Related Experiment Videos
Urolithiasis in Tunisian children: a study of 120 cases based on stone composition
A Kamoun1, M Daudon, J Abdelmoula
1Service de Pédiatrie, Hôpital Charles Nicolle, Tunis, Tunisia.
Insights
Urinary stone composition in Tunisian children varies by location, with whewellite being common. Factors like infection and endemic urolithiasis significantly influence stone formation.
Area of Science:
- Pediatric Nephrology
- Urology
- Biochemistry
Background:
- Urinary stone (urolithiasis) composition in children is influenced by diverse factors including socioeconomic status, hygiene, geography, and diet.
- Understanding these influences is crucial for effective prevention and treatment strategies in pediatric populations.
Purpose of the Study:
- To analyze the chemical composition of urinary stones in a cohort of Tunisian children.
- To identify the etiological factors contributing to pediatric urolithiasis in the region.
Main Methods:
- Analysis of 120 urinary stones from children aged 5 months to 15 years using morphological and infrared spectroscopy.
- Categorization of stones based on location (upper urinary tract vs. bladder) and detailed analysis of stone nuclei and layers.
Main Results:
- Whewellite was the predominant component in both bladder (69%) and upper urinary tract (67%) calculi.
- Ammonium urate was a significant component in the nucleus of bladder (45%) and kidney/ureteral (38%) stones.
- Urinary tract infections contributed to one-third of calculi; endemic urolithiasis (40%) involved nutritional, metabolic, and infectious factors.
Conclusions:
- Pediatric urolithiasis in Tunisia is multifactorial, with whewellite and ammonium urate being key components.
- Infectious and endemic factors play a substantial role, alongside metabolic and genetic causes (less than 25%).
- Stone analysis provides insights into underlying causes, guiding targeted interventions for pediatric kidney stones.
Abstract:
The composition of urinary stones in children depends on socioeconomic conditions and hygiene, geographical area, and dietary habits. We analyzed urinary stones from 120 consecutive Tunisian children (81 males, 39 females) aged 5 months to 15 years. The stone was located in the upper urinary tract in 91 cases (76%). Stone analysis included both a morphological examination and an infrared analysis of the nucleus and the inner and peripheral layers. The main components of bladder calculi were whewellite (69%) and struvite (22%), whereas the main component of upper urinary tract calculi was whewellite (67%). The nucleus of bladder stones was composed of ammonium urate (45%), struvite (28%), cystine (10%), and carbapatite (7%). The nucleus of kidney and ureteral calculi was mainly composed of ammonium urate (38%), whewellite (24%), carbapatite (13%), or struvite (11%). Based on stone composition, urinary tract infection was involved in the nucleation or growth of a third of calculi. Endemic urolithiasis involving simultaneous nutritional, metabolic, and infectious factors, and defined by its nucleus composed of ammonium urate without struvite, represented 40% of cases. Exclusive metabolic factors - including genetic diseases such as primary hyperoxaluria, cystinuria, and hypercalciuria - were responsible for less than 25% of cases.