Objective: To study the clinical efficiency of the urine Urease Activity (UA) test to diagnose kidney stones formation in children with urolithiasis. The prospective observational study was conducted at the Scientific Centre of Pediatrics and Pediatric Surgery (Almaty, Kazakhstan). This study included 80 patients: 40 patients with urolithiasis and 40 conditionally healthy children. The urine UA, standard urinalysis, and special methods of urine examination have been carried out for all patients. The clinical efficiency of the urine UA test was determined after comparison it with other lab tests and severity of urolithiasis among the different subgroups. The urine UA was correlated with the standard urinalysis. Patients with the high UA, between 110 and 400 mmol/l, also had the high numbers of WBC 187 [32-292], RBC 17 [3-34], and bacteria >105. These patients had most severe symptoms of urolithiasis including an inflammation. At the same time, low UA (0-50 mmol/l) were recorded for the patients with the mild symptoms. High level of UA was observed only in urine samples with phosphate and ammonium biurate crystals. The main bacterial pathogens in these cases were Klebsiella pneumonia and Pseudomonas aeruginosa. The values of UA were determined for the different types of crystals and uropathogens as well. Conclusion: The urine UA is the clinically efficient test for the diagnosis of kidney stone formation and reflects the presence of active urease-forming bacteria in urine, that contributes to the formation of the infected stones.
According to the study literature, urolithiasis remains one of the most common nosologies among the child population. In connection with the global changes in the health status of the population of our planet, the social significance of urolithiasis has recently acquired new relevance. The mechanism of stone formation is a complex process; stones are formed as a result of urine saturation with oxalates, calcium, uric acid, cystine. Most stones in children are located in the upper urinary tract. In 15%-25% of cases in children, urolithiasis may be asymptomatic. Diagnostics today are not difficult. If urolithiasis is suspected, first, among the instrumental research methods, ultrasound examination of the urinary tract is used, which identifies both X-ray-positive and X-raynegative stones. Nowadays, not all standards for treating obstructing stones of the upper urinary tract in children of various sizes and localizations, as well as the type of pelvis structure, have been defined. Simultaneously, new trends in treatment may change already existing standards. It should be noted that in the modern world and ways of metaphylaxis urolithiasis in children studied insufficiently. In the world literature, there is insufficient information on predicting the occurrence of recurrence of urolithiasis and ways to eliminate them. This literature review examines the epidemiology, etiopathogenesis of urolithiasis, diagnosis, existing treatment standards and metaphylaxis. Methods of active tactics of treatment of obstructive stones of the upper urinary tract are analysed in more detail.
Recent studies have shown that urolithiasis is becoming increasingly widespread around the world. However, there are no studies assessing the prevalence of urolithiasis in children in Kazakhstan over the last 20 years.Objective: To describe the epidemiological profile of pediatric patients with urolithiasis in the Pediatric
Objective: The aim of our study to present the results of the clinical profile, diagnosis and treatment of children with urolithiasis in the Pediatric Urology Department of the Scientific center of Pediatria and Pediatric surgery in Almaty, Kazakhstan. Materials and methods: A retrospective data from pediatric patients with urolithiasis admitted from January 2015 to December 2021. The data was obtained from medical records and included those with diagnosis confirmed by imaging and laboratory test, as 24-hour urine exams corrected for creatinine, stone composition. Results: We reviewed 204 children with urolithiasis. The male‐to‐female ratio was 1.34:1. Congenital anomalies of the urinary tract were found in 40 patients (19.6%).Urolithiasis was more common in adolescent girls, whereas in boys the frequency of observation is higher between 11 and 17 years old (p = 0.006). Majority of the patients were from southern regions (51%) in our country. Renal colic, urinary tract infection and macroscopic hematuria were the most common clinical manifestations. Urinary tract infection was diagnosed in 185 patients (90.6%). The most frequent metabolic disorders were hypercalciuria, hyperoxaluria. In 35% of cases there was a metabolic disorder and appropriate therapy was prescribed. In the remaining cases, surgical treatment was used. Conclusion: In this study we presented the prevalence of urolithiasis in the pediatric population in different regions of our country. We identified a high prevalence of infective stone as an etiological factor of pediatric urolithiasis. Clinical symptoms depending on the age and location of the stones. Bangladesh Journal of Medical Science Vol. 22 No. 02 April’23 Page : 297-304
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