Current diagnostics of the childhood urolithiasis

Abstract

The review considers diagnostic aspects of renal stone disease, or urolithiasis (UL) in children. Population prevalence and clinical features of pediatric UL are under discussion, along with most effective visualization approaches. Different risk factors of the kidney stone disease are considered, including various metabolic, climatic and ecological disorders, e. c., hyperoxaluria, hypercalciuria, certain local microbial infections, such as Proteus mirabilis, Corynebacterium urealytica, Ureaplasma urealytica etc.) Some specific features of clinical symptomatology in childhood urolytiasis are also under consideration. Protective mechanisms of the local Tamm-Horsfall protein and high citrate production are discussed. This protein performs some antiinfectious functions, as well stabilizes a complex salt balance in the urine, thus increasing solubility threshold for the salts. We have noted that prevalence of the high-molecular-weight 28 MDa isoform of the Tamm-Horsfall protein over the 7-MDa form seems to be an important protective factor in potential development of urolytiasis. We mention here a number of rare genetic syndromes is listed which cause specific inherited disorders of calcium, hyperoxaluria, or uric acid salts accumulation. In summary, we postulate a need of individualized diagnostics of urinary metabolic markers in the UL patients, in order to arrange metaphylactic measures, in order to prevent recurrent formation of kidney stones and possible urolythiasis episodes in future.