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Submitted: 09 Mar 2021
Accepted: 20 Jun 2021
ePublished: 10 Jul 2021
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J Nephropharmacol. 2022;11(1): e9-e9.
doi: 10.34172/npj.2022.09
  Abstract View: 223
  PDF Download: 76

Original

Evaluation of medical treatment in Iranian children with nephrolithiasis

Ehsan Valavi 1 ORCID logo, Azar Nickavar 2 * ORCID logo, Kamran Shehni Nejadpour 3 ORCID logo, Elmira Esmizadeh 3 ORCID logo

1 Chronic Renal Failure Research Center, Ahvaz children’s hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2 Pediatric Nephrology Department, Iran University of Medical Sciences, Tehran, Iran
3 Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
*Corresponding author: Azar Nickavar, Email: anickavar@yahoo.com, nikavar.a@iums.ac.ir

Abstract

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.


Keywords: Nephrolithiasis, Treatment, Alkalinization, Surgery

Implication for health policy/practice/research/medical education:

Management of renal stone, especially non-complicated large nephrolithiasis has been a clinical challenge to reduce surgical procedures and related complications. This study was performed to evaluate the efficacy of general and specific medical treatments in children with renal stone.

Please cite this paper as: Valavi E, Nickavar A, Shehni Nejadpour K, Esmizadeh E. Evaluation of medical treatment in Iranian children with nephrolithiasis. J Nephropharmacol. 2022;11(1):e09. DOI: 10.34172/npj.2022.09.


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