Assessment of Cardiac Functions and Subclinical Cardiovascular Risk in Children with Urolithiasis: A Pilot Study

Objective: Information on cardiovascular problems related to childhood urinary stone disease is limited. The aim of this study was to assess the ventricular functions and subclinical cardiovascular risk in children with urolithiasis using echocardiographic measurements. Materials and Methods: Children diagnosed with urolithiasis were prospectively enrolled in the study as well as children with no urinary stone disease were confirmed via urinary ultrasonography. Body mass index and blood pressures were noted, as well as basic serum parameters. Carotid intima media thickness (cIMT), epicardial fat tissue (EFT) thickness and periaortic fat tissue (PFT) thickness were measured via transthoracic echocardiography in addition to pulsed and tissue Doppler imaging. Myocardial performance indexes were also calculated and correlation analyses were conducted. Results: A total of 17 patients (10 boys) with a mean age of 8.57±2.62 years were included in this study. There were 17 children (12 boys) in the control group and their mean age was 9.53±1.72 years. There was no statistically significant difference between the two groups in terms of demographic and laboratory variables. Tissue Doppler echocardiography revealed that Tei indexes of the left ventricle, right ventricle and septum were significantly higher in the study group than in the controls (p<0.001 for all). The cIMT (0.041±0.012 vs. 0.025±0.002), EFT (0.432±0.083 vs. 0.325±0.032) and PFT thicknesses (0.138±0.029 vs. 0.113±0.008) of the study group was statistically higher than the control group (p<0.001, p<0.001 and p=0.002, respectively) indicating a higher CVD risk. Conclusion: Children with urolithiasis had not only biventricular early systolic and diastolic dysfunction but also subclinical atherosclerosis at early ages. Cardiovascular complications should be considered in the follow-up and treatment of children with urolithiasis.