Clinical features and risk factors of pediatric urolithiasis

Abstract

Objective: Urolithiasis in children although occurring less often than adults, causes considerable morbidity. The main aim of this study is to evaluate clinical features and risk factors of pediatric urolithiasis. Material & Methods: All children with documented urolithiasis who were referred to department of pediatric nephrology between 1999 and 2005, were evaluated from the point of demographic features, family history, clinical, symptoms, imaging results and laboratory findings. Findings: We investigated 184 patients (100 females and 84 males) with urolithiasis between 2 months and 14 years of age (mean age 3.66 +/- 3.49 years). The stones' diameter was 3-27 mm (mean 8.2 +/- 5.36). In 85.8% of cases the stone was located only in kidneys and in 3.3% only in bladder. The most common causes of presentation were urinary tract infection (UTI), restlessness and gross hematuria. Positive family history was detected in 41%, UTI in 40.8%, anatomic abnormality in 13% and sterile pyuria in 18.5% of patients. Metabolic evaluation, which was carried out in 162 patients, revealed that 104 (64%) of them had a metabolic risk factor including normocalcemic hypercalciuria (42%); Hyperuricosuria (10.5%), Cystinuria (7.4%), and Flyperoxaluria (4.3%). Conclusion: All children with urolithiasis should be completely evaluated, as most of them have an anatomic, infectious or metabolic risk factor.