Pediatric Urolithiasis: Developing Nation Perspectives

Abstract

No AccessJournal of UrologyPEDIATRIC UROLOGY1 Oct 2002Pediatric Urolithiasis: Developing Nation Perspectives S.A.H. Rizvi, S.A.A. Naqvi, Z. Hussain, A. Hashmi, M. Hussain, M.N. Zafar, S. Sultan, and H. Mehdi S.A.H. RizviS.A.H. Rizvi , S.A.A. NaqviS.A.A. Naqvi , Z. HussainZ. Hussain , A. HashmiA. Hashmi , M. HussainM. Hussain , M.N. ZafarM.N. Zafar , S. SultanS. Sultan , and H. MehdiH. Mehdi View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64509-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated epidemiology, etiology, dietary and urinary risk factors, and the composition of calculi in pediatric stone formers in Pakistan. Materials and Methods: This retrospective study includes 1,440 children treated between 1987 and 2000. Case records were reviewed for demographics, etiology and clinical symptoms. Dietary and urinary risk factors were analyzed prospectively in idiopathic stone formers. Stone composition was analyzed by infrared spectroscopy. Results: There were 1,075 males and 365 females for a male-to-female ratio of 3:1. The peak age for renal and bladder stones was 6 to 10 and 1 to 5 years, respectively. Overall 795 stones (55%) were renal, 198 (14%) were ureteral and 447 (31%) were vesical. Bladder stones were present in 60% of cases in the mid 1980s but decreased to 15% in the mid 1990s. The clinical symptoms were abdominal pain in 511 patients (51%) and fever in 193 (19.5%). There were anatomical abnormalities in 96 patients (12%), metabolic abnormalities in 206 (25%), infection stones in 60 (7%) and idiopathic stones in 444 (55%). Urinary analysis in idiopathic stone formers revealed hypercalciuria in 17 (11%), hyperoxaluria in 62 (40%), hyperuricosuria in 41 (27%) and hypocitruria in 97 (63%). Diet involved a low intake of protein in 60 cases (44%), calcium in 45 (33%), potassium in 105 (77%) and high oxalate in 75 (55%). The composition was calcium oxalate in 362 stones (47%), ammonium hydrogen urate in 210 (27%) and struvite in 49 (6.4%). Stones recurred in 30 patients (2%). Conclusions: The pattern of calculous disease changed from a predominantly lower tract site in the mid 1980s to the upper tract in the mid 1990s. Stone composition, urinary risk factors and dietary analysis suggest that diet, dehydration and poor nutrition are the main causative factors of stone disease. References 1 : Epidemiology of nephrolithiasis. J Nephrol2000; 13: S45. Google Scholar 2 : Spectrum of pediatric urolithiasis in Western India. Indian J Pediatr1991; 58: 543. Google Scholar 3 : Epidemiology of urolithiasis in Japan: a chronological and geographical study. Urol Int1990; 45: 104. Google Scholar 4 : Extracorporeal shockwave lithotripsy in children. 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Google Scholar From the Sindh Institute of Urology and Transplantation, Dow Medical College, Karachi, Pakistan© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAssimos D (2018) Re: Composition of Urinary Calculi in Infants: A Report from an Endemic CountryJournal of Urology, VOL. 199, NO. 5, (1105-1107), Online publication date: 1-May-2018.Elderwy A, Kurkar A, Hussein A, Abozeid H, Hammodda H and Ibraheim A (2014) Dissolution Therapy versus Shock Wave Lithotripsy for Radiolucent Renal Stones in Children: A Prospective StudyJournal of Urology, VOL. 191, NO. 5S, (1491-1495), Online publication date: 1-May-2014.Penido M, Srivastava T and Alon U (2018) Pediatric Primary Urolithiasis: 12-Year Experience at a Midwestern Children's HospitalJournal of Urology, VOL. 189, NO. 4, (1493-1497), Online publication date: 1-Apr-2013.Gabrielsen J, Laciak R, Frank E, McFadden M, Bates C, Oottamasathien S, Hamilton B and Wallis M (2018) Pediatric Urinary Stone Composition in the United StatesJournal of Urology, VOL. 187, NO. 6, (2182-2187), Online publication date: 1-Jun-2012.Knoll T, Schubert A, Fahlenkamp D, Leusmann D, Wendt-Nordahl G and Schubert G (2018) Urolithiasis Through the Ages: Data on More Than 200,000 Urinary Stone AnalysesJournal of Urology, VOL. 185, NO. 4, (1304-1311), Online publication date: 1-Apr-2011.VanDervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M and Trachtman H (2018) Urolithiasis in Pediatric Patients: A Single Center Study of Incidence, Clinical Presentation and OutcomeJournal of Urology, VOL. 177, NO. 6, (2300-2305), Online publication date: 1-Jun-2007.Shokeir A, Sheir K, El-Nahas A, El-Assmy A, Eassa W and El-Kappany H (2018) Treatment of Renal Stones in Children: A Comparison Between Percutaneous Nephrolithotomy and Shock Wave LithotripsyJournal of Urology, VOL. 176, NO. 2, (706-710), Online publication date: 1-Aug-2006. Volume 168Issue 4 Part 1October 2002Page: 1522-1525 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordskidneybladderdietdeveloping countriescalculiMetricsAuthor Information S.A.H. Rizvi More articles by this author S.A.A. Naqvi More articles by this author Z. Hussain More articles by this author A. Hashmi More articles by this author M. Hussain More articles by this author M.N. Zafar More articles by this author S. Sultan More articles by this author H. Mehdi More articles by this author Expand All Advertisement PDF downloadLoading ...