METABOLIC EVALUATION OF CHILDREN WITH UROLITHIASIS TO STUDY RISK FACTORS: A 1 YEAR PROSPECTIVE STUDY.

Abstract

Introduction: Metabolic abnormalities are common cause of urolithiasis in pediatric age group. Children with urolithiasis are associated with considerable morbidity. By treating these abnormalities stone formation is prevented. Objectives: Prospective study to nd the metabolic risk factors of urolithiasis in children and compare them with literature. Materials and Methods: In open, prospective and observational study, 85 children were evaluated from August 2019 to June 2020. In all patients' dietary history, water intake and results of laboratory ndings were recorded. All urine samples obtained from patients were without dietary restrictions. Reference pediatric 24 hour urinary parameter was used according to western literature. Results: We investigated 85 patients with urolithiasis. Low urine volume was found in 52 patients which is comparable with previous studies indicating simple intervention as to increase water intake. Low calcium intake was found in 48 patients suggesting that low calcium intake is associated with higher incidence of urolithiasis due to increased intestinal oxalate absorption. Hypocalcaemia was found in 34 patients and 24 hour urinary abnormality was found in only 18 patients'. Both these nding does not support previous literature. Stone analysis nding does not correlate with urinary nding. Conclusions: Hypocalcaemia is major metabolic abnormality in contradiction to western literature. Low urine volume secondary to low water intake is predominant nding .There are no nomograms for urinary excretion of Calcium, uric acid, oxalate and citrate in Indian children. Keeping the optimum blood calcium level & increased uid intake can prevent stone formation in children.