INTRODUCTION AND OBJECTIVES: Urolithiasis in children can cause considerable morbidity. Our aim was evaluating impact of intervention on kidney function recoverability.

METHODS: This prospective study included 93 children (66 boys and 27 girls) with median age of 3 years (range 0-14). Inclusion criteria were children with anuria, oliguria, serum creatinine >2 mg% and/or hyperkalemia 6 mmol/L. The mean duration of anuria or oliguria was 5.3 ± 0.4 days. On presentation, Mean plasma creatinine was 6.5 ± 0.29 mg/dl with an average estimated GFR (eGFR) of 14 ml/min and creatinine clearance (CC) of 8.24 ml/min. Dialysis was performed in 21 (22.6%) patients.

RESULTS: Mean follow up was 1.5 years with 82% compliance. At treatment end 83% had complete clearance of calculi. Mean plasma creatinine after treatment was 3.3 ± 0.35 mg/dl with an average GFR of 24.5 ml/min. After treatment the renal function returned to normal in 57%, improved in 27% and deteriorated in 16% of children.

Renal function recoverability rate was 94.6 %. Chronic renal failure developed in 3 (3.2%) and 2 (2.2%) patients died. When absolute plasma creatinine concentration [Pcr] improved between 20-50%, the eGFR and CC were doubled and when improved between 50-70%, eGFR and CC tripled. Beyond 70% improvement in [Pcr], eGFR and CC improved 7-8 times. Using Spearman’s correlation, mode of presentation and management had a significant correlation with renal function outcome, p = 0.019 and 0.013 respectively.

CONCLUSIONS: Urgent management of calcular anuria both medically and surgically is the cornerstone for favorable outcome.

Source of Funding: none