Renal lithiasis in children

Justification and objective: Renal lithiasis is due to the precipitation of crystals due to an imbalance in the urine between promoting substances and inhibitory substances. It is a pathology with a prevalence between 2–10% in the pediatric population, with an incidence that has increased in the last 25 years; for this reason this study aims to know the prevalence, clinical and metabolic manifestations of renal lithiasis in the pediatric population of the National Children's Hospital of Costa Rica. Methods: Tthis is a retrospective, descriptive and observational study, through the review of records of patients under 18 years of age with the diagnosis of renal lithiasis, attended at the National Children's Hospital, in the period from January 2000 to 2018. Results: A total of 106 patients were included. The average age at diagnosis was 6.6 ± 3.8 years; the frequency of cases has increased 5.5 times in the last 5 years. Risk factors detected: urinary tract abnormalities 22.6% and family history of lithiasis 17.9%. Metabolic analysis showed low urine output in 74.3%, hyperphosphaturia in 43.2%, hypomagnesuria 39.2% and hypercalciuria 37.8%. Etiologies determined: metabolic 54.7%, urinary tract malformations 16% and idiopathic in 30.9%. Intracorporeal lithotripsy was applied in 61.2%. Recurrence was observed in 28.5% of cases, and a relationship was found between the incidence of recurrence and the size of the lithotripsy (p = 0.001) and surgical treatment (p = 0.010). Conclusions: There is an increase in the frequency of cases of pediatric lithiasis with a multifactorial etiology at the National Children's Hospital of Costa Rica