Approach and Medical Management of Urinary Tract Stone in Children

Kidney stone disease has become more common in children, but it remains non diagnosed in a significant proportion of patients, due to a lack of notable signs and symptoms. All children with colicky abdominal pain or microscopic hematuria should be examined thoroughly for urolithiasis. Patients’ histories in terms of family, medical, and drug and a thorough physical examination are required to be considered during diagnostic evaluation. Thereafter, diagnostic imaging methods should be aimed to detect the size, shape and location of calculi and also urinary tract anomalies. Ultrasound should be used as the initial imaging method to evaluate children with suspected nephrolithiasis. The noncontrast computerized tomography reserved for those in whom ultrasound is unable to diagnose stone. Increased water and fluid intake and a reduction of salt consumption are the common recommen dation to those children with a history of kidney stones, though the rate of stone recurrence in children is unknown. Since metabolic  disorders are the most frequent causes of stone in children, diagnostic evaluation should also target the detection of metabolic disorders including hypercalciuria, hyperoxaluria, hyperuricosuria and so on that may cause recurrent nephrolithiasis. Kidney stone is not a disease itself, but it is only a symptom. Therefore, its early diagnosis is mandatory for every child with the first stone event. In this article, we have summarized literature and emphasize that a few studies with acceptable quality are available on children with urolithiasis in Iran and the world that warrant future studies on this topic.