Metabolic risk factors of urolithiasis on pediatric patients and long term results of metaphylaxis

Objectives: In this study we aimed to identify metabolic risk factors of urolithiasis and long term effects of metabolic proflactic treatment to the stone recurrence which was given for the metabolic risk factors.Material and Methods: Between January 2008 and June 2011, 129 patients under 16 years old had PCNL operation and became stone free. The data of these patients documanted retrospectively and results were analysed using statistical methods.Results: Mean age of 129 patients was 7.8±4.7 (1-16) years and 68 patients (%53) were male and 61 (%47) were female. After metabolic evaluation, %89.2 of the patients had one or more metabolic anomaly. Most frequent metabolic anomalies were hypositruria. Potassium citrate and scholl solution was given as medical prophylaxis to 75 patients (%58) who had hypositruria and cystinuria. After mean 26.5±9.4 months (12-46) follow up, stone recurrence was %4 in prophylaxis group and %41 in non-prophylaxis group (p<0.001). Most frequent stone types were Ca oxalate (%89), cystine calculi (%9).Discussion: In the management of pediatric urolithiasis, we found that stone recurrence can be prevented with metabolic screening and medical prophylaxis. Clinic and laboratory evaluation should be made and possible risk factors should be determined in every pediatric patient who had a stone episode or nephrocalcinosis. To prevent new stone formation, required suggestions (dietary modifications, fluid intake etc.) should be made and adequate prophylactic treatment should be administrated.Key Words: Pediatric, stone, metabolic evaluation, metaphylaxis