Overview of Microlithiasis in Infancy in Pediatric Urology

Aim: Infantile microlithiasis, defined as kidney stones smaller than 3 mm, is a multifactorial condition associated with genetic, environmental, and anatomical factors.Congenital anomalies of the kidney and urinary tract (CAKUT) are among the major structural anomalies linked to microlithiasis.This study investigated the prevalence of microlithiasis in infants with CAKUT and explored associated clinical and biochemical characteristics. Materials and Methods:This retrospective study included 148 infants diagnosed with microlithiasis via ultrasonography at a single center in the prior 2 years.Demographic data, biochemical findings, and imaging results were analyzed.CAKUT anomalies, including ureteropelvic junction obstruction (UPJO) and vesicoureteral reflux (VUR), were documented.Follow-up data covering 12 months were reviewed in order to assess stone persistence and complications.Results: Among the 148 infants, 56% were male.CAKUT anomalies were identified in 16 cases (10.8%), with UPJO being the most common (87.5%).Stones were detected incidentally in 82.4% of cases, while symptomatic presentations included urinary tract infections (9 cases) and hematuria (3 cases).Persistent stones were observed in 7.4% of patients during follow-up, primarily in those with structural anomalies.A family history of nephrolithiasis was reported in 72% of cases, and all patients received vitamin D supplementation.Conclusion: Infants with microlithiasis demonstrate a notable association with CAKUT, particularly UPJO and VUR.Routine biochemical and imaging evaluations, coupled with long-term follow-up, are crucial for identifying at-risk patients and preventing complications.Multidisciplinary approaches are essential for optimizing outcomes in this population.