Renal stones in children in Pakistan

Area of Science:

• Pediatric Nephrology
• Urology
• Pediatric Surgery

Background:

• Renal and ureteric stones in children are a significant clinical concern.
• Understanding the demographics, presentation, and etiology of pediatric urolithiasis is crucial for effective management.

Purpose of the Study:

• To analyze the clinical characteristics, stone composition, and outcomes of surgical management in children with renal or ureteric stones.
• To identify risk factors and recurrence patterns in pediatric urolithiasis.

Main Methods:

• Retrospective study of 150 children (up to 12 years) with renal/ureteric stones from 1973-1983.
• Clinical data collection including symptoms, renal function, urine cultures, and congenital anomalies.
• Calculi analysis using X-ray diffraction and infrared spectroscopy.
• Surgical intervention for stone removal.

Main Results:

• Peak incidence in children aged 10-12 years; male to female ratio 1.9:1.
• Abdominal pain was the most common symptom (66.6%); 23 patients presented asymptomatically or with vague symptoms.
• Renal insufficiency in 30 patients; 33% had positive urine cultures (Proteus spp. most common).
• Congenital urinary tract anomalies in 12%; etiology unidentified in 59%.
• Mixed-type stones, predominantly calcium oxalate, were most common.
• Surgical removal in 130 patients; 15% overall recurrence rate.

Conclusions:

• Pediatric renal stone disease presents with varied symptoms, necessitating a high index of suspicion.
• Calcium oxalate stones are common, and surgical management has a notable recurrence rate.
• Further research into etiological factors is warranted to improve prevention strategies for pediatric urolithiasis.