Evaluation of medical treatment in Iranian children with nephrolithiasis

Introduction: Nephrolithiasis has been increasingly recognized in recent years. Urine metabolic abnormality is the main cause of renal stone in children. Therefore, identification and medical treatment of metabolic abnormalities have been suggested as an alternative approach to surgical treatments....

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Autores principales:	Ehsan Valavi, Azar Nickavar, Kamran Shehni Nejadpour, Elmira Esmizadeh
Formato:	article
Lenguaje:	EN
Publicado:	Society of Diabetic Nephropathy Prevention 2022
Materias:	nephrolithiasis treatment alkalinization surgery Therapeutics. Pharmacology RM1-950 Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/346d4199a61a4f3f885eb786878cb5e9
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spelling	oai:doaj.org-article:346d4199a61a4f3f885eb786878cb5e92021-11-17T08:15:00ZEvaluation of medical treatment in Iranian children with nephrolithiasis2345-420210.34172/npj.2022.09https://doaj.org/article/346d4199a61a4f3f885eb786878cb5e92022-01-01T00:00:00Zhttps://jnephropharmacology.com/PDF/npj-10390https://doaj.org/toc/2345-4202Introduction: Nephrolithiasis has been increasingly recognized in recent years. Urine metabolic abnormality is the main cause of renal stone in children. Therefore, identification and medical treatment of metabolic abnormalities have been suggested as an alternative approach to surgical treatments. Objectives: This study was performed to evaluate the therapeutic effect of urine alkalinization and metabolic management in children with renal stone. Patients and Methods: A total of 300 children (from 408 renal clinics) with nephrolithiasis were enrolled in this study. All of them were treated by supportive managements, including urine alkalinization and specific medical treatment of underlying metabolic abnormality. Improvement was defined as stone resolution, stone passage or decrease of stone dimension. Results: Mean age at diagnosis was 28.7 ± 2.6 months (1-150 months). About 78.8% of patients had metabolic abnormality, of which, hypercalciuria (51.7%) and hypocitraturia (33.4%) were the most common causes, respectively. Resolution of renal stone occurred in 89.7% of patients after one year follow up, more in children less than 5 years (P=0.003), and stones smaller than 5 mm (P<0.001). However, 87.5% of large stones (5-12 mm) improved by medical treatment. Conclusion: Pharmacologic treatment is recommended in young children with small nephrolithiasis. Pharmacologic treatment also suggested as a primary intervention in children with uncomplicated large renal stones, and prior to invasive surgical management.Ehsan ValaviAzar NickavarKamran Shehni NejadpourElmira EsmizadehSociety of Diabetic Nephropathy Prevention articlenephrolithiasistreatmentalkalinizationsurgeryTherapeutics. PharmacologyRM1-950Diseases of the genitourinary system. UrologyRC870-923ENJournal of Nephropharmacology, Vol 11, Iss 1, Pp e9-e9 (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	nephrolithiasis treatment alkalinization surgery Therapeutics. Pharmacology RM1-950 Diseases of the genitourinary system. Urology RC870-923
spellingShingle	nephrolithiasis treatment alkalinization surgery Therapeutics. Pharmacology RM1-950 Diseases of the genitourinary system. Urology RC870-923 Ehsan Valavi Azar Nickavar Kamran Shehni Nejadpour Elmira Esmizadeh Evaluation of medical treatment in Iranian children with nephrolithiasis
description	Introduction: Nephrolithiasis has been increasingly recognized in recent years. Urine metabolic abnormality is the main cause of renal stone in children. Therefore, identification and medical treatment of metabolic abnormalities have been suggested as an alternative approach to surgical treatments. Objectives: This study was performed to evaluate the therapeutic effect of urine alkalinization and metabolic management in children with renal stone. Patients and Methods: A total of 300 children (from 408 renal clinics) with nephrolithiasis were enrolled in this study. All of them were treated by supportive managements, including urine alkalinization and specific medical treatment of underlying metabolic abnormality. Improvement was defined as stone resolution, stone passage or decrease of stone dimension. Results: Mean age at diagnosis was 28.7 ± 2.6 months (1-150 months). About 78.8% of patients had metabolic abnormality, of which, hypercalciuria (51.7%) and hypocitraturia (33.4%) were the most common causes, respectively. Resolution of renal stone occurred in 89.7% of patients after one year follow up, more in children less than 5 years (P=0.003), and stones smaller than 5 mm (P<0.001). However, 87.5% of large stones (5-12 mm) improved by medical treatment. Conclusion: Pharmacologic treatment is recommended in young children with small nephrolithiasis. Pharmacologic treatment also suggested as a primary intervention in children with uncomplicated large renal stones, and prior to invasive surgical management.
format	article
author	Ehsan Valavi Azar Nickavar Kamran Shehni Nejadpour Elmira Esmizadeh
author_facet	Ehsan Valavi Azar Nickavar Kamran Shehni Nejadpour Elmira Esmizadeh
author_sort	Ehsan Valavi
title	Evaluation of medical treatment in Iranian children with nephrolithiasis
title_short	Evaluation of medical treatment in Iranian children with nephrolithiasis
title_full	Evaluation of medical treatment in Iranian children with nephrolithiasis
title_fullStr	Evaluation of medical treatment in Iranian children with nephrolithiasis
title_full_unstemmed	Evaluation of medical treatment in Iranian children with nephrolithiasis
title_sort	evaluation of medical treatment in iranian children with nephrolithiasis
publisher	Society of Diabetic Nephropathy Prevention
publishDate	2022
url	https://doaj.org/article/346d4199a61a4f3f885eb786878cb5e9
work_keys_str_mv	AT ehsanvalavi evaluationofmedicaltreatmentiniranianchildrenwithnephrolithiasis AT azarnickavar evaluationofmedicaltreatmentiniranianchildrenwithnephrolithiasis AT kamranshehninejadpour evaluationofmedicaltreatmentiniranianchildrenwithnephrolithiasis AT elmiraesmizadeh evaluationofmedicaltreatmentiniranianchildrenwithnephrolithiasis
_version_	1718425791313739776

Evaluation of medical treatment in Iranian children with nephrolithiasis

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