Etiological Evaluation in Pediatric Urinary Stone Disease

Abstract

Introduction: Urinary stone disease is an important health problem commonly seen in some regions of the world. Determining the etiology is important for effective treatment and prevention of recurrence. The aim of this study was to evaluate the demographic and clinical features, metabolic and other risk factors of children with urinary stone disease. Methods: A total of 766 patients with urinary stone disease presented to our pediatric nephrology department over 15 years. The patients’ demographic, clinical, and treatment data were retrospectively analyzed. Results: The mean age at diagnosis was 61.6±52.7 months. The male/female ratio was 1.15:1. There was no significant difference in age at diagnosis between the sexes. The most frequent presenting complaint overall was abdominal pain. Chronic renal failure was present in 1.8% and family history in 57.5% of the patients. Metabolic abnormalities were detected in 51% of the patients, urinary tract infection in 44.8%, and urinary tract anomalies in 13.2%. No cause could be identified in the other 22.7% of the patients. Urinary tract infection was the most common etiology in patients younger than 1 year old, while metabolic risk factors were more frequent in patients aged 1-10 years. Metabolic abnormalities included hypercalciuria (51.7%), hypocitraturia (47.5%), hyperoxaluria (39.9%), hyperuricosuria (23.4%), and cystinuria (9.4%). Bilateral and multiple stones were associated with metabolic abnormalities (p