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[Clinical studies on childhood urolithiasis during the past 22 years]
Insights
This study of pediatric urolithiasis found infectious stones were common, especially in younger children. Older children showed an increase in idiopathic calcium stones over time.
Area of Science:
- Pediatric Nephrology
- Urology
- Pediatric Surgery
Background:
- Urolithiasis in children presents unique challenges compared to adults.
- Understanding the etiology and characteristics of pediatric kidney stones is crucial for effective management.
Purpose of the Study:
- To retrospectively analyze the clinical characteristics, stone composition, and outcomes of pediatric urolithiasis.
- To identify trends in stone types and predisposing factors in children over a 21-year period.
Main Methods:
- Retrospective review of 68 children with urolithiasis diagnosed between 1965 and 1986.
- Analysis of presenting symptoms, stone location, predisposing factors, and treatment outcomes.
- Infrared spectroscopy analysis of 21 kidney stones.
Main Results:
- The male to female ratio was 1.83:1, with a mean age of 9.5 years.
- Most stones (79%) were located in the upper urinary tract; common symptoms included gross hematuria (53%) and abdominal/flank pain (38%).
- Infectious stones were more frequent than in adult cases, particularly in children aged five and younger. Idiopathic calcium stones increased over time in older children.
Conclusions:
- Pediatric urolithiasis exhibits distinct patterns, with infectious stones being prevalent in younger children.
- A rising incidence of idiopathic calcium stones in older children warrants further investigation into underlying causes.
- Management strategies should consider age-specific stone types and predisposing factors.
Abstract:
We have studied retrospectively 68 children who presented with urolithiasis between 1965 and 1986. Male to female ratio was 1.83 to 1 and the mean age was 9.5 years. Fifty four children (79%) had calculi in the upper urinary tract, 9 (13%) had in the lower, and 4 (6%) had calculi both in the upper and lower urinary tract. The most common presenting symptoms were gross hematuria (53%) and abdominal or flank pain (38%). Predisposing factors could be found only in 21 children (31%). Twenty four of the 68 patients (35%) had open surgery and 16 patients (24%) passed their stones spontaneously. Twenty one stones were analyzed by infrared spectroscopy. Infectious stone was more frequent than in adult cases. Among children five years old and younger, infectious stone was the most frequent. Among children over five years old, the number of idiopathic calcium stone has been on the increase with the years.