title: An uncommon cause of acute kidney injury in young children: cystinuria.
abstract: Bilateral obstructive nephrolithiasis is a rare cause of acute kidney injury (AKI) in early childhood. As soon as the identification of AKI secondary to ureteral stone is made, it will necessitate an emergency treatment.
  
  
  METHODS
  We report three infants with AKI caused by bilateral obstructive ureteral cystine stones. They were diagnosed with acute post-renal injury due to obstructive bilateral ureteral stones based on ultrasound scan findings. Immediately, bilateral ureteral stents were inserted for urinary drainage. Once renal function recovered to normal, each patient underwent ureteroscopy and percutaneous nephrolithotomy at the same session. Cystinuria was diagnosed by stone analysis and increased urinary excretion of cystine. Patients were advised to maintain a high fluid intake and were treated with potassium citrate in addition to tiopronin.
  
  
  CONCLUSIONS
  With these three cases we would like to emphasize the importance of urolithiasis in the differential diagnosis of acute renal failure in young children, since urolithiasis may only cause nonspecific symptoms in this population. An early diagnosis with prompt treatment and a close follow-up are the key for achieving the best long-term outcome in cystinuria.
authors.affiliation: Pediatric Nephrology Department, Ondokuz Mayis University Faculty of Medicine, Kurupelit, Samsun, Turkey. hulyanalcacoglu@hotmail.com
authors.forename: Hulya
authors.initials: H
authors.lastname: Nalcacioglu
authors.forename: Ender
authors.initials: E
authors.lastname: Ozden
authors.forename: Gurkan
authors.initials: G
authors.lastname: Genc
authors.forename: Y Kamil
authors.initials: YK
authors.lastname: Yakupoglu
authors.forename: Saban
authors.initials: S
authors.lastname: Sarikaya
authors.forename: Ozan
authors.initials: O
authors.lastname: Ozkaya
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D001002:Anuria / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D002675:Child, Preschool; D003555:Cystinuria / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007223:Infant; D019357:Potassium Citrate / Q000627:therapeutic use; D008625:Tiopronin / Q000627:therapeutic use
chemical_list: D004232:Diuretics; D008625:Tiopronin; D019357:Potassium Citrate