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Some features of paediatric urolithiasis in a group of Syrian children
Insights
Pediatric urolithiasis in Syrian children is linked to increased urinary calcium and uric acid. Most kidney stones were mixed, primarily calcium oxalate and urate, highlighting metabolic factors in pediatric kidney stones.
Area of Science:
- Pediatric Nephrology
- Urology
- Metabolic Disorders
Background:
- Upper urinary tract stones (urolithiasis) can affect children, presenting with various symptoms.
- Understanding the etiology and composition of pediatric kidney stones is crucial for effective management.
Purpose of the Study:
- To investigate the clinical, radiological, and biochemical characteristics of upper urinary tract stones in Syrian children.
- To determine the common presentations and risk factors associated with pediatric urolithiasis in this population.
Main Methods:
- Clinical diagnosis and radiological imaging (plain X-ray, IVP) were used for 28 Syrian children (2.5-12 years).
- Blood and urine analyses were performed, including 24-hour urine excretion of calcium and uric acid.
- Chemical analysis of removed stones was conducted to determine their composition.
Main Results:
- Common presentations included renal colic, vomiting, hematuria, pyrexia, and abdominal pain.
- Elevated 24-hour urinary calcium and uric acid excretion were observed.
- Microscopic urinalysis revealed hematuria and pyuria in 72% of cases.
- Stone analysis showed predominantly mixed calcium oxalate and urate/phosphate stones; pure calcium oxalate or phosphate stones were less frequent.
- Plain X-rays detected approximately 95% of stones.
Conclusions:
- Pediatric urolithiasis in this cohort is associated with metabolic abnormalities, specifically increased urinary calcium and uric acid.
- Mixed calcium oxalate and urate/phosphate stones are the most common type.
- Early diagnosis and management strategies should consider these metabolic factors.
Abstract:
A group of 28 Syrian children (19 males and 9 females; age ranging from 2.5 to 12 years) were diagnosed clinically and radiologically to have upper urinary tract stones. The commonest presentations were renal colic, vomiting, haematuria, pyrexia and vague abdominal pain. Family history of renal stones was present in 21% of cases. Haematological picture and chemical analysis of blood were within the normal limits for their age and sex. Urine analysis, however, showed significantly marked increase in the 24-hour excretions of calcium and uric acid. Microscopic examination showed haematuria and pyuria in 72% of the children with urolithiasis. Chemical analysis of removed stones revealed that most of them were mixed stones of calcium oxalate and urate or/and phosphate. Pure stones of calcium oxalate or calcium phosphate were less common. Radiologically, about 95% of all stones were demonstrated by plain X-ray, while 5% only after IVP.