#1000 Assessment of metabolic risk of exposure to lithogenic factors and prevention of development of nephrolithiasis in children

Abstract Background Among all urological pathologies, nephrolithiasis (N) is in second place, second only to infectious pathologies of the urinary tract. Among all patients in urological departments of hospitals, the proportion of N varies within 30%–50%. Aims to identify risk factors for the development of nephrolithiasis in children and to create a prognostic matrix for a comprehensive risk assessment. Method In order to determine the influence of various factors on the risk of developing nephrolithiasis in children, we formed 3 groups of patients from the examined children: Group I—57 children (26 boys and 31 girls), average age—4.51 ± 3.83 years with a diagnosis of urolithiasis, Group II—32 children (21 boys and 11 girls), average age 4.66 ± 2.81 years with a diagnosis of chronic tubulointerstitial nephritis (TIN). Group III—31 children (16 boys and 15 girls), average age—4.58 ± 2.19 years with crystalluria (oxalate—74.19%, urate—6.45%, mixed—19.36. For the purpose of statistical comparison of the obtained indicators of the children studied in the work, we formed a control group (CG) of practically healthy 8 boys and 22 girls aged 2–7 years, average age—4.40 ± 1.57 years. We conducted a study of the anamnesis of the patients studied, the frequency of occurrence of certain parameters. Results The analysis of the frequency of the studied and compared nuances of the anamnesis of the examined children, their mothers, including the number of pregnancies and its course, childbirth, medications received by the pregnant woman and the already born child, the mother's comorbid background, the presence of a burden in parents and their relatives for H., as an aspect of heredity, and other compared parameters allowed us to further assess the strength of the influence of each of them on the formation and rate of development of H, taking into account different "stages" of pathology between the studied groups. The data showed that mothers of children in group I had a higher frequency of early and late gestosis, they more often took GCS and vitamins during pregnancy, suffered from diabetes mellitus and obesity, more often gave birth to premature babies and with the help of cesarean section, less often breastfed, children of this group more often suffered from rickets, diseases of the urinary system and gastrointestinal tract, more often received AB, pro- and prebiotics. In many respects it is similar to groups I and III, but we can only assess the influence of similar frequencies of possible risk factors by statistical analysis of these and other indicators of all studied groups in a comparative aspect. Analysis of the data obtained during the study allowed us to develop a methodology for assessing the probability (predicting) of the occurrence of crystalluria and H in children. We compiled a prognostic matrix, which, based on anamnestic data, allows us to identify a risk group for the development of H in children. Then, in accordance with the standards, we calculated risk subranges in 3 intervals: low (106.9–371.8), medium (371.9–636.7) and high (636.8–952.7) probability of the risk of developing HL and threshold values ​​of prognostic coefficients as the boundaries of risk groups (Table 1). Individual prediction of the development of complications allows us to anticipate the development of urolithiasis, which implies a change in eating habits and water consumption, and, if the prognosis is unfavorable, supplementing the above with treatment and preventive measures. Conclusion Individual prognosis can be used in a screening manner by studying only the most significant strong laboratory indicators and assigning them points, the sum of which will determine the risk group of a particular child.