TY - JOUR
T1 - Pediatric nephrolithiasis
T2 - a systematic approach from diagnosis to treatment
AU - Marra, Giuseppina
AU - Taroni, Francesca
AU - Berrettini, Alfredo
AU - Montanari, Emanuele
AU - Manzoni, Gianantonio
AU - Montini, Giovanni
PY - 2019
Y1 - 2019
N2 - Nephrolithiasis is a rare disease in children. For many years children with kidney stones have been managed like “small adults”, but there are significant differences between the pediatric and the adult age in clinical presentation, etiology and treatment. Management of this condition in children has some peculiarities with respect to the adult, as it is often the sign of an underlying metabolic abnormality. Some of these metabolic alterations can lead to serious consequences, such as chronic renal failure, if not adequately diagnosed and treated. Moreover, stones in children with a metabolic abnormality can recur throughout their life, with the need for repeated surgical procedures over the years. So a systematic approach to every child with nephrolithiasis is mandatory to diagnose metabolic defects and establish a personalized therapy. Even the surgical approach in the child has changed significantly over the last two decades: open surgery has now been almost completely replaced by minimally invasive surgery due to the miniaturization of endoscopic instruments and technical advancements in optical and lithotripters systems. The goal is to obtain a stone-free status with the lowest number of minimally invasive procedures and with no complications. Many breakthroughs in our understanding of the physiopathology of renal stones and in surgical technology have been made over the last decades, but the best approach to use in a child with nephrolithiasis remains a true challenge for pediatric nephrologists and urologists.
AB - Nephrolithiasis is a rare disease in children. For many years children with kidney stones have been managed like “small adults”, but there are significant differences between the pediatric and the adult age in clinical presentation, etiology and treatment. Management of this condition in children has some peculiarities with respect to the adult, as it is often the sign of an underlying metabolic abnormality. Some of these metabolic alterations can lead to serious consequences, such as chronic renal failure, if not adequately diagnosed and treated. Moreover, stones in children with a metabolic abnormality can recur throughout their life, with the need for repeated surgical procedures over the years. So a systematic approach to every child with nephrolithiasis is mandatory to diagnose metabolic defects and establish a personalized therapy. Even the surgical approach in the child has changed significantly over the last two decades: open surgery has now been almost completely replaced by minimally invasive surgery due to the miniaturization of endoscopic instruments and technical advancements in optical and lithotripters systems. The goal is to obtain a stone-free status with the lowest number of minimally invasive procedures and with no complications. Many breakthroughs in our understanding of the physiopathology of renal stones and in surgical technology have been made over the last decades, but the best approach to use in a child with nephrolithiasis remains a true challenge for pediatric nephrologists and urologists.
KW - Diagnosis
KW - Management
KW - Pediatric nephrolithiasis
KW - Surgery
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U2 - 10.1007/s40620-018-0487-1
DO - 10.1007/s40620-018-0487-1
M3 - Article
AN - SCOPUS:85045768939
VL - 32
SP - 199
EP - 210
JO - Journal of Nephrology
JF - Journal of Nephrology
SN - 1121-8428
IS - 2
ER -