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Educational review: role of the pediatric nephrologists in the work-up and management of kidney stones

  • Carmen Inés Rodriguez Cuellar
  • Peter Zhan Tao Wang
  • Michael Freundlich
  • Guido FillerEmail author
Educational Review

Abstract

Background

The incidence of nephrolithiasis in children and adolescents is increasing and appears to double every 10 years. The most important role of the pediatric nephrologist is to diagnose and modify various metabolic and non-metabolic risk factors, as well as prevent long-term complications especially in the case of recurrent nephrolithiasis.

Objective

The purpose of this review is to summarize the existing literature on the etiology and management of pediatric nephrolithiasis.

Results

The incidence of kidney stones is increasing; dietary and environmental factors are probably the main causes for this increased incidence. In most pediatric patients, the etiology for the kidney stones can be identified. Metabolic factors, such as hypercalciuria and hypocitraturia, urinary tract infection, and urinary stasis, constitute leading causes. Herein, we review the etiologies, diagnostic work-up, and treatment options for the most prevalent causes of kidney stones. The detrimental effects of excessive dietary sodium, reduced fluid intake, and the benefits of plant-based over animal-based protein consumption on urinary crystal formation are discussed. We also review the long-term complications.

Conclusions

Pediatric nephrologists have an important role in the diagnostic work-up and prevention of recurring nephrolithiasis.

Keywords

Nephrolithiasis Urolithiasis Hypercalciuria Hypocitraturia Hyperoxaluria Cystinuria Hypomagnesiuria 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.

Financial disclosure

None.

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Copyright information

© IPNA 2019

Authors and Affiliations

  1. 1.Department of Pediatrics, Schulich School of Medicine & DentistryUniversity of Western OntarioLondonCanada
  2. 2.Instituto Nacional de PediatríaCiudad de MéxicoMexico
  3. 3.Universidad Autónoma de MéxicoCiudad de MéxicoMexico
  4. 4.Lilibeth Caberto Kidney Clinical Research Unit, London Health Sciences Centre; and Department of Medicine, Schulich School of Medicine & DentistryUniversity of Western OntarioLondonCanada
  5. 5.Department of Surgery, Schulich School of Medicine & DentistryUniversity of Western OntarioLondonCanada
  6. 6.Department of Pediatrics, Division of Pediatric NephrologyUniversity of Miami Miller School of MedicineMiamiUSA
  7. 7.Department of Medicine, Schulich School of Medicine & DentistryUniversity of Western OntarioLondonCanada
  8. 8.Department of Pathology and Laboratory Medicine, Schulich School of Medicine & DentistryUniversity of Western OntarioLondonCanada
  9. 9.Children’s Health Research InstituteUniversity of Western OntarioLondonCanada
  10. 10.Children’s Hospital, London Health Science CentreUniversity of Western OntarioLondonCanada

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