Urolithiasis in a Sample of Iraqi Children

Abstract

ABSTRACT
Background: Pediatric urolithiasis is an endemic disease, especially in certain developing
regions of the world, such as the Far and Middle East. Socioeconomic, geographical and
genetic factors play important roles in determining the prevalence and composition of
urinary stones in different parts of the world.
Objective: To study prospectively demographic characteristics, clinical manifestations,
metabolic risk factors and etiology of pediatric urolithiasis in Iraq from January 2009-
January 2013.
Methods: A total of 50 patients 34 males (68%) and 16 females (32%) with renal stones
were studied according to their presenting signs, clinical and laboratory findings. The other
necessary tests were also applied to detect the etiology of the calculi formation.
Results: The most frequent form of presentation was UTI in 21(42%), hematuria in
11(22%), abdominal pain in 5 (10%). Urine cultures were positive in 17 patients (34%).
Twenty-four hour urine collection results were positive in most cases 42(84%) and mainly
hypercalciuria in 21 (50%), hyperoxaluria in 13(30.9%), hyperuricosuria in 8 (19.1%). In
most cases, the stones located in upper urinary system and in 21 cases (42%) with
bilateral multiple stones. Etiology was found in 45 (90%) of patients, metabolic disorders
were the majority 27(54%), infection in 16(32%) and renal anomalies in 2 cases (4%)
while no etiology could be found in 5 patients (10%). A positive family history was found in
8 patients (16%) all of them had metabolic cause.
Conclusion: All children with urinary stones should be followed closely due to high
morbidity and recurrence rates. Lithogenic metabolic causes were found to be the major
predisposing factor.