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Journal of the Korean Society of Pediatric Nephrology 2007;11(2): 280-287. doi: https://doi.org/10.3339/jkspn.2007.11.2.280
소아 요로 결석 : 단일 기관 연구
이현경, 이성하, 한경희, 이범희, 최현진, 하일수, 최용, 정해일
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 소아과학교실
3서울대학교 의과대학 소아과학교실
4서울대학교 의과대학 소아과학교실
5서울대학교 의과대학 소아과학교실
6서울대학교 의과대학 소아과학교실
7서울대학교 의과대학 소아과학교실
8서울대학교 의과대학 소아과학교실
Urinary Lithiasis in Children : A Single Center Study
Hyun-Kyung Lee, Sung-Ha Lee, Kyoung-Hee Han, Beom-Hee Lee, Hyun-Jin Choi, Il-Soo Ha, Yong Choi, Hae-Il Cheong
1Department of Pediatrics, Seoul National University Childrens Hospital
2Department of Pediatrics, Seoul National University Childrens Hospital
3Department of Pediatrics, Seoul National University Childrens Hospital
4Department of Pediatrics, Seoul National University Childrens Hospital
5Department of Pediatrics, Seoul National University Childrens Hospital
6Department of Pediatrics, Seoul National University Childrens Hospital
7Department of Pediatrics, Seoul National University Childrens Hospital
8Department of Pediatrics, Seoul National University Childrens Hospital
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ABSTRACT
Purpose : Urinary lithiasis is uncommon in children, however, it may lead to chronic renal insufficiency and even end stage renal disease. The etiology of stone formation in children is largely unknown; although the most common causes are known to be associated with congenital anomalies of the genito-urinary(G-U) tract, urinary tract infections(UTI), and metabolic diseases.
Methods : A total of 73 children(male:female=42:31, mean age $6.6{pm}5.3$ years) presented with urinary lithiasis between Sep. 1998 and Jul. 2007 at Seoul National University Children's Hospital. The medical records were reviewed retrospectively.
Results : The most common presenting symptoms were gross hematuria(28/73, 38%) and flank or abdominal pain(23/73, 32%). The stones were located in the upper urinary tract in 48 patients(66%), in the bladder in 18(24%), and in both the bladder and upper urinary tract in 2 (3%). Congenital anomalies of the G-U tract with/without UTI were detected in 30 children (41%), hypercalciuria with/without hypercalcemia in 15(20%), and other metabolic diseases in 8(11%). In 17 patients(23%), no underlying cause of stone formation was detected. The majority of stones were infected stones(24/36, 67%), which were followed by calcium stones(8/36, 22%), uric acid stones(3/36, 8%). and cystine stones(1/36, 3%). Thirty-four patients(46%) underwent surgical procedures and/or extracorporeal shockwave lithotripsy for stone removal, and 13(18%) passed stones spontaneously with/without medical management. Stones recurred in 6 patients(8%): 4 with neurogenic bladder augmented by ileocystoplasty, 1 with cystinuria, and 1 with unknown etiology.
Conclusion : The common causes of urinary lithiasis in children were congenital anomalies of the G-U tract with/without UTI and metabolic disorders including hypercalciuria/hypercalcemia. For the management of stones, minimally invasive procedures should be chosen on the basis of accompanying symptoms and the composition, locations and etiology of stones.
Key words: Urinary lithiasis | Presenting symptom | Location | Underlying cause | Stone analysis | Management | Recurrence
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