Clinical and Metabolic Characteristics in Children with Nephrolithiasis and the Role of These Factors in Stone Resolution: A Retrospective Cohort Study

Objective: Nephrolithiasis is a health problem that leads to frequent hospital admission in children. There are risk factors for stone development such as anatomical problems leading to urinary stasis, infections, and some metabolic abnormalities. This study involved the assessment of clinical and laboratory information from pediatric patients, with an analysis of factors that could impact treatment outcomes. Material and Methods: In this study, the clinical and laboratory records of children aged 0-18 years diagnosed with nephrolithiasis were retrospectively analyzed. The assessments of patients' information with resolved or persistent kidney stones were compared, identifying risk factors for persistence. Results: This study included 278 patients, with a slight female predominance (male/female: 1/1.17) and a mean age of 4.9 years (0.1-17.5 years). Most patients (29.5%) were diagnosed incidentally. Approximately half of the patients (45.3%) had at least 1 metabolic risk factor, hyperoxaluria is the most common one (18.7%). More than half of the patients (57.9%) have microlithiasis. The frequency of microlithiasis increases in males, younger age, hypercalciuria, hyperuricosuria and hypocitraturia. Overall treatment success rate is 60.8%, and it is higher in males, microlithiasis, left nephrolithiasis, and in the absence of hyperoxaluria or hypocitraturia. Conclusion: Metabolic examinations should be performed in every patient regardless of stone size. Treatment success can be predicted according to the underlying metabolic risk factor and individualized treatment becomes important. Since microlithiasis may improve spontaneously, the need for medical treatment should be evaluated individually for each patient.