A systematic review on urolithiasis in children with neurological disorders

Abstract

Purpose: Advancements in medical treatments and increased access to healthcare have significantly extended the life expectancy of children with neurological disorders. However, this has also led to a higher incidence of secondary health issues, such as nephrolithiasis. This review aims to analyze the risk factors, management, and treatment outcomes for stone disease in children with neurological disorders and focus on specific risk factors such as immobilization, urinary tract infections, and metabolic abnormalities to identify key points in the occurrence of nephrolithiasis.

Methods: A comprehensive literature search was conducted across two primary databases, PubMed and Ovid Medline, to identify studies on urolithiasis in children with neurological disorders. A total of 771 articles were initially identified. After removing four duplicate articles, 729 were excluded following title and abstract screening due to irrelevance. Thirty-eight articles were selected for full-text review, and after further exclusions, 11 articles were included in this review.

Results: The studies mainly consisted of small-scale, single-center investigations. Nephrolithiasis were reported in 5-54% of patients across the studies. The most commonly identified risk factors were immobilization, urinary tract infections (UTIs), and hypercalciuria. Treatment options for urinary stones included medical expulsive therapy (MET), extracorporeal shock wave lithotripsy (ESWL), endoscopic surgery (RIRS), and percutaneous nephrolithotomy (PCNL).

Conclusion: Key steps in managing these patients include monitoring bone mineral density, conducting a 24-h urine analysis to assess metabolic components (despite challenges in obtaining this), and encouraging physical activity as much as the patient's condition permits.

Keywords: Neurological disorders; Pediatric; Urinary stone disease; Urolithiasis.