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Miah T et al, 2017: Pediatric Nephrolithiasis: A Review.

Miah T, Kamat D.

Abstract

The incidence of pediatric nephrolithiasis is on the rise. The composition of kidney stones in children is different than in adults, as most stones in children have a composition of calcium oxalate and calcium phosphate mixed with a small amount of uric acid. The symptoms of pediatric nephrolithiasis are nonspecific. Computed tomography (CT) is the gold standard for diagnosis; however, because of radiation exposure associated with a CT scan, ultrasonography is also an accepted modality for the diagnosis. Extensive metabolic evaluation is important to rule out an underlying metabolic disorder. Urinary decompression, medical expulsion therapy, and surgical interventions such as ureteroscopy and extracorporeal shockwave lithotripsy are some of the options available for treating pediatric nephrolithiasis.

Pediatr Ann. 2017 Jun 1;46(6):e242-e244. doi: 10.3928/19382359-20170517-02.

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Commenti 1

Peter Alken il Mercoledì, 01 Novembre 2017 07:52

This general review on pediatric urolithiasis covers ESWL only briefly but negative:
“ … although extracorporeal shockwave lith¬otripsy (ESWL) treatment has been ris¬ing in popularity due to its noninvasive approach and high success rates, many complications are associated with this treatment. These complications range from short-term effects, such as hematu¬ria (in up to 44%), to long-term effects, such as the stunting of renal growth and renal scarring. Thus, more studies are needed before ESWL can be considered as first-line therapy. ”
I never regarded the hematuria secondary to ESWL as a complication just like pain or a scar after surgery is not a complication.
As to the long term effects they quote: Yucel S et al. (Yucel S et al.Complications and associated factors of pediatric extracorporeal shock wave lithotripsy. Urol. 2012 May;187(5):1812-6.) who retrospectively reviewed 128 children treated by ESL and ”did not note any ESWL related long-term abnormality in our study group during a median followup of 34 months.” Did the authors of the present paper not read their references?
Donal Trumps comment would probably be: “very bad!”

This general review on pediatric urolithiasis covers ESWL only briefly but negative: “ … although extracorporeal shockwave lith¬otripsy (ESWL) treatment has been ris¬ing in popularity due to its noninvasive approach and high success rates, many complications are associated with this treatment. These complications range from short-term effects, such as hematu¬ria (in up to 44%), to long-term effects, such as the stunting of renal growth and renal scarring. Thus, more studies are needed before ESWL can be considered as first-line therapy. ” I never regarded the hematuria secondary to ESWL as a complication just like pain or a scar after surgery is not a complication. As to the long term effects they quote: Yucel S et al. (Yucel S et al.Complications and associated factors of pediatric extracorporeal shock wave lithotripsy. Urol. 2012 May;187(5):1812-6.) who retrospectively reviewed 128 children treated by ESL and ”did not note any ESWL related long-term abnormality in our study group during a median followup of 34 months.” Did the authors of the present paper not read their references? Donal Trumps comment would probably be: “very bad!”
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