Paediatric renal stone disease in Tunisia: a 12 years experience

International studies may not reflect the real changes of stone disease in our own country. In this retrospective work, we describe the evolution of this pathology in Tunisia during the last 12 years.

The records of 133 children with urolithiasis treated in Tunisia between 1994 and 2006 were reviewed. The physical and chemical analysis of stones was carried out respectively by a stereomicroscope and by infra-red spectroscopy and the epidemiologic data were collected.

The male prevalence of this pathology is progressively declining. The male to female ratio, passed from 1.7 in the 1994-97 period to 1.5 in 2006. Upper urinary tract was most frequently affected by this pathology. Over the last 12 year period urinary tract infection was in continuous increase and currently reaches 50% being 21.9% in 1994. This explains the increasing frequency of struvite stones which passed from 15.6% in 1994 to 37.5% in 2006. Ammonium urate stones became more frequent in the last few years being the main component in 25% of cases (12.5% in 1994-97). Calcium oxalate monohydrate remains the most frequent stone component even if its frequency fell (59.4% in 1994 and 12.5% in 2006) in favour of the increase of phosphatic and phospho-calcic stones.

The rise in the frequency of struvite and ammonium urate stone reflects an increase in the infectious risk factors in our country.