Metabolic disorders of the urinary system in children with acute abdominal pain syndrome


N.M. Mikheeva, Ya.F. Zverev, G.I. Vykhodtseva, Yu.F. Lobanov, V.P. Tokarev

Aim. To identify the relationship between dysmetabolic nephropathy in children presenting with the abdominal pain syndrome and the need for its surgical treatment.
Materials and methods. The study included 84 children aged from 1 to 17 years admitted to the children's surgery department of Barnaul Children's City Hospital №7 with severe abdominal pain syndrome and suspected acute appendicitis. Clinical assessment included genealogical history, examination of physical status, blood count and urinalysis. To assess the state of the urinary system diagnostic investigations were carried out.
Results. All children had acute abdominal pain syndrome (mean time from the onset of the disease was 13.7±1.8 hours). Also presenting symptoms included prominent upper dyspeptic syndrome (32.1%), fever (34.5%). Three patients had dysuria. In 84.5% of cases (71 children), no signs of acute appendicitis were found. In this group, 69% of children had pathological changes in urinalysis. Significantly more children had hypersthenuria (42.2%) and crystalluria (39.4%). In 22 (31%) patients, the urine sediment revealed oxalates and in 6 (8.5%) – urates. Changes in the urinary tract, including signs dysmetabolic nephropathy were detected in 25 (35.2%) children with acute abdominal pain syndrome.
Conclusion. The abdominal pain syndrome in children is often coexists with dysmetabolic nephropathy, which requires obligatory examination of the urinary system in these patients.

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