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Özet Giriş: Çocukluk çağı taş hastalığında en sık görülen taş tipi kalsiyum taşlarıdır ve genellikle altta yatan metabolik bir anormalliğe bağlı görülür. Kalsiyum taşlarının tedavisinde potasyum sitrat sık kullanılan bir tedavi seçeneğidir. Bu çalışmada kalsiyum taşı tanısı ile takip edilen ve hiperkalsiüri/hiperokzalüri/hipositratüriye ek olarak hipomagnezürisi çocuklarda potasyum sitrat tedavisi ile potasyum sitrat ve magnezyum kombinasyonunun etkinliği araştırılmıştır. Metod: Kliniğimizde üriner sistem taş hastalığı tanısı ile takip edilen hasta dosyaları geriye dönük incelendi. Metabolik taramada hiperkalsiüri/hiperokzalüri/hipositratüri (biri veya birden fazlası) anormalliklerine ek olarak hipomagnezüri saptanan hastalar çalışmaya dahil edildi. Hiperürikozüri, primer hiperokzalüri, sistinüri ile başlangıç taş boyutu ≤3 mm ve 2 yaşın altında olan hastalar çalışma dışı bırakıldı. Tedavide sadece potasyum sitrat kullanan grup ile potasyum sitrata ek olarak magnezyum tedavisi ilave edilen grup arasında tedavi öncesi ve sonrası taş boyutları, taş düşürme oranları ve tedavi süreleri karşılaştırıldı. Bulgular: Çalışmaya potasyum sitrat kullanan 14 hasta (grup I) ile potasyum sitrat ve magnezyum kullanan 15 hasta (grup II) olmak üzere toplam 29 hasta alındı. Grup I’de 9 kız ve 5 erkek, (yaş ortalaması 9.3±4.3 yıl), grup II’de ise 7 kız ve 8 erkek (yaş ortalaması 7.0±3.9 yıl) mevcuttu. Her iki grupta yaş ve cinsiyet açısından fark yoktu (p˃0.05). Tedavi süreleri açısından iki grup arasında fark bulunmadı (grup I, 3.2±1.2 ay vs. grup 2, 3.1±1.4 ay, p=0.872). Tedavi öncesi taş boyutları grup I’de ortalama 5.2±1.6 mm, grup II’de 5.1±0.9 mm iken, tedavi sonrası grup I’de 3.4±1.3 mm, grup II’de 4.6±1.6 mm idi. Tedavi sonrası taş düşürme grup I’de 2 hastada (%14.3), grup II’de ise 5 hastada (%33.3) gözlendi. Tedavi öncesi ve sonrası taş boyutları ile taş düşürme oranları açısından her iki grupta anlamlı fark saptanmadı. Sonuç: Kalsiyum taşlarında risk faktörlerine eşlik eden hipomagnezürinin tedavi edilmesi kısa dönemde çocukluk çağı taş hastalığında etkili bulunmamıştır.
Summary Introduction: Childhood stone disease is the stone type of calcium stones that are seen and are often caused by a substantial metabolic abnormality. Potassium citrate is a commonly used treatment option in the treatment of calcium stones. In this study, the calcium stone diagnosis was followed and the effectiveness of the potassium citrate treatment and potassium citrate and magnesium combination in children with hypomagnesuria, in addition to hypercalcium/hyperocaluria/hypositaturia, was studied. Method: In our clinic, the patient files followed by the diagnosis of urine system stone disease were reviewed backwards. In addition to the abnormalities of hypercalcium/hyperocaluria/hypositraturia (one or more) in the metabolic scan, patients diagnosed with hypomagnesuria were included in the study. Patients with hyperthyroidism, primary hyperocaluria, cystinuria, starting stone size ≤3 mm and under 2 years of age were dismissed. In the treatment, the group that only used potassium citrate and the group that added magnesium treatment in addition to potassium citrate compared the pre- and post-treatment stone sizes, stone reduction rates and treatment periods. Results: A total of 29 patients, including 14 patients using potassium citrate (Group I) and 15 patients using potassium citrate and magnesium (Group II) were taken to the study. The group I included 9 girls and 5 boys (the average age is 9.3±4.3 years), and the group II included 7 girls and 8 boys (the average age is 7.0±3.9 years). There was no difference in age and gender in both groups (p.0.05). There was no difference between the two groups in terms of treatment time (Group I, 3.2±1.2 months vs. Group 2, 3.1 ± 1.4 months, p = 0.872). Pre-treatment stone sizes were an average of 5.2±1.6 mm in group I, 5.1±0.9 mm in group II, 3.4±1.3 mm in post-treatment group I, 4.6±1.6 mm in group II. Post-treatment stone reduction was observed in 2 patients in group I (14.3%), and in group II in 5 patients (33.3%). There was no significant difference in the size of the stone before and after treatment and in the rate of stone-down in both groups. The treatment of hypomagnesure accompanied by risk factors in calcium stones was not effective in childhood stone disease in a short period of time.
Abstract Background/Aims: Calcium stones are the most common stones observed in pediatric population and they are generally a consequence of an underlying metabolic problem. Potassium citrate is the standard treatment for pediatric calcium stone formers. In this study, we aimed to evaluate the effects of oral magnessium added to potassium citrate treatment for pediatric urolithiasis patients who have hipomagnesuria in addition to hipercalciuria/hiperoxaluria/hipocitraturia. Methods: Retrospective chart review was conducted for pediatric patients with urolithiasis. Patiens identified with hipomagnesuria in addition to hipercalciuria/hiperoxaluria/hipocitraturia (one or more) were included.Hiperuricosuria, primary hiperoxaluria, sistinuria and patients with stones ≤3 mm as well as under 2 years of age were excluded. Outcomes related to urinary stone disease such as stone size, spontaneous passage and duration of treatment were compared between patients receiving potassium citrate only versus potassium citrate and magnesium Results: There were 14 patients in potassium citrate arm (group 1) while there were 15 patients who received potassium citrate and magnesium (group II). There were 9 girls and 5 boys with mean age of 9.3±4.3 years and there were 7 girls and 8 boys with a mean age of 7.0±3.9 in group II. No difference wasa observed in terms of gender and age (p˃0.05). There was no statistically significant difference between grooups with regard to duration of treatment (group I, 3.2±1.2 months vs. group II, 3.1±1.4 months, p=0.872). Mean stone size before treatment was 5.2±1.6 mm in group I and 5.1±0.9 mm in group II. Mean stone size after treatment was 3.4±1.3 mm in group I while it was 4.6±1.6 mm in group II showing no difference between pre and post treatment. Spontaneous stone passage was observedin 2 patiens (14.3%) in group I whereas urinary Stones were spontaneous passed in 5 patients (33.3%) in group II. However, it did not reach to statistically significant level between groups. Conclusions: Treatment of hipomagnesuria with oral magnesium in pediatric patients with hipomagnesuria in addition to hypercalciuria/hyperoxaluria/hypocitraturia does not change the outcomes in short term.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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