Alteraciones urinarias en niños litiásicos paraguayos según estado nutricional
10 Sep 2019-Vol. 17, Iss: 3, pp 28-33
TL;DR: In this article, the frecuencia de alteraciones urinarias presentes in ninos with urolitiasis segun estado nutricional was investigated.
Abstract: La urolitiasis es una enfermedad multifactorial. En los ultimos anos se ha observado un incremento a nivel mundial de la incidencia de la litiasis urinaria tanto en adultos como en ninos. Los cambios en los habitos alimentarios y un aumento en la prevalencia de exceso de peso podrian asociarse a este fenomeno. El objetivo del trabajo fue describir la frecuencia de alteraciones urinarias presentes en ninos con urolitiasis segun estado nutricional. En este trabajo observacional transversal se incluyeron 104 ninos litiasicos de ambos sexos divididos en dos grupos segun estado nutricional: 68 ninos con peso adecuado y 36 ninos con sobrepeso u obesidad considerando criterios de la OMS. Se determinaron en orina de 24 horas calcio, fosforo, sodio, acido urico, citrato y magnesio. Del total de pacientes participantes 54 (51.9%) fueron ninas y 50 (48,1%) fueron ninos. El 65,4% de los ninos presento peso normal y el 34,6% de los ninos sobrepeso u obesidad con edades medias de 10±4 anos y 8±4 anos respectivamente. El 80% de los ninos presento al menos una alteracion urinaria, siendo las mas frecuentes en ambos grupos la hipocitraturia e hiperuricosuria. Es llamativa la elevada frecuencia de alteraciones en las concentraciones de promotores e inhibidores de cristalizacion, en ambos grupos, indicando un riesgo aumentado de recidivas.
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TL;DR: Trends in epidemiology and current concepts for the pathogenesis and pathophysiology of urinary stone disease are reviewed, suggesting a primary interstitial apatite crystal formation that secondarily leads to CaOx stone formation.
110 citations
TL;DR: This year the World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that makes preventive behaviors an affordable option.
Abstract: Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease and also for Chronic Kidney Disease. A high body mass index is one of the strongest risk factors for new-onset Chronic Kidney Disease. In individuals affected by obesity, a compensatory hyperfiltration occurs to meet the heightened metabolic demands of the increased body weight. The increase in intraglomerular pressure can damage the kidneys and raise the risk of developing Chronic Kidney Disease in the long-term. The incidence of obesity-related glomerulopathy has increased ten-fold in recent years. Obesity has also been shown to be a risk factor for nephrolithiasis, and for a number of malignancies including kidney cancer. This year the World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that makes preventive behaviors an affordable option.
97 citations
TL;DR: Both in men and women there was a significant increase in the urinary excretion of two promoters of stone formation, oxalate, and uric acid but no change in urinary calcium, and a significant decrease in urine pH only in men.
Abstract: In recent decades there has been an increasing prevalence of urolitithiasis in many western countries and at the same time there has been an increasing progression of obesity that has reached epidemic proportions. The aim of the present study was to assess the influence of overweight/obesity on the metabolic risk factors for renal stone formation. We studied 799 renal stone formers (462 men and 337 women) who came to the clinic for metabolic risk factors evaluation. They were all studied with a standard protocol (two 24-h urine collections and serum parameters). They were divided according to their BMI in normal (BMI 30). Low-weight individuals were excluded. Overall, 487 of 799 (60.9%) patients had a BMI > 25, including 40.6% overweight and 20.3% obese. Among women 55.2% had normal weight, 25.5 were overweight, and 19.3% were Obese; among men 27.3% had normal weight, 51.7 were overweight, and 21% were obese. Age increased significantly with increasing BMI both in men and women. In women there was a significant increase in the excretion of oxalate, uric acid, phosphorus, creatinine, and sodium with increasing BMI, but no change was observed in calcium, magnesium, citrate, and urine pH. In men there was a significant increase in the excretion of oxalate, uric acid, creatinine, phosphorus, sodium, magnesium, and citrate with increasing BMI, no change in urinary calcium and significant progressive decrease in urinary pH. In this population of stone formers there was a high prevalence of overweight/obesity (60.9%). Both in men and women we found a significant increase in the urinary excretion of two promoters of stone formation, oxalate, and uric acid but no change in urinary calcium. There was either no change or increase in magnesium and citrate, inhibitors of crystallization, and a significant decrease in urine pH only in men.
94 citations
TL;DR: In the setting of an increasing prevalence of childhood stone disease, improved research is critical to the development of uniform strategies for pediatric urolithiasis management.
Abstract: While once thought to be relatively rare in developed nations, the prevalence of pediatric urolithiasis appears to be increasing, and a number of factors may be contributing to this increase. Many theories are plausible and such theories include the increasing childhood obesity epidemic, a changing sex predilection, climate change, alterations in dietary habits and improving diagnostic modalities. Yet, unlike adult patients, rigorous epidemiologic studies do not exist in pediatric populations. Thus, in the setting of an increasing prevalence of childhood stone disease, improved research is critical to the development of uniform strategies for pediatric urolithiasis management.
77 citations
"Alteraciones urinarias en niños lit..." refers background in this paper
...La edad de inicio de la litiasis infantil es variable y generalmente se da entre los 5 y 15 años((17))....
[...]
...Este comportamiento difiere al de adultos, en quienes generalmente se presentan dos a más alteraciones en forma simultánea((17))....
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TL;DR: A high body mass index is associated with decreased urine oxalate and increased supersaturation of calcium phosphate and Pediatricians and pediatric subspecialists should be aware of these findings when evaluating children with nephrolithiasis.
43 citations