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Biochemical risk factors for stone formation in healthy school children
Mohsen Akhavan-Sepahi1, Mostafa Sharifian, Maasumeh Mohkam
1Department of Pediatrics, Nephrology Ward, Hazrat Maasomeh Hospital, Qom University of Medical Sciences, Qom, Iran. akhavansepahim@yahoo.com
Insights
This study found a 1% prevalence of renal stones in Qom elementary students, but high rates of hypercalciuria (23%) and hypocitraturia (100%), suggesting metabolic issues are common in pediatric urolithiasis.
Area of Science:
- Pediatric Nephrology
- Urology
- Public Health
Background:
- Childhood urolithiasis (kidney stones) is rising globally, with significant geographic variations linked to environmental and lifestyle factors.
- Metabolic abnormalities are frequently observed in children with kidney stones, particularly in regions like Southeast Asia where urinary calculi are endemic.
- Understanding the local prevalence of renal stones and associated metabolic risk factors in children is crucial for targeted public health interventions.
Purpose of the Study:
- To investigate the prevalence of renal stones and abnormal renal sonography in elementary school children in Qom.
- To identify common urine metabolic abnormalities, including hypercalciuria and hypocitraturia, in this pediatric population.
- To assess blood pressure control and demographic characteristics in relation to urinary stone disease risk.
Main Methods:
- A cross-sectional study was conducted on 110 primary school children (aged 7-11 years) in Qom.
- Data collected included demographics, blood pressure, urine analysis (including levels of calcium, citrate, oxalate, etc.), and renal sonography.
- Urinary stone disease risk factors such as hypercalciuria and hypocitraturia were specifically evaluated.
Main Results:
- The prevalence of renal stones was low (1%), but abnormal renal sonography findings were present in 7% of children.
- Hypercalciuria (23%) and hypocitraturia (100%) were the most common urine metabolic abnormalities identified.
- Elevated blood pressure was noted in 7.1% of girls and 11.1% of boys; 11.2% of children had positive urine cultures, predominantly females.
Conclusions:
- While overt renal stones were rare, the high prevalence of metabolic abnormalities like hypercalciuria and hypocitraturia in Qom's children warrants further investigation.
- The findings suggest a potential link between dietary factors, such as high sodium intake, and increased risk of hypercalciuria in Iranian children.
- Comprehensive studies are needed to accurately determine the prevalence of renal stones and associated risk factors in Qom's pediatric population.
Abstract:
Prevalence of urolithiasis in childhood is increasing. The wide geographic variation in the incidence of lithiasis in childhood is related to climatic, dietary, and socioeconomic factors. Many children with stone disease have a metabolic abnormality. In Southeast Asia, urinary calculi are endemic and are related to dietary factors. The main aim of this study was to determine the prevalence of renal stone, urine metabolic abnormality, control of blood pressure and demographic character in elementary school children of Qom. A cross sectional study was performed on 110 primary school children (56 girls and 54 boys) aged 7 to 11 years old. Demographic data such as age, height, weight were gathered, and systolic and diastolic blood pressure, Urine analysis and culture, urinary levels of calcium, creatinine, phosphorus, magnesium, sodium, potassium, uric acid, cystine, citrate, oxalate, protein and sonographic findings were evaluated. The mean (±SD) of age was 8.85±1.51 years. Only one child had renal stone (1%), but the prevalence of abnormal renal sonography was 7%. The most prevalent urine metabolic abnormalities were hypercalciuria (23%) and hypocitraturia (100%). 11.2% of children had positive urine culture that all were female. The prevalence of high blood pressure was 7.1% for girls and 11.1% for boys. The prevalence of renal stone in children in this study was 1%, which means the accurate judgment about the prevalence of renal stone in Qom city needs more comprehensive studies. Similar to other studies in Iran this study shows that the prevalence of hypercalciuria is significantly higher comparing to other countries, it may be associated with excessive intake of sodium.
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