Bahriye ATMIŞ, Atilla GEMİCİ, Raziye ERGÜN

Çocuklarda üriner sistem taşı klinik görünümü ve metabolik özellikleri: Tek merkez deneyimi

Amaç: Çalışmamızda hastanemize üriner sistem taş hastalığı (ÜSTH) saptanarakbaşvuran çocukların demografik özellikleri, metabolik etyolojileri ve tedaviye yanıtlarının değerlendirilmesi amaçlanmıştır.Hastalar ve Yöntem: 01/04/2017-31/03/2018 arası Çocuk Nefroloji-Üroloji kliniklerine başvuran ÜSTH tanısı konulmuş 259 hastanın kayıtları retrospektif olarak incelenmiştir.Bulgular: Olguların en fazla başvuru şikayeti, başka nedenlerle yapılan ultrasonografide saptanan ÜSTH (n:100, %38.6) idi. Olguların 52’sinde (%20.1) piyüri veidrar kültüründe üreme vardı. Hematüri 31 (%11.2) olguda saptandı. Hipositratüri(38/82) %46.3, hipomagnezüri (22/116) %13.2, hiperkalsiüri (28/225) %12.4, hiperürikozüri (17/219) %7.7, hiperokzalüri (4/76) %5.2 olguda tespit edildi. Serum vitamin D düzeyi olguların (15/259) %5.8’inde yüksekti. Taş yerleşimi en sık böbrekalt polünde (%38.2) saptandı. Medikal tedavi verilen olgu 92 (%35.5), vücut dışı şokdalga litotripsi (ESWL) yapılan 34 olgu (%13.12), diğer cerrahi girişimlerin yapıldığıolgular ise 9 (%3.74) idi. 17 olguya eş zamanlı medikal ve cerrahi tedavi uygulandı.Takibe devam eden 199 olgunun ortanca takip süresi 3 ay (en kısa 1 ay en uzun 12ay) idi. Son takiplerinde hastaların 142’sinde (%71.35) iyileşme görülürken, 36’sında(%18.05) taş boyutunda değişiklik saptanmadı, 21’inde (%10.6) ise taş boyutundaartış mevcuttu.Sonuç: Günümüzde tanısal yöntemlerin artması ile çocuklarda ÜSTH’nın nadir olmadığı görülmektedir. Metabolik nedenin saptanması ve tedavisi; taş tekrarını, cerrahi işlem gereksinimini ve etkilenmiş çocuklarda SDBY azalttığı kanaatindeyiz.

Clinical presentation and metabolic features of urinary stones in children: Single center experience

Aim: We aimed to evaluate the demographic characteristics, metabolic etiology, and response to treatment of children who admitted to our hospital with an urinary stone disease (USD) in our study. Patients and Method: The medical records of 259 patients who had been diagnosed with USD, between 01/04/2017-31/03/2018 were reviewed retrospectively. Results: The most common presenting symptoms of the patients were USD detected by ultrasonography performed for other reasons (n: 100, 38.6%). 52 of the patients (20.1%) had pyuria and urine culture positivity. Hematuria was detected in 31 (11.2%) patients. Hypocitraturia (38/82) 46.3%, hypomagnesuria (22/116) 13.2%, hypercalciuria (28/225) 12.4%, hyperuricosuria (17/219) 7.7%, hyperoxaluria (4/76) 5.2% was found in cases. Serum vitamin D levels were high in 5.8% of cases (15/259). The most common localization of stone was lower kidney pole (38.2%). Medical treatment was given to 92 (35.5%) patients while extracorporeal shock wave lithotripsy (ESWL) was performed in 34 (13.12%) patients and other surgical procedures were performed in 9 (3.74%) cases. Concurrent medical and surgical treatment was performed in 17 patients. The median follow-up period of 199 cases under followed-up was 3 months (1-12 months). In the last follow-up, 142 (71.35%) of the patients showed improvement, while 36 (18.05%) had no change in stone size, and 21 (10.6%) had an increase in stone size. Conclusion: Currently, USD is not rare in children with increasing in diagnostic methods. We believe that the detection and treatment of metabolic causes, reduce the stone recurrence, the requirement for surgical procedures, and ESRD in affected children.

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