Clinical analysis of urinary calculus and acute renal failure due to urinary calculus in children

Abstract

Objective The incidence of urinary calculus in children has increased in last years.We were aimed to explore the high risk factors causing urinary calculus,clinical presentation,diagnosis and treatment methods for acute renal failure caused by ureterolith in pediatric patients.Methods There were 35 admitted patients of urinary calculus in our hospital from 2002 to 2007,we described their presentation features as well as diagnosis methods,medical treatment and prognosis.Results All the patients were diagnosed by B-ultrasonics and KUB X-ray.Twenty four patients of all were combined with acute renal failure(ARF),the course waspositively correlated to blood urea nitrogen(r=0.549,P=0.007)and creatinine(r=0.575,P=0.004). The ratio of the patients with radiopaque calculus in ARF group was less than that of the patients without ARF(X2=8.70,P=0.006).The level of serum uric acid was significantly higher in ARF gmup than that of the patients without ARF(t=3.04,P=0.009).We treated the ARF patients with cistoscope drainage as well as conservative treatment or hemodialysis.All obstructed kidneys were relieved with medical treatment,and no renal sequel remained.The urine volume of them was increased,symptoms of urinemia were disappeared,BUN and creatinine were normal after operations.Conclusion Most children with urinarv calculus have no classical symptoms.B-ultrasonics is the best way for diagnosing the obstruction of upper urinary tract resulted from multiple lithiasis.Acute renal failure caused by ureterolith should be diagnosed and treated as soon as possible.Removing the ureterofith is the most important.Correcting water and electrolyte disturbance is also important,Preventing recurrence of stones and follow-up is advised. Key words: Cistoscope; Urinary calculus; Acute renat failure