Paediatric urolithiasis in emerging economies

Area of Science:

• Urology
• Paediatric Nephrology
• Public Health

Background:

• Paediatric urolithiasis is endemic in low-resource nations, posing a significant health burden.
• This review focuses on the epidemiology, etiology, and management of urolithiasis in children within an Asian emerging economy context.

Purpose of the Study:

• To review the current literature on paediatric urolithiasis in developing countries.
• To highlight the specific challenges and management strategies employed in an Asian setting.

Main Methods:

• A comprehensive literature review was conducted using keywords related to paediatric urolithiasis and developing countries.
• 51 relevant articles were selected, with a focus on the experience of a specific center over two decades.

Main Results:

• Prevalence of paediatric urolithiasis is up to 15% in children under 15, with a male predominance. Bladder stones account for a substantial portion (10-70%).
• Etiologies include idiopathic (55%), metabolic (25%), infection (7%), and anatomical abnormalities (12%). Hot climate, poor nutrition, and diarrheal diseases are key factors. Common stone compositions include calcium oxalate (CaOX) and ammonium urate (AAU).
• Minimally invasive surgery (MIS) is the primary treatment. Success rates for extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and ureteroscopy (URS) are high (84-90%).

Conclusions:

• Paediatric urolithiasis is a major health concern in resource-limited settings.
• MIS provides effective treatment with excellent stone-free rates and shorter hospital stays.
• Preventative measures, including nutritional improvement and risk factor management, are essential.