Educational review: role of the pediatric nephrologists in the work-up and management of kidney stones

• Published in: Pediatric nephrology (Berlin, West) Vol. 35; no. 3; pp. 383 - 397
• Main Authors: Rodriguez Cuellar, Carmen Inés, Wang, Peter Zhan Tao, Freundlich, Michael, Filler, Guido
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2020; Springer; Springer Nature B.V
• Subjects: Adolescent; Adolescents; Calculi; Care and treatment; Child; Children; Diagnosis; Educational Review; Environmental factors; Etiology; Fluid intake; Humans; Hypercalciuria; Hypercalciuria - diagnosis; Hypercalciuria - metabolism; Hypercalciuria - therapy; Hypercalciuria - urine; Hyperoxaluria - diagnosis; Hyperoxaluria - metabolism; Hyperoxaluria - therapy; Hyperoxaluria - urine; Incidence; Kidney Calculi - diagnosis; Kidney Calculi - epidemiology; Kidney Calculi - metabolism; Kidney Calculi - therapy; Kidney stones; Kidneys; Medicine; Medicine & Public Health; Metabolism; Nephrolithiasis; Nephrologists; Nephrologists - organization & administration; Nephrology; Pediatric research; Pediatrics; Practice; Professional Role; Recurrence; Risk Factors; Secondary Prevention - organization & administration; Sodium; Urinary tract; Urology; Canada; Hypercalciuria; Urolithiasis; Hypomagnesiuria; Hyperoxaluria; Nephrolithiasis; Hypocitraturia; Cystinuria
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/s00467-018-4179-9

Background The incidence of nephrolithiasis in children and adolescents is increasing and appears to double every 10 years. The most important role of the pediatric nephrologist is to diagnose and modify various metabolic and non-metabolic risk factors, as well as prevent long-term complications especially in the case of recurrent nephrolithiasis. Objective The purpose of this review is to summarize the existing literature on the etiology and management of pediatric nephrolithiasis. Results The incidence of kidney stones is increasing; dietary and environmental factors are probably the main causes for this increased incidence. In most pediatric patients, the etiology for the kidney stones can be identified. Metabolic factors, such as hypercalciuria and hypocitraturia, urinary tract infection, and urinary stasis, constitute leading causes. Herein, we review the etiologies, diagnostic work-up, and treatment options for the most prevalent causes of kidney stones. The detrimental effects of excessive dietary sodium, reduced fluid intake, and the benefits of plant-based over animal-based protein consumption on urinary crystal formation are discussed. We also review the long-term complications. Conclusions Pediatric nephrologists have an important role in the diagnostic work-up and prevention of recurring nephrolithiasis.