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Prevention of recurrent nephrolithiasis in children

Authors
Jodi Smith, MD, MPH
F Bruder Stapleton, MD
Section Editor
Laurence S Baskin, MD, FAAP
Deputy Editor
Melanie S Kim, MD

INTRODUCTION

The management of pediatric nephrolithiasis is divided into two parts.

Acute episode – During the acute phase when the stone is being passed, management is directed towards pain control, and facilitating passage or removal of the stone(s).

Prevention of recurrent disease – After the acute episode, management is directed towards prevention of recurrent stone disease. This includes an evaluation to identify any underlying cause or risk factors for stone formation. Based upon this assessment, interventions are tailored to reduce the risk of recurrent stone formation.

The prevention of recurrent childhood nephrolithiasis will be reviewed here. The acute management, epidemiology, risk factors, clinical manifestations, and diagnosis of nephrolithiasis in children are discussed separately. (See "Acute management of nephrolithiasis in children" and "Epidemiology of and risk factors for nephrolithiasis in children" and "Clinical features and diagnosis of nephrolithiasis in children".)

EPIDEMIOLOGY

In children and adolescents with nephrolithiasis, renal stones recur frequently. This was illustrated in a large case series of 221 children from the Mayo Clinic that demonstrated two-thirds of the patients developed one or more additional stones at a mean follow-up of 59 months [1]. Other centers have reported a lower but still substantial recurrence rate of 30 percent [2,3]. The incidence of recurrent nephrolithiasis increases if there is an identified underlying metabolic abnormality that contributes to stone formation [2,3].

                         

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Literature review current through: Nov 2016. | This topic last updated: Tue Jun 09 00:00:00 GMT 2015.
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