatric urolithiasis: experience at a tertiary care pediatric hospital.

INTRODUCTION
Pediatric urolithiasis has become more prevalent in recent decades, with high recurrence rates and considerable morbidity. Most children with idiopathic urolithiasis have an underlying metabolic abnormality and proper research provides therapeutic interventions to reduce the formation of new stones and its complications.


OBJECTIVE
To identify demographic and clinical characteristics of pediatric urolithiasis, etiology, treatment management, disease recurrence and patient outcomes in a tertiary care pediatric hospital.


METHODS
A retrospective descriptive study of pediatric patients admitted to the Hospital Infantil Joana de Gusmão in Florianópolis, SC, Brazil, who were diagnosed with urolithiasis, from January 2002 to December 2012. Data were obtained from medical records. Those patients with diagnosis confirmed by imaging and 24hr urine or single sample urine were included.


RESULTS
We evaluated 106 pediatric patients (65% M). Average age at diagnosis was 8.0 ± 4.2 and 85% of them had positive family history of urolithiasis. Abdominal pain, renal colic and urinary tract infection were the main manifestations. 93.2% had metabolic abnormality and hypercalciuria was the most common. Pharmacological treatment was established in 78% of cases. Potassium citrate and hydrochlorothiazide were used. Surgical treatment was performed in 38% of patients. There was response to treatment in 39% of patients with recurrence of urolithiasis in 34.2% of them. Only 4.7% of patients continued follow-up, 6.6% were referred to other services, 8.5% were discharged and 73.8% lost follow-up.


CONCLUSION
Pediatric urolithiasis deserves a detailed metabolic evaluation after their initial presentation for treatment, monitoring and prevention of its formation and its complications.