Metabolic Evaluation in Paediatric Urolithiasis: A 4-Year Open Prospective Study

Area of Science:

• Pediatric Nephrology
• Urology
• Metabolic Disorders

Background:

• Urolithiasis in children presents significant morbidity, often linked to underlying metabolic abnormalities.
• Addressing these metabolic issues is crucial for preventing recurrent stone formation.

Purpose of the Study:

• To investigate metabolic risk factors associated with pediatric urolithiasis.
• To compare findings in Indian children with existing international literature.

Main Methods:

• A prospective, observational study evaluated 75 children with urolithiasis from August 2010 to June 2014.
• Data collected included dietary history, water intake, and laboratory findings, with urine samples analyzed without dietary restrictions.
• Standardized pediatric 24-hour urinary parameters from Western literature were used for comparison.

Main Results:

• Low urine volume, observed in 49 patients, suggests increased fluid intake as a primary intervention.
• Low calcium intake was noted in 44 patients, potentially increasing intestinal oxalate absorption and urolithiasis risk.
• Hypocalcemia (32 patients) and 24-hour urinary abnormalities (16 patients) were observed, with findings for hypocalcemia contradicting previous studies.

Conclusions:

• Reduced water intake leading to low urine volume is the predominant finding in pediatric urolithiasis.
• Hypocalcemia represents a major metabolic abnormality in this cohort, diverging from Western literature findings.
• Establishing normative data for urinary excretion of key metabolites in Indian children is essential; maintaining optimal blood calcium and fluid intake may prevent stone formation.