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73: Nephrolithiasis
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Published:May 2023
Julie Cernanec, MD, FAAP, SFHM, "Nephrolithiasis", Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics, American Academy of Pediatrics Section on Hospital Medicine, Jeffrey C. Gershel, MD, FAAP, Daniel A. Rauch, MD, FAAP, SFHM
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Nephrolithiasis accounts for up to 1 in 1,000 pediatric hospitalizations in the United States. Consequences of untreated nephrolithiasis include severe pain, increased risk of infection, and, rarely, kidney injury.
Physiological risk factors for nephrolithiasis include low urine volume, low urine pH level (but alkaline urine pH for calcium carbonate and struvite stones), bacterial urinary tract infection (UTI), increased urinary concentrations of stone-forming metabolites, and reduced concentrations of inhibitors (eg, citrate, magnesium) of stone formation. Metabolic abnormalities cause more than 50% of pediatric renal calculi, with hypercalciuria and hypocitraturia being the most common, especially in younger children. Repeated infection, with or...
