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Urinary calculi in children in Western Australia: 1972-86
1Princess Margaret Hospital for Children, Perth, Western Australia.
Insights
Urinary calculi in children present differently between Aboriginal and Caucasian groups. Aboriginal children had early-onset uric acid stones and failure to thrive, while Caucasian children had later-onset stones often linked to other health issues.
Area of Science:
- Pediatric Nephrology
- Urology
- Public Health
Background:
- Urinary calculi (urolithiasis) in children is a significant health concern.
- Understanding demographic and clinical differences is crucial for effective management.
Purpose of the Study:
- To compare the clinical features, findings, and treatment of urinary calculi in Aboriginal and Caucasian children.
- To identify distinct patterns of urolithiasis between these two pediatric populations.
Main Methods:
- Retrospective review of pediatric urinary calculi cases from 1972-1986.
- Analysis of clinical presentation, laboratory results, radiographic findings, and treatment outcomes.
- Comparison of features between Aboriginal (n=59) and Caucasian (n=26) children.
Main Results:
- Aboriginal children presented younger (median 2.1 years) with uric acid/urate stones, often with failure to thrive and upper tract calculi requiring surgery.
- Caucasian children presented later (median 10.5 years) with abdominal pain, and calculi were frequently associated with underlying urological or metabolic abnormalities.
- Sequelae in Aboriginal children included renal scarring and hypertension.
Conclusions:
- Significant differences exist in the presentation, etiology, and management of urinary calculi between Aboriginal and Caucasian children.
- Early detection and tailored interventions are essential, particularly for Aboriginal children presenting with failure to thrive and uric acid stones.
Abstract:
Records of all children presenting with urinary calculi in the period 1972-86 were reviewed in order to detail clinical features, laboratory and radiographic findings and treatment. Of a total of 85 children, 59 were Aboriginal and 26 were Caucasian. The features of urolithiasis differed between these groups. In the Aboriginal patients, calculi consisted mainly of uric acid and urates. Important clinical characteristics of this group included a young age at presentation (median = 2.1 years) and frequent presentation with failure to thrive. Calculi were commonly located in the upper urinary tract and most required surgical removal. Documented sequelae included renal scarring and hypertension. Caucasian children presented at a later age (median = 10.5 years), frequently with abdominal pain, and most calculi were associated with an underlying urological or metabolic abnormality.