ESPN 51th Annual Meeting

ESPN 2018


 
Renal stone disease in infants and small children: A case series
MARTINA FILIPIč 1 NATAšA MARčUN VARDA 1 MLADEN CRNOBRNJA 1 SONJA GOLOB JANčIč 1

1- UNIVERSITY MEDICAL CENTRE MARIBOR, DIVISION OF PAEDIATRICS, UNIT FOR NEPHROLOGY AND ARTERIAL HYPERTENSION
 
Introduction:

Incidence of renal stone disease in children is increasing. In general population, this is probably attributed to changes in environmental factors, like diet and obesity. However, genetic and/or metabolic disorders are still the main reason for renal stones in children. Premature infants are a special risk goup; in extreme low birth weight babies with prolonged NICU admission, the reported rates of renal calcifications are considerable.

Material and methods:

We conducted a retrospective case series of patients younger than 3 years of age diagnosed with renal stones on imaging at our institution in 2017. Data were collected through review of medical records of patients. The paper provides clinical data and case descriptions of all included patients. 

Results:

Five patients, four males and one female,  were diagnosed with renal stones by ultrasound at a median age of 6 months. Four were treated in NICU because of prematurity, low birth weight or comorbidities. Two patients had a stone at initial ultrasound and in two patients, we initially observed signs of nephrocalcinosis. All patiens were checked for hypercalciuria and signs for possible metabolic disorder. To date, no underlying metabolic disorders were identified.  Two were treated for urinary tract infection before the stones were diagnosed, all of them were identified as having an asymptomatic bacteriuria at least once during follow up. One had an important congenital anomaly of the kidneys and the urinary tract, namely severe bilateral hydronephosis due to high-grade vesicoureteral reflux. Two patients were symptomatic, one of them needed surgical treatment due to obstruction.

Conclusions:

We report this case series to emphasize the importance of prematurity and NICU admission as a risk factor for development of renal stones in infancy. Follow up of all prematurely born children treated in our NICU, especially those with identified risk factors, will be established in our institution.