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Urinary lithiasis in childhood in the Bristol clinical area
Insights
This study analyzed childhood urinary calculi (kidney stones) in Bristol. Hard, alkaline water may be linked to increased stone risk in children.
Area of Science:
- Pediatric Nephrology
- Urology
- Environmental Health
Background:
- Urinary calculi in children present unique diagnostic and management challenges.
- Understanding the etiology of pediatric kidney stones is crucial for prevention and treatment.
Purpose of the Study:
- To investigate the characteristics and potential environmental factors associated with urinary calculi in a pediatric cohort.
- To identify underlying causes and recurrence rates of kidney stones in children.
Main Methods:
- Retrospective analysis of 59 consecutive pediatric urinary calculi cases treated between 1950 and 1973.
- Evaluation of anatomical, metabolic, and infective abnormalities.
- Correlation with local water supply characteristics (hardness and pH).
Main Results:
- Peak incidence observed in the 2nd-3rd and 10th years of life.
- Identified causes included anatomical (39%), infective (29%), and metabolic (8.5%) abnormalities, with 22% classified as idiopathic.
- Overall recurrence rate was 7%, reduced to 3.5% excluding cystinuria cases.
- A potential association between stone formation and residence in areas with hard, alkaline water (pH > 8) was suggested.
Conclusions:
- Pediatric urinary calculi have diverse etiologies, with a significant idiopathic group.
- Environmental factors, specifically hard and alkaline water, may play a role in stone formation.
- Further research into water quality and pediatric urolithiasis is warranted.
Abstract:
A series of 59 consecutive cases of urinary calculi in childhood is presented, being acquired from one local area (Bristol). These children were treated from 1950 to 1973. The peak presentation was in the 2nd and 3rd year of life, with a secondary peak in the 10th year. Anatomical (39%), metabolic (8.5%) or primary infective abnormalities (29%) were demonstrable, but 22% had to be left in an unsatisfactory "idiopathic classification''. The overall recurrence rate of 7% was reduced to 3.5% when those patients with cystinuria were excluded. The local water supply areas have been studied and a tentative association is suggested between patients and their environment when they live in an area where the water is not only hard but also alkaline (pHgreater than 8).