ESPN 51th Annual Meeting

ESPN 2018


 
Nephrolithiasis in infants on exclusively breastfeeding within the first 6 months of life: risk factors and prognosis
SELCUK YUKSEL 1 NESLIHAN YILMAZ 1 FATIH ALTINTA┼× 2 HANDE ┼×ENOL 3

1- PAMUKKALE UNIVERSITY SCHOOL OF MEDICINE, PEDIATRIC NEPHROLOGY
2- PAMUKKALE UNIVERSITY SCHOOL OF MEDICINE, DEPARTMENT OF PHYSIOLOGY
3- PAMUKKALE UNIVERSITY SCHOOL OF MEDICINE, BIOSTATISTICS
 
Introduction:

We aimed to investigate the etiology and prognosis of nephro-urolithiasis in infants on exclusively breastfeeding within the first 6 months of life.

Material and methods:

Prospective cohort study was composed 30 infants with nephro-urolithiasis and 30 healthy infants on exclusively breastfeeding within the first 6 months of life. All have normal growth and development, no history of other disease and medicines, received vitamin-D supplement 400 IU/day. Levels of lithogenic (calcium, oxalate, uric acid) and antilithogenic substances (citrate, magnesium) in breast milks, calcium, phosphorus, alkaline phosphatase, magnesium, uric acid, 25(OH)-vitamin-D, parathormone and bicarbonate levels in serum samples, and calcium, uric acid, cystine, citrate and magnesium excretions in spot urine of the patients were compared with normal values and healthy infants. Patients were followed-up for at least 12 months by ultrasonography.

Results:

At the presentation, calculi size (largest diameter) were found to be >4 mm (7%) in 2, 2-4 mm (80%) in 24 and <2 mm (13%) in 4 patients. In terms of lithogenic and antilithogenic factors, there was no difference in contents of breast milks. Calcium, alkaline phosphatase and 25(OH)-vitamin-D levels were found to be significantly higher in the sera of patients, but parathormone level was found to be significantly low. Calcium excretion was significantly higher in the patients. At the end of the study, 80% of the patients were stone free. 73% of patients and 37% of controls were born in summer (p=0.004).

Conclusions:

In terms of serum vitamin-D levels and related variables, there were significantly differences between infants with and without nephro-urolithiasis. Oral-vitamin-D supplementation should be individualized in infants, especially during the summer.