Urolithiasis in Children

Abstract

Background: Urolithiasis is already one of the oldest diseases even in pediatric patients. The prevalence of kidney stones is estimated to be 1:20.000 children/year. The medium age of onset is between 5-7 years. The aim of our study was to see the characteristic features, predisposing factors and therapeutic procedures for urolithiasis in children, as well as metabolic abnormalities especially hypercalciuria. Methods: In a retrospective study we involved 216 patients (46% of them with family history for kidney stones) in an 8 year period (study period from 2007 till 2015). All patients underwent abdominal ultrasonography and laboratory examination. Results: Male/female ratio was 2.17:1. Diagnostic medium age was 6.44 years. The most frequent symptoms were: back pain in 33.3%, abdominal pain in 19.4%, gross hematuria in 19.4%, microhematuria in 14%, urinary retention in 9.7%, dysuria in 8.3%, vomiting in 11.1%, growth retardation in 4.2%, hypertension in 1.4%, spontaneous passage of renal calculi in 5.5%. 4.2% of patients were asymptomatic. Infectious stone was found in 47.2% of cases. The chemical composition of the stone was studied only in 51% of cases from which 56% appeared to be calcium oxalate and phosphate stones. Metabolic abnormalities were found in 50% of patients. Conclusions: Urolithiasis is common disease among Albanian children. 50% of patients had metabolic disorders. Calcium-oxalate and calcium-phosphate represents the most frequent types of calculi. Hypercalciuria is the most important metabolic disorder. Hypocitraturia is the risk factor to calcium urolithiasis. We recommend that every child with stone must be estimated for a metabolic screening.